Davita Rx Agrees to Pay $63.7 Million to Resolve False Claims Act Allegations

DALLAS – DaVita Rx LLC, a nationwide pharmacy that specializes in serving patients with severe kidney disease, agreed to pay a total of $63.7 million to resolve False Claims Act allegations relating to improper billing practices and unlawful financial inducements to federal healthcare program beneficiaries, the Justice Department announced today.  DaVita Rx is based in Coppell, Texas.
The settlement resolves allegations that DaVita Rx billed federal healthcare programs for prescription medications that were never shipped, that were shipped but subsequently returned, and that did not comply with requirements for documentation of proof of delivery, refill requests, or patient consent.  In addition, the settlement also resolves allegations that DaVita paid financial inducements to Federal healthcare program beneficiaries in violation of the Anti-Kickback Statute.  Specifically, DaVita Rx allegedly accepted manufacturer copayment discount cards in lieu of collecting copayments from Medicare beneficiaries, routinely wrote off unpaid beneficiary debt, and extended discounts to beneficiaries who paid for their medications by credit card.  These allegations relating to improper billing and unlawful financial inducements were the subject of self-disclosures by DaVita Rx and a subsequently filed whistleblower lawsuit.
“Providers should not make patient care decisions based upon improper financial incentives or encourage their patients to do the same,” said U.S. Attorney Erin Nealy Cox for the Northern District of Texas.  “The U.S. Attorney’s Office has and will continue to work cooperatively with providers that bring such issues to light to redress the losses the federal healthcare system has incurred.”
DaVita Rx has agreed to pay a total of $63.7 million to resolve the allegations in its self-disclosures and the whistleblower lawsuit.  DaVita Rx repaid approximately $22.2 million to federal healthcare programs following its self-disclosure and will pay an additional $38.3 million to the United States as part of the settlement agreement.  In addition, $3.2 million has been allocated to cover Medicaid program claims by states that elect to participate in the settlement.  The Medicaid program is jointly funded by the federal and state governments.
“Improper billing practices and unlawful financial inducements to health program beneficiaries can drive up our nation’s health care costs,” said Civil Division Acting Assistant Attorney General Chad Readler.  “The settlement announced today reflects not only our commitment to protect the integrity of the healthcare system, but also our willingness to work with providers who review their own practices and make appropriate self-disclosures.”
“The conduct being resolved in this matter presents serious program integrity concerns” said CJ Porter, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services, “DaVita Rx’s cooperation in the investigation of this matter was necessary and appropriate to reach this resolution.”
The lawsuit resolved by the settlement was filed by two former DaVita Rx employees, Patsy Gallian and Monique Jones, under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private parties to sue on behalf of the government when they discover evidence that defendants have submitted false claims for government funds and to receive a share of any recovery.  The case is captioned United States ex rel. Gallian v. DaVita Rx, LLC, No. 3:16-cv-0943-B (N.D. Tex.).  The relators will receive roughly $2.1 million from the federal recovery.
The settlement of this matter illustrates the government’s emphasis on combating health care fraud.  One of the most powerful tools in this effort is the False Claims Act.  Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services, at 800-HHS-TIPS (800-447-8477).  HHS also offers several programs for health care providers to self-report potential fraud.  More information on self-disclosure processes can be found on the HHS-OIG website.
The investigation was conducted by HHS-OIG, the Civil Division’s Commercial Litigation Branch and the U.S. Attorney’s Office for the Northern District of Texas.  The claims asserted by the government are allegations only and there has been no determination of liability.
Assistant U.S. Attorney Lisa-Beth C. Meletta handled this matter for the U.S. Attorney’s Office.
Read the original article from the Department of Justice

Valeant Unit Settles Sex Discrimination Claims For $7.2M

Law360, Los Angeles (July 12, 2016, 4:56 PM EDT) — Valeant-owned Medicis Pharmaceutical Corp. will pay $7.2 million to settle a class action alleging gender discrimination and other claims brought by female sales representatives of the medical cosmetics company, according to a final settlement order signed by a D.C. federal judge Monday. Continue reading

Let the Mother Beware: Pregnancy in the Workplace

Seal of the United States Equal Employment Opp...
Seal of the United States Equal Employment Opportunity Commission. (Photo credit: Wikipedia)

