Archive

December 17, 2019

Miracle Home Care, Inc. and its owner, Shashicka Tyre-Hill, have together been ordered to pay more than $10 million following judgment in an action under the False Claims Act finding that defendants defrauded Georgia’s Medicaid program.  In a civil complaint filed in July 2018, the federal government and State of Georgia alleged that Miracle Home Care submitted thousands of fraudulent reimbursement claims for medically unnecessary transportation and health services.  USAO SDGA

November 15, 2019

Pharmaceutical manufacturer Lupin Limited and related entities, together with company executives Vinita Gupta and Robert Hoffman, will pay $63 million to Texas to resolve claims under the Texas Medicaid Fraud Prevention Action that they reported inflated drug prices to the state's Medicaid program in order to receive excess reimbursements.  The investigation of Lupin was initiated by a whistleblower lawsuit filed by Expess Med Pharmaceuticals, Inc.  TX

November 8, 2019

Two New York City real estate development companies, Mica Gabe Brooklyn LLC and Brooklyn Warehouse 180 LLC, will pay $3 million to resolve claims that they secured a New York tax break, Section 421-a, by falsely stating that building service employees would be paid prevailing wages when, in fact, employees hired at the buildings were paid less than the wages required by law.  The $3 million settlement consists of $2.5 million in damages under Section 421-a and the New York False Claims Act, and $415,000 in back wages.  The investigation was initiated with the filing of a whistleblower complaint under the NY FCA by local union 32BJ SEIU, which will receive a portion of the damages as a whistleblower reward.  NY

October 28, 2019

The State of Illinois has reached a settlement with more than a dozen drug manufacturers alleged to have published inflated "average wholesale prices" for drugs whose purchase was reimbursed by Illinois's Medicaid program at prices based on those false AWPs.  The settlement for $242 million includes Abbott Laboratories, Inc.; Aventis Pharmaceuticals Inc.; Aventis Behring LLC, n/k/a ZLB Behring; B. Braun Medical Inc.; Forest Laboratories, Inc.; GlaxoSmithKline LLC; Johnson & Johnson, Inc.; Janssen Pharmaceutical Products, LP; McNeil-PPC, Inc.; Ortho Biotech Products, LP; Ortho-McNeil Pharmaceutical, Inc.; Novartis Pharmaceuticals Corporation; Pfizer Inc.; Pharmacia Corporation; and TAP Pharmaceutical Products, Inc.  In total, Illinois has settled inflated AWP claims against more than four dozen manufacturers (see, e.g., January 2019 settlement with TEVA Pharmaceuticals), recovering $678 million in total.  IL AG  

October 4, 2019

Southern California-based Retina Institute of California Medical Group (RIC), its former CEO, and several of its physicians have agreed to pay the State of California and United States $6.65 million to settle alleged violations of state and federal False Claims Acts.  According to former administrators Bobbette Smith and Susan Rogers, between 2006 and 2017, the ophthalmology group improperly billed Medicare and Medicaid for unnecessary and unperformed eye exams, upcoded simple exams using codes normally reserved for emergency conditions, and waived mandatory co-payments and deductibles to induce patient referrals.  Smith and Rogers will receive a relator’s share, which remains to be determined.  USAO CDCA

October 3, 2019

Counselor Valerie Williams and her business, Circle of Life Transition Center, LLC, will pay $45,500 to resolve claims that they submitted false claims to the Connecticut Medicaid program, representing that services had been provided by Williams when, in fact, those services had been provided by unlicensed individuals.  USAO CT

September 26, 2019

Pharmaceutical manufacturer Avanir Pharmaceuticals will pay approximately $116 million to resolve civil and criminal charges related to its marketing of Nuedextra for off-label purposes and payment of kickbacks to prescribers and others.  The government alleged that Avanir marketed Nuedextra to long-term care facilities, suggesting that it could be used as an alternative to anti-psychotics for dementia patients, even though Nuedextra had only been approved by the FDA for treatment of particular symptoms secondary to a neurologic disease or brain injury.  In addition, Avanir provided certain physicians and other healthcare professionals with unlawful remuneration in the form of money, honoraria, travel, and food to induce them to write prescriptions for Nuedexta. The civil settlement for $103 million, which includes a five-year corporate integrity agreement, resolves whistleblower actions brought under federal and state False Claims Acts by former Avanir employees Kevin Manieri, Duane Arnold, and Mark Shipman.  Manieri will receive $12.4 million, and Arnold and Shipman will receive $5.4 million. In addition to the civil settlement, Avanir will pay a criminal penalty of $7.8 million, forfeit $5.1 million, and enter into a deferred prosecution agreement admitting to payment of kickbacks and requiring cooperation in ongoing in ongoing criminal investigations of individuals involved in marketing and prescribing Nuedextra.  Indictments against four individuals, including former Avanir employees and one of the top prescribers of Nuedexta in the country, were announced, charging the individuals with conspiracy to solicit, receive, offer and pay health care kickbacks.  DOJ

August 1, 2019

The United States and 15 states have settled with Cisco Systems, Inc. for $8.6 million in the first cybersecurity whistleblower case ever successfully brought under the False Claims Act.  Cisco was accused of selling a video surveillance software to the U.S. government and state purchasers – including the military, FEMA, Homeland Security, and the Secret Service -- that could be easily exploited by hackers, and doing nothing to resolve or report the issue for years after the vulnerability was identified.  AG NY; AG VA

July 18, 2019

Connecticut-based Comprehensive Pain and Headache Treatment Centers, LLC (CPHTC), and owner Mark Thimineur, M.D., have settled federal and state False Claims allegations of improperly submitting claims for urine tests that were not performed or were already part of drug screens paid for by Medicare and Medicaid.  As part of the settlement, they will pay $425,000.  USAO CT

July 10, 2019

Overstock.com has been ordered by a Delaware court to pay $7.3 million following a jury verdict against it on claims that the online retailer misrepresented its disposition of abandoned gift card balances to Delaware's revenue agency in order to avoid obligations under the Delaware escheat law, which requires that Delaware-chartered companies turn over unclaimed assets to the state.  The case was brought by whistleblower William Sean French, a former employee of a gift card company, under the Delaware False Claims and Reporting Act. DEL (note: the trial court judgment was reversed by the Delaware Supreme Court in an opinion issued June 24, 2020)