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July 27, 2016

Connecticut psychiatrist Dr. Anton Fry and his company CPC Associates agreed to pay $36,704 to resolve allegations they violated the False Claims Act by submitting improper claims to Medicare for psychiatric services that were provided over the phone instead of by meeting with the beneficiaries in the office and treating them in person.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Jodi Cohen, a former patient of Dr. Fry, and Medical Bill Consultants, LLC, a billing company.  They will receive a whistleblower award of $6,239 from the proceeds of the government's recovery.  DOJ (DCT)

Tagged in: FCA Federal, Improper Medical Facility, Medicare, Multiple Whistleblowers and First-to-File, Whistleblower Case, Whistleblower Eligibility, Whistleblower Rewards,

July 22, 2016

California-based medical device manufacturer Acclarent Inc., a subsidiary of Johnson & Johnson, agreed to pay $18 million to resolve allegations it violated the False Claims Act by causing health care providers to submit false claims to Medicare and other federal health care programs by marketing and distributing its sinus spacer product known as the Relieva Stratus MicroFlow Spacer (Stratus) for use as a drug delivery device without FDA approval of that use.  The government further alleged that Acclarent marketed the Stratus as a drug delivery device even after the FDA rejected the company’s 2007 request to expand the approved uses for the Stratus.  On July 20, Acclarent’s former CEO William Facteau and former VP of Sales Patrick Fabian were convicted of introducing adulterated and misbranded medical devices into interstate commerce.  The allegations originated in a whistleblower lawsuit filed by Melayna Lokosky under the qui tam provisions of the False Claims Act.  The whistleblower will receive an award of roughly $3.5 million from the proceeds of the government's recovery.  DOJ

Tagged in: FCA Federal, Healthcare Fraud, Medical Devices and DME, Whistleblower Case, Whistleblower Rewards,

July 22, 2016

Preferred Imaging, LLC, a provider of diagnostic imaging services, agreed to pay $3,510,000 to resolve allegations it violated the False Claims Act by improperly billing Medicare and Texas Medicaid for services performed without proper medical supervision.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Preferred Imaging employee Tracy Sifuentes.  She will receive a whistleblower award of $596,700 from the proceeds of the government's recovery.  DOJ (NDTX)

Tagged in: FCA Federal, Improper Medical Personnel, Laboratory and IDTF, Medicare, Whistleblower Case, Whistleblower Rewards,

July 14, 2016

Columbia University agreed to pay $9.5 million to resolve charges it violated the False Claims Act for improperly seeking and receiving excessive cost recoveries in connection with research grants funded by the National Institutes of Health (NIH).  According to the government, Columbia impermissibly applied its “on-campus” indirect cost rate, instead of the much lower “off-campus” indirect cost rate, when seeking federal reimbursement for 423 NIH grants where the research was primarily performed at off-campus facilities owned and operated by the State of New York and New York City.  The government further alleged Columbia failed to disclose to NIH that it did not own or operate these facilities and that Columbia did not pay for use of the space for most of the relevant period.  The allegations originated with a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act.  The whistleblower will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (SDNY)

Tagged in: FCA Federal, Grant and Research Fraud, Whistleblower Case, Whistleblower Rewards,

July 13, 2016

Minnesota-based provider of hospice care Evercare Hospice and Palliative Care agreed to pay $18 million to resolve charges it violated the False Claims Act by claiming Medicare reimbursement for hospice care for patients not eligible for such care because they were not terminally ill.  Specifically, the government alleged that Evercare’s business practices were designed to maximize the number of patients for whom it could bill Medicare without regard to whether the patients were eligible for and needed hospice.  The allegations originated in whistleblower lawsuits filed by former employees of Evercare under the qui tam provisions of the False Claims Act.  They will receive a yet-to-be-determined whistleblower award from the proceeds of the government’s recovery.  Whistleblower Insider

Tagged in: FCA Federal, Home Health and Hospice, Whistleblower Case, Whistleblower Rewards,

