#10830863 at 2020-09-29 05:14:29 (UTC+1) Q Research General #13861: Grenell On Hannity Edition
Of the $117 million to be paid by UHS to resolve these claims, the federal government will receive a total of $88,124,761.27, and a total of $28,875,238.73 will be returned to individual states, which jointly fund state Medicaid programs.
"Quality mental health treatment is critical for the patients who place their trust in the hands of service providers," said U.S. Attorney McSwain. "The allegations involved in this matter – inappropriate billing and inadequate care - have no place in our health care system. Behavioral health service entities must have strong mechanisms in place, including appropriate supervision and oversight, to avoid fraud and abuse in order to ensure they provide the level of care that their patients deserve."
The government's investigation included 19 lawsuits filed under the whistleblower provision of the False Claims Act, which permits private citizens to file suit on behalf of the United States for false claims and share in a portion of the government's recovery. The global settlement with UHS involved 18 cases that are currently pending in the Eastern District of Pennsylvania, Western District of Michigan, the Eastern District of Michigan, and Northern District of Georgia. As part of the resolution with UHS, the whistleblowers will receive $15,862,457.03, from the federal share of the settlement.
"We sincerely thank the relators in these cases. Together with their lawyers, these citizens provided essential assistance to the government throughout this case. Without the willingness of relators to shed light on allegations of fraud, preserving government program funds would be far more challenging. Their efforts played a vital role in the resolution of these cases," said U.S. Attorney McSwain.
"The Department of Justice is committed to protecting patients and taxpayers by ensuring that the treatment provided to federal healthcare beneficiaries is reasonable, necessary, and free from illegal inducements," said Acting Assistant Attorney General EthanP.Davis for the Department of Justice's Civil Division. "The Department will continue to be especially vigilant when vulnerable patient populations are involved, like those served by behavioral healthcare providers."
In connection with the settlements, UHS has entered into a Corporate Integrity Agreement with the U.S. Department of Health and Human Services, Office of Inspector General (OIG), which will remain in effect for five years. UHS must retain an independent monitor, selected by the OIG, which will assess UHS's Behavioral Health Division's patient care protections and report to the OIG. In addition, an independent review organization will perform annual reviews of UHS inpatient behavioral health claims to federal health care programs.
#10500601 at 2020-09-02 06:54:12 (UTC+1) Q Research General #13438: All Your Base Are Belong To Us Edition
Resignations in the news 9/1/2020
2nd Ward Alderman Tony Gasparini announces his resignation
WTO DG Roberto AzevÍdo steps down
South Holland District Council chief executive resigns
Spectrum News Photojournalist Helen Moore Retiring After More Than 30 Years
Acting Assistant Attorney General EthanP.Davis Announces Departure from Civil Division
Directors resign from Singapore group linked with Newcastle United takeover
Sweetwater Commissioner Pleads Guilty to Perjury Charge, Resigns Seat
Costume curator for Museum of Darien retiring after 50 years
Columbia Human Resources Director Margrace Buckler retiring in January
Ann Arbor judge retiring after 28 years on the bench
Former Gulf Breeze Mayor Ed Gray leaves city amid investigation
Tivity Health Announces Resignation of Board Director Daniel G. Tully
State's top tech official stepping down
Thailand's new finance minister resigns amid economic crisis
Four directors, including chairman Evangeline Shen, resign from Axington
Vietnamese lawmaker resigns after dual nationality exposure
Grand Island library director Steve Fosselman retiring
Wyoming County Board of Supervisors chairman to step down
Public Safety, DOH directors, Nolan Espinda and Dr. Bruce Anderson retiring
Warren County's finance director resigns after three months
Montgomery Senator David Burkette resigns
Athens Utilities manager retiring after 40 years with city
Colonel William Higgins Is Retiring From The Army Reserve After 32 Years Of Service
Harrisburg rabbi retiring and moving to Jerusalem after 17 years in the community
Longtime Heart, Love & Soul Executive Director Sister Beth Brosmer stepping down
#10500357 at 2020-09-02 06:25:16 (UTC+1) Q Research General #13438: All Your Base Are Belong To Us Edition
Dough: >>10499881 Ghost: >>10500145
>>10500332 Statement by FinCEN Regarding Unlawfully Disclosed Suspicious Activity Reports
>>10500318 Just the News CEO Solomon files motion to hold St. Louis Circuit Attorney Gardner in contempt
