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June 1, 2022

Behavioral health provider Healthkeeperz, Inc. has agreed to pay $2.1 million to resolve allegations that it falsely billed North Carolina’s Medicaid program for services that were not covered.  The allegations arose from a lawsuit filed by Ginger Hill under the qui tam provisions of the federal False Claims Act and the North Carolina False Claims Act.  USAO WD NC; NC

May 19, 2022

Retailer H&M will pay $36 million to New York State to resolve claims that the company violated a New York law which requires gift card issuers to turn over unused balances on gift cards to the state’s Abandoned Property Fund after five years of inactivity.  The retailer repeatedly lied to the state about its failure to transfer the unused gift card balances as required, and falsely told the state that an out-of-state company was handling its gift cards business. A whistleblower who filed a lawsuit under the New York False Claims Act will receive $7.74 million for bringing H&M’s misconduct to light.  NY

May 9, 2022

Prism Behavioral Solutions has agreed to pay $650,000 to resolve allegations of violating the federal and California False Claims Acts by billing California’s Medicaid program for services not provided to autistic children and young adults.  The whistleblower in this case, Diana Mason, is a behavioral analyst employed by Prism, and will receive a $170,000 share of the settlement.  USAO SDCA; CA AG

April 12, 2022

Providence Health & Services Washington has agreed to pay $22.7 million to settle allegations of submitting false claims to Medicare, Medicaid, and TRICARE.  According to an unnamed whistleblower, who will receive a $4.2 million relator’s share, the hospital allegedly gave their neurosurgeons volume-based financial incentives to perform complex surgeries, thereby incentivizing two neurosurgeons to perform an excessive number of complex surgeries on inappropriate candidates without regard to medical necessity or patient safety, and ultimately causing an excessive level of complications.  USAO EDWA

March 25, 2022

Two New York-based home health agencies, All American Homecare Agency and Crown of Life Care NY LLC, have agreed to pay a total of $5.4 million to settle allegations of violating federal and state False Claims Acts.  The agencies had allegedly paid their home health aides below minimum wage, despite claiming otherwise and receiving millions for said wages from Medicaid.  In addition to the monetary penalties, the agencies will also pay back wages owed to current and former aides.  NY AG; USAO EDNY

March 7, 2022

Redwood Toxicology Laboratory has agreed to pay nearly $4.8 million to settle allegations that the California-based urine drug testing service overcharged the Connecticut Medicaid program for certain laboratory services, in violation of Connecticut’s “Most Favored Nation” regulation, which provides that the state should not be charged more than the lowest price charged to third parties.  The settlement covered claims submitted between January 2015 through February 2018.  USAO CT

March 3, 2022

Multiple chemical companies agreed to pay a collective total of $11.7 million to resolve claims by state and local entities that from 1997 through at least 2011, they participated in a nationwide conspiracy to allocate territories and customers, unlawfully rig bids, and fix prices paid by government entities for the purchase of coagulant liquid aluminum sulfate, a chemical used in water treatment and purification.  The defendants include General Chemical entities, GenTek, Inc., Chemtrade entities, GEO Specialty Chemicals, Inc., C&S Chemicals, Inc., USALCO, LLC, Delta Chemical Corporation, and American Securities, LLC.  The Commonwealth of Virginia recovered $1.1 million in a whistleblower case initiated under the Virginia Fraud Against Taxpayers Act by Lawrence McShane.  VA

February 11, 2022

Transportation company Academy Bus, LLC, together with related entities and individuals, will pay $20.5 million to resolve claims brought in a whistleblower lawsuit under New Jersey’s False Claims Act that the defendants defrauded New Jersey Transit, for whom defendants operated bus routes.  Defendants were paid by NJ Transit based, in part, on miles and hours driven, with deductions for missed bus trips; they were alleged to have over-reported miles and hours driven, and underreported their missed bus trips to the state.  The settlement also required Academy to implement specific compliance procedures.  The whistleblower, former Academy employee Hector Peralta, will receive an award totaling $3.9 millionNJ

December 6, 2021

Pharmacy benefit manager Centene Corp. will pay $27.6 million to the State of Kansas to resolve allegations that it failed to satisfy its obligation to represent the state’s best interests in negotiations with companies that supply drugs to the state Medicaid program, failed to accurately report discounts it received from CVS-Caremark on certain retail pharmacy claims, and artificially inflated dispensing-fee amounts reported to state regulators.  The state alleged that Centene used an opaque reporting system that made it difficult for the state to determine the nature and appropriateness of certain pharmacy transactions.  As part of the settlement, Centene also agreed to change certain business practices to ensure greater transparency.  KS
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