GE to settle $30M Medicare fraud lawsuit
Article Thumbnail ImageDecember 29, 2011 -- GE Healthcare will pay $30 million to the U.S. Centers for Medicare and Medicaid Services (CMS) to settle a lawsuit alleging Medicare overbilling for the cardiac radiopharmaceutical Myoview, as reported on December 29 by Crain's Detroit Business.
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A federal whistleblower lawsuit was filed in the U.S. District Court for the Eastern District of Michigan in 2006 by James Wagel. Wagel was a pharmaceutical representative of Bristol-Myers Squibb who sold a competitive cardiac tracer, Cardiolite.

Myoview, or technetium (Tc-99m) tetrofosmin, is a radiopharmaceutical drug used to perform nuclear stress tests.

Wagel alleged that GE Healthcare and Amersham, which GE purchased in 2004, had actively encouraged healthcare providers to dilute Myoview and bill Medicare for additional doses of the drug. The federal government and 18 states, including Michigan, joined the lawsuits, but claims by the states were dismissed because only federal healthcare billing was involved.

The lawsuit also named more than 20 Michigan hospital and cardiology laboratories that allegedly took part in the billing, but all healthcare providers named were dismissed from the case prior to the settlement, according to Crain's Detroit Business.

The settlement for the claims reflected a time period from 2000 to 2003. As a relator, Wagel will receive $5.1 million of the $30 million payment.

GE spokesperson Aleisia Gibson pointed out that the allegations in the case predate GE's acquisition of Amersham.

"GE Healthcare is pleased to have reached a resolution in this long-standing case," Gibson said. "Origins of this issue date back to 2000-2003, or more than a year before GE Healthcare acquired the manufacturers and distributors for the Myoview product."