>>10500292 Lebanon Erupts In Violent Protest As Political Factions Appoint New Prime Minister
>>10500273 Acting Assistant AG EthanP.Davis Announces Departure from Civil Division
>>10500228 , >>10500257 Judge Sullivan Files Order Dragging Out Flynn Case Past Election
>>10500200 Battleground Michigan: Lawsuits challenge state's coronavirus restrictions, ballot rules
>>10500189 Kamala Harris ancestor was slave owner in Jamaica, her father says
>>10500173 Planefag Reports
>>10500129 Australia Plunges Into First Recession In 29 Year
>>10500109 POTUS on Drug Testing Joe Biden: "He's on Some Kind of an Enhancement"
>>10500100 , >>10500126 CNN's Brian Stelter Goes on CSPAN - Callers Chew Him Up and Spit Him Out
>>10500072 New York Launches Unsecured Online 'Portal' For Requesting Absentee Ballots
>>10499993 POTUS Schedule for WEDNESDAY September 2, 2020
>>10499981 , >>10500280 The WH tweet about DC's monuments
>>10499965 WaPo: Melania Trump used private email accounts while in the White House
>>10499940 , >>10500143, >>10499969 Whoa - the Joseph Mifsud 302 is out
>>10499935 , >>10500018, >>10500124 Drudge publishes Q's cannon photo alongside the 'mini-stroke' story
Note taker out
#10500273 at 2020-09-02 06:14:43 (UTC+1) Q Research General #13438: All Your Base Are Belong To Us Edition
Acting Assistant Attorney General EthanP.Davis Announces Departure from Civil Division
United States Files False Claims Act Complaint Against Drug Maker Teva Pharmaceuticals Alleging Illegal Kickbacks
The United States has filed a False Claims Act complaint against Teva Pharmaceuticals USA Inc. and Teva Neuroscience Inc. (Teva), alleging that they illegally paid the Medicare co-pays for their multiple sclerosis (MS) product, Copaxone, through purportedly independent foundations that the companies used as conduits in violation of the Anti-Kickback Statute, the Department of Justice announced today.
"The department is committed to stopping pharmaceutical companies from using foundations as conduits to funnel kickbacks to Medicare patients, and to prop up excessive drug costs at the expense of the American taxpayers," said Acting Assistant Attorney General EthanP.Davis of the Department of Justice's Civil Division. "We will continue to root out these unlawful kickback arrangements that undermine the integrity of federal health care programs."
"The government's complaint today alleges that Teva used ostensibly independent charitable foundations as vehicles to pay hundreds of millions of dollars in kickbacks, all while raising the price of its drug, Copaxone, at a rate over 19 times the rate of inflation," said Andrew E. Lelling, United States Attorney for the District of Massachusetts. "Teva's alleged kickbacks undermined the Medicare program's co-pay structure, which Congress created as a safeguard against inflated drug prices."
"Drug manufacturers that offer kickbacks in order to boost profits - as alleged in this case - drive up health care costs for everyone and undermine the public's trust in the health care system," said Special Agent in Charge Phillip M. Coyne of the U.S. Department of Health and Human Services, Office of Inspector General. "Our agency, working closely with our law enforcement partners, will continue to thoroughly investigate such corrosive schemes."
"As alleged, Teva gamed Medicare and tried to deflect attention away from a 329% increase in the cost of its drug by masking kickbacks as charitable contributions," said Joseph R. Bonavolonta, Special Agent in Charge of the FBI's Boston Division. "This case demonstrates the FBI's ongoing commitment to protect our government programs and the American taxpayers who contribute to them from being victimized by corporations who allegedly pay kickbacks to pad their bottom line."
When a Medicare beneficiary obtains a prescription drug covered by Medicare Part D, the beneficiary may be required to make a partial payment, which may take the form of a co-payment, co-insurance, or deductible (collectively, co-pays). These co-pay obligations may be substantial for expensive medications. Congress included co-pay requirements in these programs, in part, to encourage market forces to serve as a check on health care costs, including the prices that pharmaceutical manufacturers can demand for their drugs. The Anti-Kickback Statute prohibits pharmaceutical companies from offering or paying, directly or indirectly, any remuneration - which includes money or any other thing of value - to induce Medicare patients to purchase the companies' drugs.
The government alleges that, from 2007 through 2015, Teva paid The Assistance Fund (TAF) and Chronic Disease Fund (CDF) with the intent and understanding that the foundations would use Teva's money to cover the Medicare co-pays of patients taking Copaxone. During the same period, Teva raised the price of Copaxone from approximately $17,000 per year to over $73,000 per year.
