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Sutter Health – Healthcare Fraud/Medicare Advantage ($90 million)

Constantine Cannon represented a whistleblower in a False Claims Act case alleging Sutter Health and its affiliates inflated the number and severity of Medicare Advantage patient diagnoses, manipulated patient records, ignored audit red flags, and engaged in other misconduct to increase patient risk scores and obtain Medicare Advantage payments to which they were not entitled.  In August 2021, Sutter agreed to pay $90 million to settle the matter, the largest Medicare Advantage False Claims Act settlement to date against a hospital system, and at the time, the second largest reported Medicare Advantage fraud settlement ever.  Our client received a whistleblower award of roughly $22 million.  Read more -- AP, Reuters, SF ChronicleDOJ, PR NewswireCC.

VNSNY - Healthcare Fraud/Home Health ($57 million)

Constantine Cannon represented a whistleblower in a False Claims Act case alleging Visiting Nurse Service of New York, the largest not-for-profit home health agency in the country, failed to provide its patients all the critical nursing and therapy visits and services their doctors prescribed under the patient Plans of Care.  In June 2020, VNSNY agreed to pay $57 million to settle the matter.  It is the first reported False Claims Act settlement involving allegations of a home health agency failing to follow patient Plans of Care.  It also is the largest non-kickback False Claims Act settlement ever against a home health company and the second largest settlement of any home health fraud case.  Our client received a whistleblower award of roughly $16.5 million.  Read more -- Politico, Modern Healthcare, CrainsCC.

Group Health Cooperative - Healthcare Fraud/Medicare Advantage ($6.375 million)

Constantine Cannon represented a whistleblower in a False Claims Act case alleging Group Health Cooperative (now a subsidiary of Kaiser Permanente) submitted false or inaccurate Medicare Advantage patient diagnosis codes to inflate the reimbursement it received under the Medicare Part C program.  In November 2020, the company agreed to pay $6.375 million to settle the matter.  Our client received a whistleblower award of 25% of the government's recovery.  Read more -- NPR, Seattle Times, DOJ, CC.

Mid Dakota Clinic - Healthcare Fraud/Kickbacks ($5.45 million)

Constantine Cannon represented a whistleblower in a False Claim Act alleging Mid Dakota Clinic engaged in a kickback scheme with its wholly owned ambulatory surgery center to elicit improper patient referrals.  In November 2019, the medical clinic agreed to pay $4.15 million to settle the matter.  Our client received a whistleblower award of 25% of the government's recovery.  Read more -- AP, Becker's, CC.

Skyline Urology - Healthcare Fraud ($2.1 million)

Constantine Cannon represented a whistleblower in a False Claim Act case alleging Skyline Urology misused a billing code to increase reimbursements from Medicare and private insurers in California.  In February 2019, the company agreed to pay roughly $2.1 million to settle the matter. Our client received a whistleblower award of roughly 18% of the government's recovery.  Read more -- NLR, Becker's, DOJ, CC.

Sharp HealthCare - Healthcare Fraud/Kickbacks (Undisclosed)

Constantine Cannon represented a whistleblower in a False Claims Act case alleging Sharp HealthCare Center for Research, Sharp’s clinical-trial research arm, paid kickbacks to entice prospective trial sponsors to host clinical trials at Sharp.  In November 2019, the company agreed to pay an undisclosed amount to settle the matter.  Our client received a whistleblower award of an undisclosed portion of the government's recovery.  Read more -- CC.

Freedom Health/Optimum - Healthcare Fraud/Medicare Advantage ($32.5 million)

Constantine Cannon represented a whistleblower in a False Claims Act case alleging Freedom Health and Optimum Healthcare inflated their Medicare Advantage patient risk scores to secure artificially high Medicare reimbursement.  In May 2017, the companies agreed to pay $32.5 million to settle the matter.  Our client received a whistleblower award of roughly $6.4 million.  Read more -- NPRMiami Herald, DOJ, CC.

Radiology Practice - Healthcare Fraud/Unnecessary Testing ($10.5M)

Constantine Cannon represented two whistleblowers in a False Claims Act case alleging New York-based Zwanger-Pesiri Radiology improperly billed Medicare for testing that was medically unnecessary or never performed.  In November 2016, the company agreed to pay $10.5 million to settle both criminal and civil charges.  Our clients received a whistleblower award of more than $1 million.  Read more -- Newsday, DOJ, PR Newswire, CC.

Bay Sleep Clinic - Healthcare Fraud/Kickbacks ($2.6 million)

Constantine Cannon represented a whistleblower under the False Claims Act case alleging Bay Sleep Clinic billed Medicare for sleep studies by unlicensed technicians and paid kickbacks to doctors for patient referrals.  In December 2016, the company agreed to pay $2.6 million to settle the matter.  Our client received a whistleblower award of roughly 21% of the government’s recovery.  Read more -- SF Gate, DOJ, PR Newswire, CC.

Rose Cancer Center - Healthcare Fraud ($5.7 million)

Constantine Cannon represented a whistleblower in a False Claims Act case alleging Mississippi-based Rose Cancer Center used unqualified technicians performing bone marrow biopsies, diluted chemotherapy drugs, and falsified patient records to conceal the clinic’s fraudulent Medicare billings.  The physician who owned and ran the practice plead guilty to various Medicare fraud violations, forfeited $5.7 million, and was sentenced to 20 years in prison.  In August 2014, our client (along with three other whistleblowers) received a whistleblower award of $525,000 from the government's recovery.  Read more -- Clarion Ledger, CC.