This newsletter provides a compilation of the latest news headlines by our Healthcare attorneys. Certain online publications may require a site registration or subscription in order to access the article.
AmMed Pays US, Tenn. $18M To Settle Medicare Fraud Suit, Law360, April 13, 2012
On April 12, 2012, AmMed Direct LLC reached an $18 million settlement with the United States and Tennessee to settle a False Claims Act lawsuit that had been brought against it. The lawsuit alleged that AmMed Direct LLC submitted thousands of false claims to Medicare and Tennessee's TennCare program for supplies that it sold through prohibited unsolicited phone calls to Medicare beneficiaries.
Court Refuses to Dismiss Lawsuit Alleging Ineligible Rx Company Claims, Bloomberg BNA, April 4, 2012
On March 26, 2012, a federal trial court in Massachusetts refused to dismiss a lawsuit under the False Claims Act against Healthpoint Ltd because the government had adequately pleaded that Healthpoint Ltd. had committed fraud. The government's complaint alleges that Healthpoint Ltd. violated the False Claims Act by submitting claims for reimbursement for a topical wound ointment, Xenederm, that was ineligible for payment.
Department of Justice Closes Investigation Into Affiliation Agreement Between Highmark Inc. and West Penn Allegheny Health System, DOJ ( www.justice.gov ), April 10, 2012
The Department of Justice closed its investigation into an affiliation agreement between the second-largest hospital network in the Pittsburgh region, West Penn Allegheny System ("West Penn"), and the region's dominant health insurer, Highmark Inc. Under the affiliation agreement, a new nonprofit parent company will hold all corporate membership rights in Highmark and West Penn. According to the Department of Justice, the vertical combination of Highmark and West Penn "holds the promise of bringing increased competition to western Pennsylvania's health care markets by providing [West Penn] with a significant infusion of capital and increases the incentives of market participants to compete vigorously."
Illinois Health Systems Scuttle Merger Plans, Law360, April 12, 2012
OSF Healthcare System and Rockford Health System announced that they will no longer pursue their proposed merger in light of a federal district court's recent decision to grant the Federal Trade Commission's (FTC) motion for a preliminary injunction enjoining the merger until the FTC completes its administrative trial. On April 5, 2012, the district court found that the FTC had made its initial case that the proposed deal would result in the merged entity controlling a substantial share of the general acute care inpatient services market in the Rockford area.
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