It is somewhat hard to believe in this day and age that women experiencing pregnancy in the workplace are still being subjected to workplace policies that put their livelihood in jeopardy. Despite federal laws dating back to the Civil Rights Act of 1964 and several updates and addendums, there are still employers in the United States that have written policies that terminate workers due to pregnancy, regardless of the ability to perform that job’s duties and the overall physical capabilities of the workers.
A recent case in point was brought by the EEOC against a Baytown, Texas, restaurant chain called Bayou City Wings. Acting on behalf of a former employee named Maryann Castillo and eight other dismissed workers, the EEOC claimed that Bayou City Wings, and its parent company, JC Wings Enterprises, LLC, operated with a discriminatory policy against their workers who were experiencing pregnancy in the workplace. Their written policy mandated laying off workers after their third month of pregnancy, regardless of the employees’ desire and ability to stay on the job. In this case, Castillo was not experiencing any difficulties performing her job duties and had received approval from her doctor to work up to her 36th week of pregnancy.
Despite the honorable desire of the employer to take responsibility for the well-being of the unborn babies in these cases, it is important to note that the law and previous Supreme Court cases have determined that it is not the responsibility of employers to make decisions to protect the well-being of the unborn children of their employees, but rather the sole responsibility of the mothers involved. For employers, this could be a release of guilt if a mother’s decision to work jeopardizes her unborn child. The true benefit for this is that the women carrying their children should be able to have control over what they can or cannot do, without the arbitrary decisions of companies that are driven by the bottom line.
The EEOC cannot be the only protector of these cases of injustice and discrimination in the workplace. It is important for all employees, and especially women, to know their rights in a situation where they are facing a pregnancy in the workplace. Under the laws of this country, mothers-to-be are protected and have the law on their side. The Law offices of Valli, Kane, and Vagnini are specially equipped to help any victim of this or any other kind of discrimination in the workplace. Contact them for a free consultation to make sure that your rights are protected.

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What To Do If Being Harassed At Work

sexual harassment in the workplaceThose who suffer sexual harassment in the workplace do not have to tolerate the behavior; there are options. However, people who suffer through sexual harassment in the workplace are often hesitant to report the behavior. They are intimidated by the fear that reporting this degrading and demeaning behavior could have negative consequences. These feared consequences could include termination, damage to prospects of future employment, demotions and negative transfers. These potential negative consequences can be mitigated by empowering the sexually harassed individual to stop the behavior and demand redress for the professional and emotional distress as a result of the illegal behavior.
Sexual Harassment and Employment Law
Sexual harassment falls under the federal employment discrimination laws. In many areas, it not only violates United States federal law, but state and local laws. Employers are obligated to take action to prevent sexual harassment at the workplace. If sexual harassment is reported to the employer, immediate action must be taken to deal with the situation. In addition, the employee reporting sexual harassment is legally protected from retaliation by the employer.
 What is Sexual Harassment?
Sexual harassment comes in many forms. Some of these forms include:

  • Being directly asked for sex or sexual contact.
  • Unwanted and unwelcome sexual advances. This can be requests for dates or requests for meeting outside of the workplace.
  • Sexually charged speech.
  • Physical contact of a sexual nature.
  • Being required to function in a hostile work environment.
  • Behavior deemed inappropriate to the workplace. This includes sexist and derogatory language and pornographic images in the workplace.
  • Discriminatory and unfair treatment, including denial of opportunities and promotion, based on gender.

Should I Pursue a Sexual Harassment Lawsuit?
Individuals victimized by sexual harassment are often reluctant to pursue a lawsuit. They are often caught in the dilemma of fearing the potential of negative consequences of reporting sexual harassment, while knowing that action must be taken. Attorneys experienced in sexual harassment cases take great care in the way they treat clients that have been victims of harassment. Great attention will be given to the privacy of the client. And, if possible, the case will be pursued on a completely private basis through negotiations with the employer or through filings with agencies such as the EEOC which are charged with the responsibility of investigating claims of such harassment.
Whether it is sexual harassment or other forms of discrimination in the workplace, it is important to understand the rights and legal options of the worker.  If an employer has violated your rights, set up a no cost consultation with a law firm that is experienced in workplace discrimination.

Kudo v. Panda Express

This action was instituted to address a failure to pay overtime to General Managers of Panda Express Restaurants nationwide. The complaint alleges that General Managers across the country were required to work in excess of 40 hours per work week without overtime pay. The complaint further alleges that Panda Express misclassified these managers as exempt based on their titles alone and required them to perform the tasks of hourly workers such as ringing registers, serving food and cleaning the restaurant.
Downloads:

  1. Panda Express Overtime Complaint
  2. Court Order Conditionally Certifying Overtime Class
  3. Notice to join Panda Express Lawsuit (English)
  4. Notice to join Panda Express Lawsuit (Chinese)