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February 18, 2015

Hospice services provider Compassionate Care Hospice Group agreed to pay $6.7M to settle charges it violated the federal and New York False Claims Acts by submitting claims to Medicare and Medicaid for hospice nursing services not actually or adequately provided.  Specifically, the government alleged CCH nurses routinely missed their required visits and then falsified nursing notes in patients’ files to make it appear as though the visits had been performed.  The charges originated in a whistleblower lawsuit filed by a former employee under the qui tam provisions of the False Claims Act.  Whistleblower Insider, NY

February 13, 2015

Illinois physician Dr. Michael J. Reinstein pleaded guilty to the crime of receiving illegal kickbacks and benefits totaling nearly $600,000 from pharmaceutical manufacturer Teva Pharmaceuticals USA Inc. and its subsidiary IVAX LLC in exchange for regularly prescribing the anti-psychotic drug clozapine to his patients.  Reinstein also agreed to pay $3.79M to settle a parallel civil lawsuit alleging he violated the False Claims Act for causing the submission of false claims to Medicare and Medicaid for the clozapine he prescribed for thousands of elderly and indigent patients in at least 30 Chicago-area nursing homes and other facilities.  In March 2014, Teva Pharmaceuticals and IVAX paid $27.6M million for their role in the kickback scheme. DOJ

February 12, 2015

Three importers agreed to pay more than $3M to resolve allegations they violated the False Claims Act by lying to US Customs and Border Protection agents to evade customs duties on imports of aluminum extrusions from China.  The companies, which included California-based C.R. Laurence Co. Inc., Florida-based Southeastern Aluminum Products Inc.and Texas-based Waterfall Group LLC, sell shower doors and shower enclosures made with the aluminum extrusions.  The charges were first raised in a whistleblower lawsuit brought by James F. Valenti Jr. under the qui tam provisions of the False Claims Act.  He will receive a whistleblower award of $555,000.  DOJ

February 11, 2015

Delaware-based pharmaceutical manufacturer AstraZeneca LP agreed to pay $7.9M to settle charges it violated the False Claims Act by engaging in an illegal kickback scheme with pharmacy benefit manager Medco Health Solutions.  The government alleged, among other things, that AstraZeneca agreed to provide remuneration to Medco in exchange for Medco maintaining for AstraZeneca’s Nexium drug “sole and exclusive” status on certain Medco formularies and through other marketing activities.  The charges originated with a whistleblower lawsuit filed by former AstraZeneca employees Paul DiMattia and F. Folger Tuggle under the qui tam provisions of the False Claims Act.  They will collectively receive a whistleblower award of $1,422,000.  Whistleblower Insider

February 10, 2015

Iowa-based home healthcare company ResCare Iowa Inc. agreed to pay $5.63M to resolve allegations it violated the False Claims Act by submitting false home healthcare billings to the Medicare and Medicaid programs.  DOJ

February 6, 2015

Oklahoma-based Hospice care provider Good Shepherd Hospice Inc.agreed to pay $4M to resolve allegations it submitted false claims for hospice patients who were not terminally ill. Specifically, the government contended Good Shepherd pressured staff to meet admissions and census targets and paid bonuses to staff, including hospice marketers, admissions nurses and executive directors, based on the number of patients enrolled even if they were not eligible for hospice care. The settlement resolves allegations first raised by former Good Shepherd employees Kathi Cordingley and Tracy Jones in a whistleblower lawsuit they filed under the qui tam provisions of the False Claims Act. They will receive a whistleblower award of approximately $680,000. DOJ

February 5, 2015

Minnesota-based medical device manufacturer ev3 Inc. (formerly known as Fox Hollow Technologies Inc.) agreed to pay $1.25M to resolve allegations it violated the False Claims Act by causing certain hospitals to submit false claims to Medicare for unnecessary inpatient admissions related to minimally-invasive atherectomy procedures for removing hardening of the arteries. According to the government, Fox Hollow sold the Silver Hawk Plaque Excision System for these procedures and advised hospitals to bill them as more expensive inpatient procedures, as opposed to less costly outpatient procedures, to artificially increase their Medicare reimbursement claims. The charges originated with a whistleblower lawsuit was filed under the qui tam provisions of the False Claims Act by former Fox Hollow sales representative Amanda Cashi. She will receive a whistleblower award of $250,000. DOJ

February 2, 2015

Tennessee-based Community Health Systems Professional Services Corporation and three affiliated New Mexico hospitals agreed to pay $75M to settle allegations they violated the False Claims Act by making illegal donations to county governments which were used to fund the state share of Medicaid payments to the hospitals. The allegations were first raised in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Community Health revenue manager Robert Baker. He will receive a whistleblower reward of $18,671,561 as his share of the government’s recovery. DOJ

January 26, 2015

Composite Engineering Inc., a Sacramento-based subsidiary of Kratos Defense & Security Solutions that manufactures remote-controlled subscale aircraft for the US. military, agreed to pay $2M to resolve allegations it violated the False Claims Act by submitting inflated costs in connection with a 2007 Air Force contract. DOJ

January 26, 2015

Kentucky-based ambulance services company Lafferty Enterprises, LLC(d/b/a Trans-Star Ambulance Services) agreed to pay $948,000 to settle charges it violated the False Claims Act by billing federal health care programs for medically unnecessary services over the course of several years. According to the government, from February 2006 until December 2012, the company transported Medicare patients to and from dialysis clinics by ambulance when an ambulance transport was not medically necessary. The charges originated from a whistleblower lawsuit filed by Kevin Fairlie under the qui tam provisions of the False Claims Act. He will receive a whistleblower award of $189,600. DOJ
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