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Sunday, September 26, 2021

Medicare cracks down on false claims

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A $2.3 billion settlement in September between drugmaker Pfizer and the Department of Justice over illegal marketing practices underscores a recent campaign by government agencies to investigate false claims made to Medicare and Medicaid, according to health care attorneys.

Pfizer allegedly promoted four drugs – Bextra, Geodon, Zyvox and Lyrica – for off-label indications and caused false claims to be submitted to government health care programs for uses that were not medically accepted indications and therefore not covered by those programs, according to the Department of Justice.

Giant pharmaceutical companies aren’t the only targets of false claims investigations.

“The enforcement would apply to every health care provider who bills and receives payment from a government agency,” says health care attorney Mark Armstrong, a partner in the Houston office for law firm Epstein Becker & Green PC. “… When there’s no money to get, they just put them in jail.”

Armstrong advises practices to have a compliance program in place to catch potentially fraudulent claims.

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