Anti-Kickback Statute (AKS)
Whistleblower Lawsuit Ends in $25M Price-Fixing Settlement
Drugmaker allegedly conspired with competitors to manipulate drug prices
Mark Strauss
October 1, 2024
Drugmaker allegedly conspired with competitors to manipulate drug prices
A medical device sales representative who filed the False Claims Act lawsuit received a $1.37 million whistleblower award.
The fraud was discovered by a medical office manager who filed a whistleblower lawsuit under the qui tam provisions of the False Claims Act.
The fraud was exposed by two former company executives who filed a qui tam lawsuit under the False Claims Act. They will share a whistleblower award of $8.3 million.
The fraud was exposed by a former ModMed executive who filed a qui tam lawsuit under the False Claims Act. He will receive a $9 million whistleblower award.
The lawsuit is part of an effort by the U.S. Justice Department to investigate and litigate fraudulent diagnosis-coding practices by Medicare Advantage (Part C) insurers
The settlement follows Cardinal Health’s payment of $13M to resolve related False Claims Act allegations earlier this year
Management pressured staff to inflate Medicare reimbursements by “upcoding” and “ramping.”
