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Top-10 DOJ False Claims Act Recoveries For 2015

Posted  January 4, 2016

By the C|C Whistleblower Lawyer Team

Here is our look-back at the top-10 Department of Justice False Claims Act recoveries for 2015.

     10.  TUOMEY HEALTHCARE — The South Carolina-based hospital system agreed to pay $72.4 million to settle charges of billing Medicare for services referred by physicians with whom the hospital had improper financial relationships.

     9.  COMMUNITY HEALTH SYSTEMS — The Tennessee-based hospital system and three affiliated New Mexico hospitals agreed to pay $75 million to settle allegations they made illegal donations to county governments which were used to fund the state share of Medicaid payments to the hospitals. Click here for more.

     8.  FIFTH THIRD BANK — The bank agreed to pay $85 million to resolve charges of originating residential mortgage loans insured by the Federal Housing Administration which it had certified as eligible for FHA insurance but were actually materially defective and thus not so eligible, resulting in millions of dollars in HUD losses. Click here for more.

     7.  EDUCATION MANAGEMENT — The Pittsburgh-based for-profit education company agreed to pay $95.5 million to resolve allegations it falsely certified compliance with Title IV of the Higher Education Act when in fact it violated the statute’s Incentive Compensation Ban by allegedly running a high pressure boiler room where admissions personnel were paid based purely on the number of students they enrolled.

     6.  ADVENTIST HEALTH SYSTEM — The non-profit healthcare organization agreed to pay $115 million to settle allegations it maintained improper compensation arrangements with referring physicians and by miscoding Medicare and Medicaid claims. Click here for more.

     5.  METLIFE HOME LOANS — The Texas-based mortgage finance company agreed to pay $123.5 million to resolve allegations it originated and underwrote (through MetLife Bank) mortgage loans insured by the Department of Housing and Urban Development’s (HUD) Federal Housing Administration (FHA) that did not meet applicable FHA requirements.

     4.  WARNER CHILCOTT — The pharmaceutical company agreed to pay $125 million to resolve its criminal and civil liability arising from illegally marketing the drugs Actonel, Asacol, Atelvia, Doryx, Enablex, Estrace and Loestrin by paying physicians to induce them to prescribe the drugs.

     3.  FIRST TENNESSEE BANK — The Memphis-based financial institution agreed to pay $212.5 million to resolve allegations it originated and underwrote (through First Horizon Home Loans) mortgage loans insured by the Department of Housing and Urban Development’s (HUD) Federal Housing Administration (FHA) that did not meet applicable requirements.

     2.  MILLENNIUM HEALTH The company (formerly Millennium Laboratories) agreed to pay $256 million to resolve charges it billed Medicare for medically unnecessary urine drug and genetic testing.

     1.  NOVARTIS — The pharmaceutical giant agreed to pay $390 million to resolve charges it gave kickbacks to specialty pharmacies in return for recommending two of its drugs, Exjade and Myfortic.

Tagged in: FCA Federal, Top 10,