Medicare Fraud

Every year, we lose billions of dollars to fraud in federal and state health care programs. Every dollar we lose to fraud and abuse is a dollar that is not available to provide home care to seniors, to treat HIV and AIDS, to immunize children, and to discover new treatments for cancer and other diseases. Some fraud schemes even pose a direct threat to the health and safety of patients. Many instances of health care fraud sug­gest that existing control systems do not work the way we imagine they should. Often the manner in which schemes are revealed suggests detection is more luck than system. Whistleblower lawsuits have exposed billing by health care providers for services not rendered, billing for products not delivered, misrepresenting services, unbundling services, billing for medically unnecessary services, duplicate billing, increasing units of service which are subject to a payment rate, falsifying cost reports resulting in increased payment to the health care provider, kickbacks, and on and on. Healthcare fraud is still going strong and this blog is intended to keep readers up to date with all healthcare fraud related news and to provide commentary when warranted. This blog also contains an array of laws and regulations concerning healthcare fraud set out in an easy to read format.

Spectranetics Corporation to Pay $5 Million to Resolve Allegations of Health Care Fraud

by Nolan and Auerbach on January 7, 2010

Spectranetics Corporation, a medical device manufacturer, has agreed to pay the United States $4.9 million in civil damages, as well $100,000 forfeiture to resolve claims against the company, the United States Department of Justice (DOJ) announced December 29, 2009.

The claims arise from allegations that the company illegally imported unapproved medical devices and provided them to physicians for use in patients; committed fraud in a clinical study by failing to comply with federal regulations; and promoted certain products for procedures for which the company had not received Food and Drug Administration approval or clearance.

The company manufactures, distributes and sells certain medical lasers and peripheral devices for those lasers, such as lead wires that guide the lasers through vascular tissue and catheters that carry and contain the lasers inside the veins, including, specifically, the CVX-300 Medical Laser and the CliRpath Turbo Laser Catheter, the TURBO Elite Laser Ablation Catheter, and the TURBO-Booster Laser Guide Catheter, according to the DOJ.

To read the full press release, go to: http://www.justice.gov/opa/pr/2009/December/09-civ-1385.html.

For more information about qui tam and health care fraud, contact Nolan and Auerbach, PA.

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