According to the United States' complaint, Teva largely effectuated its scheme through its vendor, Advanced Care Scripts Inc. (ACS), a specialty pharmacy to which Teva referred virtually all Copaxone patients who faced Medicare co-pays for the drug. Teva used information from ACS and from TAF and CDF to calculate how much money to pay each foundation to maintain coverage of the Medicare co-pays of Copaxone patients enrolled in each foundation. The U.S. further alleges that ACS coordinated the referral of newly-prescribed Copaxone patients to TAF and CDF with Teva, referring patients in batches at the same time that Teva made payments to the foundations, which ensured that Copaxone patients received the vast majority of the co-pay assistance TAF and CDF provided with money from Teva.
#9952378 at 2020-07-14 01:49:33 (UTC+1) Q Research General #12735: Sessions Activated!! Edition
Twenty-Seven Skilled Nursing Facilities Controlled By Longwood Management Corporation To Pay $16.7 Million To Resolve False Claims Act Allegations
Longwood Management Corporation and 27 affiliated skilled nursing facilities (Longwood) have agreed to resolve allegations that they violated the False Claims Act by submitting false claims to Medicare for rehabilitation therapy services that were not reasonable or necessary, the Department of Justice announced today. Longwood is headquartered in California and the 27 skilled nursing facilities are also located in California.
"This settlement reflects the Department's continuing commitment to ensure that patients are receiving individualized healthcare services appropriate to their specific medical needs," said Acting Assistant Attorney General EthanP.Davis for the Department of Justice's Civil Division. "When skilled nursing facilities provide rehabilitation therapy services based on maximizing revenue rather than the interests of their patients, we will hold them accountable."
"Longwood's business plan called for substantial revenue from Medicare, and it pressured therapists to provide additional, unnecessary services when targets were not met," said U.S. Attorney Nick Hanna for the Central District of California. "This case demonstrates the power of whistleblowers to shine a light on improper business practices and obtain significant recoveries on behalf of United States taxpayers."
The settlement resolves allegations that Longwood submitted false claims for rehabilitation therapy by engaging in a systematic effort to increase Medicare billings. Medicare reimburses skilled nursing facilities at a daily rate that reflects the skilled therapy and nursing needs of qualifying patients. The greater the patient's needs, the higher the level of Medicare reimbursement. The highest level of Medicare reimbursement for skilled nursing facilities is for "Ultra High" therapy patients, who require a minimum of 720 minutes of skilled therapy from two therapy disciplines (e.g., physical, occupational, or speech therapy), one of which has to be provided five days a week.
Longwood allegedly knowingly submitted or caused the submission of false and fraudulent claims to Medicare for medically unreasonable and unnecessary Ultra High levels of rehabilitation therapy for Medicare Part A residents. Specifically, Longwood allegedly pressured therapists to increase the amount of therapy provided to patients to meet pre-planned targets for Medicare revenue. These targets were alleged to have been set without regard to patients' individual therapy needs and could only be achieved by billing for a high percentage of patients at the Ultra High level.
The settlement covers conduct that occurred from May 1, 2008 through Aug. 1, 2012 at six facilities (Alameda Care Center, Burbank Rehabilitation Center, Magnolia Gardens Convalescent Hospital, Montrose Healthcare Center, Sherman Oaks Health & Rehab Center, and West Hills Health & Rehab Center); and from Jan. 1, 2006 through Oct. 10, 2014 at twenty-one facilities (Burlington Convalescent Hospital, Chino Valley Rehabilitation Center LLC, Colonial Care Center, Covina Rehabilitation Center, Crenshaw Nursing Home, Green Acres Lodge, Imperial Care Center, Imperial Crest Health Care Center, Laurel Convalescent Hospital, Live Oak Rehabilitation Center, Longwood Manor Convalescent Hospital, Monterey Care Center, Intercommunity Healthcare Center, Park Anaheim Healthcare Center, Pico Rivera Healthcare Center, San Gabriel Convalescent Center, Whittier Pacific Care Center, Studio City Rehabilitation Center, Sunnyview Care Center, View Park Convalescent Center, Western Convalescent Hospital).
Contemporaneous with the civil settlement, Longwood has entered into a five-year Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General (HHS-OIG) that requires an independent review organization to annually assess the medical necessity and appropriateness of therapy services billed to Medicare.
"The government contended Longwood falsely claimed medically unreasonable and unnecessary levels of rehabilitation services at the expense of taxpayers," said Timothy B. DeFrancesca, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. "My agency's compliance agreement is designed to monitor claims to Medicare and prevent submission of false claims in the future."