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Whistleblower News From The Inside -- June 15, 2017

Posted  June 15, 2017

By the C|C Whistleblower Lawyer Team

Georgia pharmacist and pharmacy settle FCA suit for $2.175M – Andrew Clements Jr. and his company, Rhine Drug company, settled allegations they submitted claims to Medicare for drugs never actually dispensed. The settlement also includes a payment under the Controlled Substances Act, to settle allegations the pharmacy’s recordkeeping was not compliant with the law. USAO Southern District of Georgia

Three Georgia farmers settle FCA suit for $675K – Julian Rigby, Jasper Allen, and Ben Swain settled allegations they defrauded the USDA’s crop insurance program. The government’s complaint alleged that to obtain more favorable coverage, the trio misrepresented the persons who had an insured interest and submitted false documents when submitting claims. USAO Southern District of Georgia

University of Rochester Medical Center settles Federal and NY FCA suit for $113K – URMC’s Flaum Eye Institute allegedly used an improper billing modifier, resulting in payments to which it was not entitled. Modifier 25 is used where a provider renders a significant, separately identifiable evaluation and management service to the same patient on the same day as another, separately billed procedure or other service. By using modifier 25 improperly, URMC received higher compensation than it should have received for certain ophthalmology claims it submitted to government programs. USAO Northern District of New York