Archive

December 3, 2014

Rite Aid Corporation agreed to pay $3M to resolve allegations it violated the False Claims Act by offering illegal inducements to Medicare and Medicaid beneficiaries to transfer their prescriptions to Rite Aid pharmacies. The government alleged that from 2008 to 2010, Rite Aid had improperly influenced the decisions of Medicare and Medicaid beneficiaries to transfer their prescriptions to Rite Aid pharmacies by offering them gift cards in exchange for their business. The charges originated in a whistleblower complaint filed by Jack Chin under the qui tam provisions of the False Claims Act. Chin will receive a whistleblower award of approximately $500,000. DOJ

December 2, 2014

Luis Duluc, a Florida owner and operator of multiple physical therapy rehabilitation facilities, was sentenced to serve 11 years in prison for his role in organizing a $28.3M Medicare fraud scheme involving physical and occupational therapy services. Duluc was chairman and president of a Delaware holding company known as Ulysses Acquisitions Inc. which was used to purchase comprehensive outpatient rehabilitation facilities and outpatient physical therapy providers, including West Coast Rehab Inc. in Fort Myers, Florida; Rehab Dynamics Inc. in Venice, Florida;Polk Rehabilitation Inc. in Lake Wales, Florida; and Renew Therapy Centerof Port St. Lucie LLC in Port St. Lucie, Florida. Duluc admitted that he and his co-conspirators paid kickbacks to obtain, and stole, the personal identifying information of Medicare beneficiaries and used this information to create and submit false claims to Medicare through the clinics owned by Ulysses Acquisitions. DOJ

December 1, 2014

North Atlantic Medical Services Inc., doing business as Regional Home Care Inc., agreed to pay $852,378 to resolve allegations it violated the False Claims Act by submitting claims to Medicare and Medicaid for respiratory therapy services provided by unlicensed personnel. NAMS is a medical device company based in Massachusetts that provides equipment and services for the treatment of respiratory ailments, such as oxygen deficiency and sleep apnea. According to the government, from September 2010 to January 2013, NAMS used unlicensed employees to set up sleep apnea masks and oxygen therapy equipment for patients in Massachusetts. The charges were initiated by former NAMS employees Konstantinos Gakis and Demetri Papageorgiou who filed a whistleblower action under the qui tamprovisions of the False Claims Act. They will receive a whistleblower award of $153,428. DOJ

November 13, 2014

Ramon Regueira, owner of Miami home health care company Nation’s Best Care Home Health Corp., pleaded guilty for his role in a $30M home health Medicare fraud scheme. Regueira admitted that he and his co-conspirators operated Nation’s Best for the purpose of billing the Medicare program for expensive physical therapy and home health care services not medically necessary or provided. Specifically, Regueira admitted he and his co-conspirators paid kickbacks and bribes to patient recruiters who provided patients to Nation’s Best, as well as prescriptions, plans of care (POCs) and certifications for medically unnecessary therapy and home health services. From January 2007 through November 2012, Nation’s Best submitted approximately $35M in false claims and Medicare paid approximately $21M for these fraudulent claims. DOJ

November 12, 2014

Home healthcare agency CareAll Management LLC agreed to pay $25M to settle charges it violated the False Claims Act by submitting false and upcoded home healthcare billings to Medicare and Medicaid. According to the government, between 2006 and 2013, CareAll overstated the severity of patients’ conditions to increase billings and billed for services that were not medically necessary and rendered to patients who were not homebound. The current allegations first arose in a whistleblower lawsuit filed by Toney Gonzales under the qui tam provisions of the False Claims Act.  Gonzales will receive a whistleblower award in an undisclosed amount.  Whistleblower Insider

November 6, 2014

Medical device maker Biotronik Inc. agreed to pay $4.9M to resolve allegations it violated the False Claims Act by paying kickbacks to induce physicians to use its products. Specifically, the government charged that Biotronik induced electrophysiologists and cardiologists practicing in Nevada and Arizona to use Biotronik pacemakers, defibrillators and cardiac resynchronization therapy devices by paying them in the form of repeated meals at expensive restaurants and inflated payments for membership on a physician advisory board. The allegations first arose in a whistleblower lawsuit filed by a former Biotronik employee, Brian Sant, under the qui tam provisions of the False Claims Act. Sant will receive a whistleblower award of $840,000. DOJ

October 30, 2014

San Francisco based hospital system Dignity Health (formerly known as Catholic Healthcare West) agreed to pay $37M to settle False Claim Act charges that 13 of its hospitals in California, Nevada and Arizona submitted false claims to Medicare and TRICARE by admitting patients for inpatient services who could have been treated on a less costly, outpatient basis. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Kathleen Hawkins, a former employee of Dignity. She will receive a whistleblower award of $6.25M. DOJ

October 29, 2014

Medical device maker EBI LLC, doing business as Biomet Spine and Bone Healing Technologies and Biomet Inc., agreed to pay $6M to resolve allegations it violated the False Claims Act by paying kickbacks to induce use of its bone growth stimulators, which are used to repair fractures that are slow to heal. Specifically, the government alleged that from 2001 to 2008 EBI paid staff at doctors’ offices (through personal service agreements) to influence doctors to order its bone growth stimulators. The allegations originated in a whistleblower lawsuit filed by former EBI product manager Yu Yue under the qui tam provisions of the False Claims Act, who will receive an undisclosed whistleblower award. DOJ

October 22, 2014

Tayyab Aziz, founder of three Detroit-area home health agencies Prestige Home Health Services Inc., Royal Home Health Care Inc., and Platinum Home Health Services Inc. pleaded guilty for his role in a $22M home health care fraud scheme. Specifically, Aziz admitted he and his co-conspirators submitted fraudulent claims to Medicare for services that were medically unnecessary or never performed. They also submitted claims for services purportedly provided to Medicare beneficiaries who were recruited through illegal kickbacks paid to the patients and recruiters. DOJ

October 21, 2014

Kentucky-based cardiologists Satyabrata Chatterjee and Ashwini Anand, who jointly owned cardiologist physician group Cumberland Clinic, agreed to pay $380,000 to resolve allegations they violated the False Claims Act by entering into sham management agreements with Saint Joseph Hospital in exchange for the referral of cardiology procedures and other healthcare services to Saint Joseph. The government alleged that St. Joseph Hospital entered into sham agreements with Chatterjee and Anand, under which the physicians were paid to provide management services but did not in fact do so and that in exchange Chatterjee and Anand agreed to enter into an exclusive agreement with Saint Joseph to refer Cumberland Clinic patients to the hospital for cardiology and other services in violation of the Stark Law and the Anti-Kickback Statute. The government previously entered into a $16.5M settlement with Saint Joseph for the allegedly sham management contracts for unnecessary and excessive cardiology procedures. The allegations originated from a whistleblower lawsuit filed by three Lexington, Kentucky cardiologists under the qui tam provisions of the False Claims Act. The three whistleblowers, Drs. Michael Jones, Paula Hollingsworth and Michael Rukavina, will collectively receive a whistleblower award of $68,400. DOJ