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March 23, 2015

Michigan-based Portage Hospital, LLC agreed to pay $4,446,392 to settle allegations its hospital-owned home health care agency, Portage Health Home Care & Hospice, violated the False Claims Act by submitting false claims to Medicare for unnecessary or unwarranted physical therapy services.  DOJ

Tagged in: FCA Federal, Home Health and Hospice, Hospital Fraud, Lack of Medical Necessity,

March 18, 2015

Gilbane Building Company agreed to pay $1.1 million to resolve allegations that W.G. Mills Incorporated (which Gilbane merged with in November 2010) violated the False Claims Act by creating a front company, Veterans Constructors Incorporated (VCI), in order to be awarded a Coast Guard contract that was designated for Service Disabled Veteran Owned Small Businesses.  VCI agreed to pay $50,000 plus five annual contingency payments equal to one percent of VCI’s total annual revenues to resolve the same allegations.  DOJ

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

March 12, 2015

Miami-based lender Hencorp Becstone Capital L.C. agreed to pay $3.8 million to resolve allegations under the False Claims Act that it made false statements and claims to the Export-Import Bank of the United States in order to obtain loan guarantees.  According to the government, Ricardo Maza, a Peruvian-based former Hencorp business agent, created false documentation to obtain Ex-Im Bank guarantees on fictitious transactions on which no products were sold or exported, and that Maza then diverted the proceeds of the loans to himself and to his friends and business associates in Peru.  The allegations arose in a whistleblower lawsuit filed by Genaro Benites Caballero, the former owner of one of the purported purchasers, and Patricia Doris Lee Dominguez, a former attorney for the purported purchaser, under the qui tam provisions of the False Claims Act.  They will receive a whistleblower award of $608,000.  DOJ

Tagged in: FCA Federal, Financial and Investment Fraud, Whistleblower Case, Whistleblower Rewards,

March 9, 2015

Florida home health care companies Recovery Home Care Inc., Recovery Home Care Services Inc. and National Home Care Holdings LLC have agreed to pay $1.1 million to resolve allegations that Recovery Home Care violated the False Claims Act by improperly paying doctors for referrals of home health care services provided to Medicare patients.  According to the government, the physicians were over-compensated for any actual work they performed and, in reality, they were paid to induce them to refer their patients to Recovery Home Care in violation of the Anti-Kickback Statute and the Stark Law.  The allegations originated in a whistleblower lawsuit filed by former Recovery Home Care employee Gregory Simony under the qui tam provisions of the False Claims Act.  Simony will receive a whistleblower award of $198,000.  DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Home Health and Hospice, Whistleblower Case, Whistleblower Rewards,

March 2, 2015

Patient safety consultant Dr. Charles Denham and his consulting company Health Care Concepts Inc. and his research organization Texas Medical Institute of Technology agreed to pay $1 million to settle allegations they violated the False Claims Act by soliciting and accepting kickbacks.  According to the government, Denham received monthly payments from CareFusion Corporation while serving as the co-chair of the Safe Practices Committee of the National Quality Forum which reviews, endorses and recommends standardized healthcare performance measures and practices, and Denham received these payments in exchange for recommending, promoting and/or arranging for the purchase of CareFusion’s product, ChloraPrep, in violation of the Federal Anti-Kickback Statute.  DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Medical Devices and DME,

February 27, 2015

Gerald R. Funderburg Jr., owner of Funderburg Clinical & Community Services, was sentenced to 87 months in prison and to pay $1.45M in restitution for violating the False Claims Act through his submission of false claims to Medicare for purported psychotherapy services.  Specifically, Funderburg admitted he used the Medicare information and identities of hundreds of Medicare beneficiaries without their consent to submit claims for psychotherapy services not actually provided.  DOJ

Tagged in: FCA Federal, Medical Billing Fraud, Provider Fraud,

February 25, 2015

Texas-based mortgage finance company MetLife Home Loans LLC, a wholly-owned subsidiary of MetLife Inc., agreed to pay $123.5M to resolve allegations it violated the False Claims Act by originating and underwriting (through MetLife Bank) mortgage loans insured by the Department of Housing and Urban Development’s (HUD) Federal Housing Administration (FHA) that did not meet applicable FHA requirements.  Whistleblower Insider

Tagged in: FCA Federal, Housing and Mortgage Fraud,

February 24, 2015

Acadiana Cardiology LLC, Acadiana Cardiovascular Center and convicted doctor Mehmood Patel agreed to pay $650,000 to settle charges they violated the False Claims Act through unnecessary cardiovascular, endovascular and related procedures that Patel performed at Our Lady of Lourdes Hospital, Lafayette General Medical Center, Acadiana Cardiology and Acadiana Cardiovascular Center.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Dr. Christopher Mallavarapu, a cardiologist who formerly practiced with Patel.  DOJ

Tagged in: FCA Federal, Hospital Fraud, Lack of Medical Necessity, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

February 24, 2015

Louisiana oncologist Prabhjit S. Purewal agreed to pay $550,000 to settle allegations he defrauded Medicare, Tricare and Medicaid in violation of the False Claims Act by billing for chemotherapy drugs not approved by the FDA.  Dr. Purewal purchased the drugs from UK-based drug distributor Warwick Healthcare Solutions, Inc. (also known as Richard’s Pharma), which did not have a license to distribute drugs in the US.  DOJ

Tagged in: FCA Federal, Off-Label and Unapproved Use, Other Government Health Programs, Pharma Fraud, Provider Fraud,

February 23, 2015

Two South Florida medical doctors and their wives, Dr. Alan and Lynn Buhler and Dr. Craig and Cynthia Prokos agreed to pay $1M and $90,000, respectively, to settle allegations they violated the False Claims Act when their wives accepted sham marketer salaries in exchange for their husbands’ referrals to a home health care company called A Plus Home Health Care Inc.  The US previously settled with A Plus and its owner Tracy Nemerofsky and five other couples that allegedly accepted payments from A Plus.  DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Home Health and Hospice,

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