July 13, 2016

A Kentucky federal court entered a civil judgment of roughly $4.5 million against Vesta Brue and her medical device companies LifeTechniques, Inc. and Care Team Solutions LLC for violating the False Claims Act by making false statements that allowed them to receive millions of dollars in federal grants from the National Institutes of Health (NIH).  According to the settlement agreement, NIH awarded Brue and her companies five Small Business Innovation Research grants, worth millions of dollars, to support the development of electronic pillboxes customized for specific patient populations, including HIV and pediatric patients.  But Brue and her companies acknowledged that Brue spent the grant money on personal expenses, such as plastic surgery, jewelry, home renovations, and massages, among other expenses.  She also used grant money on business expenses not allowed under the grant regulations, such as costs associated with marketing and promoting her businesses.  DOJ (EDKY)

Tagged in: FCA Federal, Grant and Research Fraud, Medical Devices and DME,

July 13, 2016

Clothing importer Motives, Inc. and its affiliated foreign clothing manufacturers Motives Far East and Motives China Ltd. agreed to pay $13.375 million to settle charges of violating the False Claims Act by engaging in a double invoicing scheme to defraud the United States out of millions of dollars in customs duties.  As part of the settlement, the companies admitted to and accepted responsibility for under-reporting the value of its imported merchandise.  Under the scheme, the companies used two sets of invoices: one that undervalued the garments and was presented to the government for calculation of the appropriate customs duty, and the second that reflected the actual value of the garments.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act.  The whistleblower will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (SDNY)

Tagged in: Customs Fraud, FCA Federal, Whistleblower Case, Whistleblower Rewards,

July 12, 2016

New Jersey couple Nita and Kirtish Patel and their diagnostic imaging companies Biosound Medical Services Inc. and Heart Solution PC were ordered to pay more than $7.75 million for violating the False Claims Act by submitting false claims to Medicare for thousands of falsified diagnostic test reports and the underlying tests.  The government had alleged that defendants created fraudulent diagnostic test reports, forged physician signatures on these reports, and then billed Medicare for the fraudulent reports and the underlying tests that were used solely to create these reports.  The government further alleged that defendants billed Medicare for neurological tests that they conducted without the required physician supervision.  The allegations originated in a whistleblower lawsuit filed by a former Biosound employee under the qui tam provisions of the False Claims Act.  The whistleblower will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (DNJ)

Tagged in: FCA Federal, Laboratory and IDTF, Medicare, Whistleblower Case, Whistleblower Rewards,

July 7, 2016

MD2U Holding Company agreed to pay $3.3 million and a percentage of its net income over the next five years to settle charges they violated the False Claims Act by submitting false medical claims to Medicare and other government health care programs, altering records to support false claims and providing services that were medically unnecessary.  Specifically, the government alleged MD2U submitted false billings for patients who were neither homebound nor home-limited; improperly billed the government for medically unnecessary visits; billed government health care programs at the highest payment codes (upcoding) when a lower code would have been more appropriate; and cloned medical records (a cut, copy, paste electronic program) in order to justify patient visits.  The company admitted being liable to the government for roughly $21.5 million.  DOJ

Tagged in: FCA Federal, Lack of Medical Necessity, Medicare, Upcoding,

July 6, 2016

En Pointe Gov. Inc. (now known as Modern Gov IT Inc.), En Pointe Technologies Inc. (now known as Dinco Inc.), En Pointe Technologies Sales Inc. (now known as Collab9 Inc.), Dominguez East Holdings LLC and Din Global Corp. agreed to pay roughly $5.8 million to resolve allegations that they violated the False Claims Act by falsely certifying that En Pointe Gov. was a small business so it could obtain contracts set aside for small businesses and by underreporting sales under a General Services Administration (GSA) contract to avoid the payment of fees.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Minburn Technology Group, , a Virginia company that sells information technology products and services, and Anthony Colangelo, Minburn’s managing member.  Minburn and Colangelo will receive a whistleblower award of approximately $1.4 million.  DOJ

Tagged in: FCA Federal, Government Procurement Fraud, Set-Asides and Preferences, Whistleblower Case, Whistleblower Rewards,

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