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Zwanger-Pesiri Radiology – Medicare and Medicaid Fraud ($10.5M).

Two of our whistleblower attorneys led the representation of Linda Gibb and Donna Geraci, former billing specialists at Zwanger-Pesiri Radiology in Long Island, New York. Ms. Geraci and Ms. Gibb brought a qui tam action under the False Claims Act (FCA) against Zwanger-Pesiri, alleging the company defrauded the government by performing unnecessary testing, charging for services not performed, and using uncredentialed physicians. The government joined the case, and in 2016, Zwanger-Pesiri paid $8.1M to settle civil allegations in the FCA case, as well as $2.4M in related criminal forfeiture. Ms. Geraci and Ms. Gibb received a whistleblower award of $1.25M collectively. See DOJ for more.

DaVita — Medicare Fraud/Kickbacks ($400 million)

Two of our whistleblower attorneys led the representation of David Barbetta, a former financial analyst for DaVita HealthCare Partners, one of the largest providers of dialysis services in the United States. Mr. Barbetta brought a qui tam action under the False Claims Act against DaVita alleging the company violated the Anti-Kickback Statute by paying physicians to refer their patients to DaVita clinics for dialysis. According to the complaint, DaVita sold doctors shares of DaVita clinics at below fair market value, and purchased doctors’ interests in other clinics at above fair market value. The government joined the case, and alleged that DaVita had entered into these sweetheart deals with doctors, which gave the doctors returns of over 100%, and the doctors then steered their patients to DaVita clinics. In 2014, DaVita paid $400 million to settle the case, the largest stand-alone kickback settlement to date. See Denver Post and Modern Healthcare for more.

Rose Cancer Center — Medicare Fraud ($5.7 million).

Two of our whistleblower attorneys co-led the representation of Kristi Beeson who reported Medicare fraud violations at her former employer Rose Cancer Center in Mississippi. Ms. Beeson, who was a laboratory technician for the clinic, brought a qui tam action under the False Claims Act against the clinic alleging, among other things, unqualified technicians performing bone marrow biopsies, diluting chemotherapy drugs, and doctoring patient records to conceal the clinic’s fraudulent Medicare billings. The physician who owned and ran the practice, Dr. Meera Sachdeva, plead guilty to various Medicare fraud violations, forfeited $5.7 million, and is now serving a 20 year prison sentence for her crimes. Ms. Beeson, along with three other whistleblowers, collectively received a whistleblower award of $525,000 for their efforts in exposing the fraud. See Clarion Ledger for more.

Health Line Clinical Laboratories — Medicare Fraud/Unnecessary on Nonexistent Testing ($10 million).

One of our whistleblower attorneys led the representation of two whistleblowers who brought a qui tam action under the False Claims Act alleging the medical laboratory was charging for tests not performed or not necessary. For many of the tests involved, records suggested treating physicians had ordered over inclusive “747” panels, and the defense relied heavily on these order forms. The Department of Justice was persuaded the defendants’ conduct caused the unnecessary testing and intervened. Following the defeat of motions to dismiss and focused discovery the case settled for $10 million. The whistleblowers received 18% of the government recovery.