Tag Archives: Fraud

Medical Devices: The New Low-Hanging Fruit for Healthcare Fraud?

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A highlight from the 7th Annual Medical Device and Diagnostic Compliance Congress in June was the talk by Jeremy Sternberg, deputy chief of the healthcare fraud unit, U.S. Attorney’s Office for the District of Massachusetts. His succinct and compelling story to medical device manufacturers, sales agents and distributors can be summarized as: We are smarter than ever (thanks pharma!), and we are coming after the new low-hanging fruit: medical devicesContinue reading

OIG Executive Exclusion Authority Alarming

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Last week the Office of Inspector General (OIG) released a fact sheet to correct what it characterized as “inaccuracies” in the media coverage surrounding the notice of potential exclusion received by Howard Solomon, CEO of Forest Laboratories. The fact sheet clarifies that the OIG has not excluded Mr. Solomon from Federal health care programs, but its broader purpose appears to be to reiterate the OIG’s permissive exclusion authority and summarize the process it will follow as it expands its use of the authority against officers and managing employees at pharmaceutical and medical device companies. Continue reading

Keeping Companies Out of Trouble

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I am at the Dow Jones Global Compliance Symposium today. I will recap major sessions here.

In response to “What are you doing to keep your company out of trouble?”, here are some highlights I thought you all would find useful. Continue reading

Under Investigation: 180 Qui Tams for Pharma or Device Fraud

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In May 2009, the Department of Justice (DOJ) and Human Health and Human Services (HHS) announced the creation of the Health Care Fraud Prevention and Enforcement Action Team (HEAT).  As part of a larger effort by the Obama administration, HEAT and its parent organizations have made the fight against Medicare fraud a Cabinet-level priority.  The purpose of HEAT is to build upon existing partnerships between the DOJ and HHS and gather resources across the government to help prevent waste, fraud and abuse in the Medicare and Medicaid programs. Continue reading

WSJ Fraud-Fighting Superhero vs. Physician Villains

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Adding to the feeding frenzy, the media is piling on and doing their own healthcare fraud investigations.  Over the last month, the WSJ and Russell Adams (russell.adams@wsj.com) have published a series of articles on physician fraud and abuse based on their thorough analysis of public records.  And, now Dow Jones, the publisher of the WSJ is suing the American Medical Association (AMA) for access to full Medicare records in an effort to further expose fraud:

“The Medicare system is funded by taxpayers, and yet taxpayers are blocked from seeing how their money is spent,” said Robert Thomson, editor-in-chief of The Wall Street Journal. “It is in the interest of law-abiding practitioners that those who are gaming the system are exposed. Unless funds are used efficiently and intelligently, the health of the nation, physically and fiscally, will be undermined.” (excerpted from this WSJ article) Continue reading