Archive

May 2, 2017

Maine dentist Joseph W. Griffin agreed to pay $90,000 to resolve allegations he violated the False Claims Act by submitting submitted false claims to MaineCare (Maine’s Medicaid program) for dental services not rendered, were medically unnecessary, or were so inadequately documented in the patient’s medical record as to be unreviewable. DOJ (DME)

May 1, 2017

Kansas City area chiropractor Brian Schnitta and his clinic, Natural Way Chiropractic Center, agreed to pay roughly $1 million to settle allegations they violated the False Claims Act by charging Medicare for treatments for peripheral neuropathy not medically necessary or not otherwise covered by the program. DOJ (DKS)

May 1, 2017

Memphis-based Poplar Healthcare PLLC and Poplar Healthcare Management, LLC agreed to pay $897,640 to resolve allegations they violated the False Claims Act by billing the government directly and through a subsidiary known as GI Pathology for diagnostic tests not medically necessary. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Poplar pathologist Gordon Wang. He will receive a whistleblower award of roughly $206,000 from the proceeds of the government's recovery. DOJ (DRI)

April 28, 2017

New Jersey-based Quest Diagnostics Inc. agreed to pay $6 million to resolve charges that Berkeley HeartLab Inc., which Quest acquired in 2011, violated the False Claims Act by paying kickbacks to physicians and patients to induce the use of Berkeley for blood testing services and by charging for medically unnecessary tests. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Dr. Michael Mayes. He will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery. DOJ

April 27, 2017

Indiana University Health Inc. (IU Health) and HealthNet Inc. agreed to pay a total of $18 million to resolve allegations they violated the False Claims Act by engaging in an illegal kickback scheme related to the referral of HealthNet’s OB/GYN patients to IU Health’s Methodist Hospital. According to the government, IU Health provided HealthNet with an interest-free line of credit, the balance of which consistently exceeded $10 million. The government further charged that HealthNet was not expected to repay a substantial portion of this loan and that this financial arrangement was intended to induce HealthNet to refer its OB/GYN patients to IU Health’s Methodist Hospital. DOJ

April 27, 2017

Forrest S. Kuhn, Jr., M.D., a Kentucky physician specializing in allergy, asthma and immunology, agreed to pay roughly $750,000 to resolve allegations he violated the False Claims Act by submitting false claims to Medicare, Medicaid, and other government health care programs for allergy tests never performed. DOJ (WDKY)

April 25, 2017

Braden Partners, L.P. (d/b/a Pacific Pulmonary Services) agreed to pay $11.4 million to resolve allegations against it and its general partner, Teijin Pharma USA LLC, for violating the False Claims Act by submitting claims for reimbursement to Medicare and other federal healthcare programs for oxygen and related equipment supplied in violation of program rules, and for sleep therapy equipment supplied as part of a cross-referral kickback scheme with sleep clinics. According to the government, Pacific Pulmonary submitted claims to the Medicare, TRICARE and Federal Employee Health Benefits programs for home oxygen and oxygen equipment without obtaining the required physician authorization. The government further charged that certain of the company’s patient care coordinators agreed to make patient referrals to sleep testing clinics in exchange for those clinics’ agreement to refer patients to Pacific Pulmonary for sleep therapy equipment in violation of the Anti-Kickback Act. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Manuel Alcaine, a former sales representative of Pacific Pulmonary. Mr. Alcaine will receive a whistleblower award of roughly $1.8 million from the proceeds of the government's recovery. DOJ

April 24, 2017

Crittenton Hospital Medical Center and the Crittenton Cancer Center, together with their current owners Ascension Michigan and Ascension Health agreed to pay roughly $790,000 to resolve allegations they violated the False Claims Act by billing for medically unnecessary laboratory testing for patients who had been referred to Crittenton by Dr. Farid Fata and physicians in his office. In an earlier unrelated criminal matter, Fata pleaded guilty to health care fraud, conspiracy to pay and receive kickbacks, and promotional money laundering, and was sentenced to a term of 45 years in prison. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by an office administrator in Fata’s medical practice, Michigan Hematology-Oncology P.C. The whistleblower will receive a whistleblower award from the proceeds of the government's recovery. DOJ (EDMI)

April 20, 2017

Illinois-based drugstore giant Walgreen Co. agreed to pay $9.86 million to resolve allegations it violated the False Claims Act by submitting claims for reimbursement to California’s Medi-Cal program that were not supported by applicable diagnosis and documentation requirements. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a former Walgreens pharmacist and a former pharmacy technician. They will receive a whistleblower award of roughly $2.3 million from the proceeds of the government's recovery. DOJ (EDCA)

April 20, 2017

Dr. Norman A. Brooks, a dermatologist and surgeon and owner of Skin Cancer Medical Center in Encino, agreed to pay roughly $2.7 million to resolve allegations he submitted bills to Medicare for Mohs micrographic surgeries for skin cancers that were medically unnecessary. The government alleged that Brooks falsely diagnosed skin cancer in some of his patients so that he could perform, and bill for, Mohs surgeries. The allegations originated in a whistleblower lawsuit by former employee Janet Burke. She will receive a whistleblower award of roughly $483,000 from the proceeds of the government's recovery. DOJ (CDCA)