Archive

November 4, 2015

AstraZeneca LP and Cephalon, Inc. agreed to pay $54 million to settle government charges they violated federal and state False Claims Acts by overcharging state Medicaid programs for their pharmaceutical products. AstraZeneca will pay $46.5 million and Cephalon, the wholly-owned subsidiary of Teva Pharmaceutical Industries. Ltd., will pay $7.5 million. According to the government, the two pharmaceutical companies underpaid drug rebates owed the states under the Medicaid Drug Rebate Program, which requires drug makers to periodically return to the government a portion of their Medicaid proceeds. The allegations first arose in a whistleblower lawsuit filed by Virginia pharmacist and attorney Ronald Streck under the quit tam provisions of the Federal False Claims Act, New York False Claims Act and other state false claims statutes. Mr. Streck will receive a yet-to-be-disclosed whistleblower award from a portion of the government’s recoveries. Whistleblower Insider

Tagged in: Drug and DME Pricing, FCA Federal, FCA State, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

September 4, 2015

Columbus Regional Healthcare System and Dr. Andrew Pippas agreed to pay more than $25 million to resolve allegations they violated the False Claims Act by submitting claims in violation of the Stark Law. The settlement also resolves allegations that Columbus Regional and Pippas submitted claims for payment to federal health care programs that misrepresented the level of services they provided. According to the government, between 2003 and 2013, Columbus Regional provided excessive salary and directorship payments to Pippas that violated the Stark Law. The government further alleged Columbus Regional submitted claims to federal health care programs for services at higher levels than supported by the documentation. The allegations first arose in two whistleblower lawsuits filed former Columbus Regional executive Richard Barker under the qui tam provisions of the False Claims Act and the Georgia False Medicaid Claims Act. Barker will receive a yet-to-be-determined whistleblower award. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Hospital Fraud, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

June 15, 2015

Children’s Hospital, Children’s National Medical Center Inc. and its affiliated entities agreed to pay $12.9 million to resolve allegations they violated the False Claims Act by submitting false cost reports and other applications to the components and contractors of the Department of Health and Human Services, as well as to Virginia and District of Columbia Medicaid programs. The allegations first arose in a whistleblower lawsuit filed by former Children’s National Medical Center employee James A. Roark Sr. under the qui tam provisions of the False Claims Act. Mr. Roark will receive a whistleblower award of $1,890,649.98. DOJ

Tagged in: FCA Federal, FCA State, Hospital Fraud, Whistleblower Case, Whistleblower Rewards,

June 4, 2015

Hospital operator Health Management Associates (HMA) and Georgia-based hospital Clearview Regional Medical Center agreed to pay $595,155 to settle charges they violated the False Claims Act through an illegal kickback scheme. Clearview was previously named Walton Regional Medical Center and owned by HMA during the time period relevant to the lawsuit. Clearview is now owned by Community Health Systems which purchased HMA in January 2014. According to the government, HMA’s Walton Regional Medical Center paid kickbacks to Hispanic Medical Management (d/b/a Clinica de la Mama), in return for Clinica’s agreement to send pregnant women to Walton Regional for deliveries paid for by Medicaid, in violation of the federal Anti-Kickback Statute. As part of the settlement, HMA and Clearview will pay the State of Georgia an additional $396,770 to settle Georgia’s claims under the Georgia False Medicaid Claims Act. The allegations originated in a whistleblower lawsuit filed by former Walton Regional CFO Ralph D. Williams under the qui tam provisions of the False Claims Act. He will receive a whistleblower award of $119,031. DOJ, GA

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Hospital Fraud, Medicaid, Whistleblower Case, Whistleblower Rewards,

June 1, 2015

A group of home health care companies collectively known as “Friendship” and the companies’ owner Theophilus Egbujor agreed to pay $6.5 million to resolve allegations they improperly billed TennCare, Medicare and TRICARE for home health services. Specifically, the government claimed Friendship billed TennCare for private duty nursing services that were furnished or supervised by a woman who was excluded from billing federal and state health care programs and that Friendship submitted required forms to TennCare that contained the forged signature of Friendship’s Director of Nursing. The specific entities included in the settlement agreement are Friendship Home Healthcare, Inc., which has also done business as Friendship HealthCare System; Friendship Home Health, Inc., and Angel Private Duty and Home Health, which have also done business as Friendship Private Duty; and Friendship Home Health Agency, LLC. The allegations first arose in a whistleblower lawsuit filed by Kay Flippo, a licensed practical nurse who previously worked for Friendship Home Healthcare, under the qui tam provisions of the False Claims Act. She will receive a yet-to-be determined whistleblower award. DOJ

Tagged in: FCA Federal, FCA State, Home Health and Hospice, Improper Medical Personnel, Medicaid, Medical Billing Fraud, Medicare, Other Government Health Programs, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

April 29, 2015

The Hospital Authority of Irwin County (ICH) and several doctors agreed to pay $520,000 to settle charges they violated the False Claims Act, the Anti-Kickback Statute, the Stark Law and related Georgia Medicaid policies in connection with the amount of compensation paid by ICH to one of the doctors, ICH’s leases with the doctors, and the supervision of certain diagnostic imaging services at ICH. The allegations first arose in a whistleblower lawsuit filed by Connie Brogdon and Summer Holland under the qui tam provisions of the False Claims Act and the Georgia False Medicaid Claims Act. They will receive an undisclosed portion of the settlement payment. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Hospital Fraud, Whistleblower Case, Whistleblower Rewards,

March 19, 2015

Bank of New York Mellon agreed to pay $714 million to settle charges the bank engaged in fraud and other misconduct when providing foreign exchange (“FX”) services to its customers. As part of the settlements with the US and New York, BNYM admitted that contrary to representations to clients that it provided “best rates” and “best execution” for FX transactions, the Bank actually gave clients the worst reported interbank rates of the trading day. The charges originated in a lawsuit brought by a whistleblower under the New York False Claims Act. Whistleblower Insider

Tagged in: FCA State, Financial Institution Fraud, Foreign Exchange, Misrepresentations, Whistleblower Case, Whistleblower Rewards,

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

Tagged in: FCA Federal, FCA State, Home Health and Hospice, Lack of Medical Necessity, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

January 22, 2016

Virginia has recovered more than $63 million collectively from eleven banks to settle allegations that the banks misled the Commonwealth of Virginia and the Virginia Retirement System through the sale of allegedly misrepresented residential mortgage-backed securities. This is the largest non-healthcare-related recovery ever obtained in a suit alleging violations of the Virginia Fraud Against Taxpayers Act. The eleven banks included in the settlement are Countrywide Securities Corporation, Merrill Lynch, Pierce, Fenner & Smith, Inc., RBS Securities Inc., Barclays Capital Inc., Morgan Stanley & Co. LLC, Deutsche Bank Securities Inc., Citigroup Global Markets Inc., Goldman, Sachs & Co., HSBC Securities (USA) Inc., Credit Suisse Securities (USA) LLC, and UBS Securities LLC. VA

Tagged in: FCA State, Financial and Investment Fraud, Housing and Mortgage Fraud,

September 25, 2013

Kan-Di-Ki LLC, d/b/a Diagnostic Laboratories and Radiology agreed to pay $17.5M to settle allegations that the California-based company violated the federal and California False Claims Acts by paying kickbacks for referral of mobile lab and radiology services subsequently billed to Medicare and Medi-Cal (the state of California’s Medicaid program). The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Laboratory and IDTF, Whistleblower Case,

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