Since 1987, defendants in the health care and pharmaceutical industry have paid over $24 billion in damages – nearly 70% of the total damages under the False Claims Act during that period. Since 2010, the Department of Justice has averaged over $2 billion per year in False Claims Act recoveries in this field. Any provider that bills Medicaid or Medicare could be a target of a False Claims Act claim.
Vorys has a wide variety of experience in the health care and pharmaceutical fields, including False Claims Act cases involving health care systems; hospitals; intermediaries and insurers; skilled nursing facilities; durable medical equipment providers; pharmaceutical companies; physicians and medical practices; in-home therapy providers; and academic medical centers. Vorys has handled an array of substantive issues arising out of these cases, including allegations of:
- Anti-Kickback/Stark violations;
- Billing for services not rendered;
- Average wholesale pricing violations;
- Lack of medical necessity;
- Substandard medical care;
- False statements in connection with medical research grants.
In addition, we work closely with Vorys’ health care team to conduct internal investigations related to allegations of fraud and abuse, advise clients on the advantages and disadvantages of voluntary disclosure of overpayments or other compliance issues, and assist clients in creating compliance programs designed to protect against fraud and abuse charges. For more information on when to contact Vorys and the ways we can assist your company, please see “How We Can Help.”