GlaxoSmithKline agrees to $3 billion settlement with Justice Department in largest sum of its kind over health care fraud

GlaxoSmithKline agrees to $3 billion settlement with Justice Department in largest sum of its kind over health care fraud

(CBS News) Pharmaceutical giant GlaxoSmithKline will plead guilty and pay $3 billion in the largest settlement of health care fraud in U.S. history, the Justice Department announced Monday.

The settlement will resolve criminal and civil liability from the company’s unlawful promotion of certain prescription drugs. The company is to plead guilty to a three-count criminal information, including two counts of introducing misbranded antidepressant drugs Paxil and Wellbutrin to interstate commerce and one count of failing to report safety data about the diabetes drug Avandia to the FDA. The criminal complaints will total $1 billion.

GSK will also pay $2 billion to resolve civil liabilities relating to Paxil, Wellbutrin and Avandia, as well as other drugs and also resolves allegations of pricing fraud.

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Reporter’s notebook: When the FBI comes calling

Reporter’s notebook: When the FBI comes calling

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Friday, July 20, 2012

YARMOUTH, Maine – Typically, when the HME industry makes headlines as part of a fraud bust, the companies involved are little more than sham operations. But, in recent months, two well-established providers with strong ties to the industry were the target of FBI raids: Visalia, Calif.-based Care Medical in May, and Novato, Calif.-based Pacific Pulmonary Services in February. HME talked to industry experts recently who confirmed that this is happening more often. Here’s what they had to say.

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OIG: Conflict of interest among potential ZPICs

OIG: Conflict of interest among potential ZPICs

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Wednesday, July 11, 2012

WASHINGTON – Companies that seek ZPIC contracts from CMS often have conflicts of interest that could compromise the integrity of the program, according to a new report from the Office of Inspector General (OIG).

The OIG reviewed conflict-of-interest information for 18 such companies, called offerors, and 85 subcontractors and found that, while many had business and contractual relationships with CMS and other offerors, they didn’t consider them conflicts of interest. They reported having relationships with CMS or contractors of CMS that provide Medicare Parts C and D plans, claims processing, program integrity, and/or quality improvement services.

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U.S. Settles Lawsuit Against Christus Spohn Health System Corp.

U.S. Settles Lawsuit Against Christus Spohn Health System Corp.

Federal prosecutors say a Texas-based hospital system has paid millions of dollars to settle a false claims lawsuit.

Christus Spohn Health System Corp. has paid the United States more than $5 million to settle allegations regarding violations of the False Claims Act, U.S. Attorney Kenneth Magidson announced. The allegations included inappropriately admitting patients to inpatient status for outpatient procedures.

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