Archive

April 18, 2017

International Tutoring Services, LLC (d/b/a Hospice Plus; Goodwin Hospice, LLC; Phoenix Hospice, LP; Hospice Plus, L.P.; and Curo Health Services, LLC) agreed to pay $12.21 million to resolve allegations they violated the False Claims Act by paying kickbacks in exchange for patient referrals. The alleged kickbacks took the form of cash, gift cards, sham loans, a free equity interest in another entity, stock dividends, and free rental space. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. The whistleblowers will receive a whistleblower award from the proceeds of the government's recovery. DOJ (NDTX)

April 11, 2017

Norman Regional Hospital Authority (d/b/a Norman Regional Health System) and certain employees and physicians of Norman Regional agreed to pay roughly $1.6 million to settle charges of violating the False Claims Act by submitting false claims to Medicare for radiological services performed without the proper supervision by a physician.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Norman Regional radiologist Dr. Lance Garber.  He will receive a yet-to-be-identified whistleblower award from the proceeds of the government's recovery. DOJ (WDOK)

April 10, 2017

Kentucky based nursing home operator Prestige Healthcare agreed to pay $995,500 to resolve allegations it violated the False Claims Act with regard to its role in an alleged scheme to falsely bill Medicare for unnecessary genetic testing.  According to the government, Prestige provided genetic testing company Genomix LLC with information on and access to Prestige nursing home patients without ensuring physician orders were obtained for the testing and where Prestige physicians were not aware of and did not agree with the medical necessity of the testing. DOJ (WDWI)

April 2, 2017

Sanofi-Pasteur agreed to pay roughly $20 million to resolve claims it incorrectly calculated drug prices and thereby overcharged the U.S. Department of Veterans Affairs for drugs under two contracts between 2002 and 2011. DOJ

March 31, 2017

Tennessee based Exemplary Behavior, LLC and its principal, Andre Anderson, agreed to pay $20,000 to settle allegations they violated the False Claims Act by submitting false claims for payment to the Defense Health Agency’s TRICARE program for the provision of therapy services, including Applied Behavior Analysis (“ABA”) to children with Autism Spectrum Disorder (“ASD”).  Specifically, the settlement resolves charges that Exemplary Behavior submitted false claims to TRICARE as a result of their (1) double billing for services rendered; (2) billing for services not rendered by the billing provider; (3) providing group therapy while billing for individual therapy; and (4) billing for services, including ABA therapy, that were not actually provided. DOJ (MDTN)

March 30, 2017

Godwin Oriakhi, owner of five Houston-area home health agencies pleaded guilty to conspiring to defraud Medicare and the State of Texas’s Medicaid-funded Home and Community-Based Service and Primary Home Care programs of more than $17 million.  According to his plea, Oriakhi admitted that he, his daughter and co-defendant Idia Oriakhi, and other members of his family owned and operated: Aabraham Blessings LLC, Baptist Home Care Providers Inc., Community Wide Home Health Inc., Four Seasons Home Healthcare Inc. and Kis Med Concepts Inc., and that they obtained patients for these home health agencies by paying illegal kickback payments to patient recruiters and his office employees for hundreds of patient referrals.  Oriakhi also admitted that they paid Medicare and Medicaid patients by cash, check, Western Union and Moneygram for receiving services from his family’s home health agencies in exchange for the ability to use their Medicare and Medicaid numbers to bill the programs for home healthcare. DOJ

April 20, 2017

California announced a $9.8 million settlement with Walgreens, one of the largest drugstore chains in the United States. The settlement involved allegations that Walgreens failed to adhere fully to requirements imposed by California law for the dispensing of certain prescriptions drugs under Medi‑Cal. The settlement is the result of lawsuits filed by whistleblowers and investigated and resolved by federal and state prosecutors. The lawsuits alleged that for more than five years, Walgreens falsely certified that it had complied with diagnosis-related requirements for the lawful dispensing of prescriptions to Medi‑Cal patients. Through the Bureau of Medi‑Cal Fraud and Elder Abuse (BMFEA), the Attorney General’s office regularly works with whistleblowers and law enforcement agencies to investigate and prosecute fraud perpetrated on the Medi‑Cal program. False claims lawsuits pursued by the Attorney General in the last two years have recovered tens of millions of dollars from some of the nation’s largest pharmaceutical companies for allegations of improper marketing, falsifying reports to inflate prices, and other wrongful practices. CA

March 13, 2017

Massachusetts-based Charles River Laboratories International Inc. agreed to pay $1.8 million to settle claims it violated the False Claims Act by improperly charging for labor and other associated costs not actually provided on certain National Institutes of Health contracts relating to the provision of laboratory animals to the NIH. DOJ

March 6, 2017

Simon Hong, owner of Los Angeles-based JH Physical Therapy Inc., was sentenced to 63 months in prison and to pay roughly $2.4 million in restitution, for his role in a $3.4 million Medicare fraud scheme that involved billing for occupational therapy services that were not medically necessary and not provided.   Hong admitted billing Medicare for occupational therapy services when what were provided instead were acupuncture and massage services, not reimbursable by Medicare.  Hong further admitted directing co-conspirator therapists to falsify medical records to make it appear as if the services billed actually had been provided. DOJ

March 6, 2017

New Jersey family doctor Bernard Greenspan was convicted for accepting bribes in exchange for test referrals as part of a long-running scheme operated by Biodiagnostic Laboratory Services LLC. DOJ (DNJ)