October 20, 2010
Assistant AG Tony West delivered the Keynote Address to the Pharmaceutical Regulatory and Compliance Congress and Best Practices Forum today at the Marriott Hotel in Washington, DC.
Read his full statement here
Excerpts:
Since January 2009, we’ve commenced more health care fraud investigations, secured larger fines and judgments, and recovered more taxpayer dollars lost to health care fraud than in any other two-year period. During that period, our civil fraud attorneys in the Civil Division have used the False Claims Act – a powerful tool that provides for treble damages – to recover about $4.2 billion lost to fraud against government health care programs…
…strongly encouraged Civil Division and United States Attorneys throughout the country to be appropriately aggressive in their use of the wide array of affirmative civil enforcement tools at their disposal. Tools like Civil Investigative Demands, or “CIDs,” which allow law enforcement to speed up civil investigations by obtaining documents and testimony quickly and under oath. The authority to issue CIDs once rested only with the Attorney General, but amendments to the False Claims Act last year allowed the Attorney General to delegate that authority to me as the Assistant Attorney General for the Civil Division. I, in turn, have re-delegated much of that authority to U.S. Attorneys around the country so that they will be able to use this powerful investigative tool properly and effectively…
…And then there are those cases we pursue because they cut to the core of protecting both patient safety and the integrity of our public health care programs. Cases like Small Smiles. You may have heard about this case. It involved a nationwide network of dental clinics that provided unnecessary dental services to needy children on Medicaid in order to maximize the company’s Medicaid reimbursements…
…And the stories we learned about during the course of our investigation were horrific: unnecessary tooth extractions performed on children where healthy teeth were pulled; unnecessary dental surgery such as needless crowns; and excessive baby root canals – one child had 16 root canals in a one sitting…
In that case we not only obtained a $24 million settlement, but more importantly, important reforms to Small Smiles’ practices under new management, as well as the company’s cooperation in our ongoing investigation into individual dentists..
That last point—working cooperatively with companies—is an important one. To be clear, no company is required to cooperate in the context of a civil or criminal case. Yet when a company acts responsibly by timely and voluntarily disclosing unlawful conduct, it is the case that the Department may consider such cooperation in deciding whether or how to charge a corporation or to resolve a case, and indeed, it has been my practice to encourage that in appropriate cases. In addition, when a company cooperates fully with an investigation, the Civil Division typically informs the HHS Inspector General’s office about the assistance the company provided…
It almost sounds like FORBA's Small Smiles clinics are getting a big pat on the back doesn't it. Since they are "working cooperatively" and all. They are still using the BIOB (Blame It On Bush) excuse saying all these terrible things happened with the DeRose family owned the clinics. Never mentioning that one of their top VP's was with the company while under DeRose rule since 2003!
I bet if they really took a look at the practices of the company just in 2010 they would find 'shocking' things still happening.
As recently as October 5th (yes, 15 days ago) one child received 12 stainless steel crowns 3 fillings and 11 pulopotomies all in one session. Mom outraged.
On the same day another child received 3 fillings, 3 pulpotomies, 1 seal, 1 extraction and 5 stainless steel crowns.
The very next day on parent was told their child needed 8 stainless steel crowns and wanted to do them asap.
