Tag Archives: kickbacks

First Miami defendant in nation’s biggest mental healthcare fraud case pleads guilty

The first Miami defendant in the nation’s largest mental healthcare fraud case pleaded guilty to paying millions of dollars in kickbacks in exchange for Medicare patients who didn’t need the costly therapy.Her job as marketing director for a Miami-based mental healthcare chain was to bring in the patients and nobody did their job better than Margarita Acevedo. Investigators say she paid millions of dollars in kickbacks to South Florida assisted-living facilities, halfway houses and recruiters to supply thousands of Medicare beneficiaries to American Therapeutic Corp.’s chain of seven clinics — patients who didn’t need the costly treatment.

On Thursday, Acevedo, 41, of Southwest Miami-Dade, pleaded guilty to conspiring to pay kickbacks in exchange for patients and conspiring to bilk between $100 million and $200 million from Medicare, in the largest mental healthcare fraud case in the country. Her change of plea in a Miami federal court makes Acevedo the first defendant among 24 indicted since last fall to admit playing a role in American Therapeutic’s “massive fraud scheme” against the taxpayer-funded healthcare program for seniors and the disabled, according to court records. She faces between 12 and 15 years in prison at her mid-July sentencing, according to sentencing guidelines.

Read more: http://www.miamiherald.com/2011/04/08/2158019/first-miami-defendant-in-nations.html#ixzz1JWM85A6L

California claims drug giant bribed docs to prescribe

California has joined a whistleblower lawsuit that claims Bristol-Myers Squibb Co. bribed doctors to prescribe its drugs, costing insurers perhaps millions of dollars in the largest alleged health care fraud case ever handled by the state, Insurance Commissioner Dave Jones announced Friday. The suit claims company salespeople plied physicians with speaking fees, expensive meals, gifts and trips to induce or reward them for prescribing large amounts of its drugs, which were billed to private insurers.

For example, the company invited doctors to attend Los Angeles Lakers games at Staples Center and spent thousands of dollars on luxury suites, the suit claimed.
“Golf outings, basketball camps, samba lessons, you name it,” Jones said at a news conference. The lawsuit said the aim was to boost prescription levels for legally approved and so-called “off-label” uses of drugs ranging from the antipsychotic Abilify to the blood thinner Plavix.

California Official Accuses Bristol Bristol-Myers Squibb of Bribing Doctors to Prescribe Drugs

Pharmaceutical giant Bristol-Myers Squibb bribed thousands of California doctors and pharmacists to promote its drugs, using illegal kickbacks, lavish gifts and “happy hours” with the Los Angeles Lakers to expand its market share in the state, state officials said.

California Insurance Commissioner Dave Jones announced Friday that his office had joined a previously sealed whistleblower lawsuit against the company, calling it the largest health insurance fraud case ever pursued by a California state agency.

Two of the three whistleblowers in the case are former Lakers player Lucius Allen and his wife, Eve, who worked for the drug company as employees and provided access to the basketball team, whose players participated in “Lakers Dream Camps” set up by the drug company for doctors and their family members, the lawsuit said. The lawsuit was filed in 2007 but was sealed until the state joined the case recently.

Is J&J Cooking Its Books? Suit Alleges Double-Counting at the Pharma Giant

A whistleblower lawsuit filed against Johnson & Johnson (JNJ) didn’t get much attention in the media because the unproven accusations within it — paying kickbacks to nursing home pharmacy Omnicare (OCR) — sounded familiar. But the details in the complaint are worth exploring because they go further than the usual allegations of paying for no-work contracts to boost pharmacy distribution of their drugs.