Contact

Click here for a confidential contact or call:

1-347-417-2192

Archive

Page 22 of 129

September 2, 2021

Jonathan Dean Davis, the owner of for-profit trade school called Retail Ready Career Center, has agreed to forfeit over $72 million after being convicted of defrauding the U.S. Department of Veterans Affairs.  According to evidence presented at trial, Davis falsely certified that he was not personally facing any criminal or civil actions, and that his school was an established, financially-secure educational institution—neither of which were true.  The scheme unraveled after student veterans realized the HVAC training they received at the school was insufficient for entry-level jobs in the industry.  USAO NDTX; subsequent sentencing

Tagged in: Certifications, Criminal Proceedings, Education Fraud, FCA Federal, Government Programs Fraud,

September 1, 2021

The Van Andel Research Institute has agreed to pay $1.1 million to resolve allegations of failing to disclose foreign ties in awards granted by the National Institutes of Health (NIH), in violation of the False Claims Act.  The foreign ties included foreign-sourced research samples and funding by the Chinese government.  In December 2019, the institute settled similar claims for $5.5 million.  With this second settlement, specific conditions have now been imposed on the remainder of the institute’s NIH grants, including a requirement that an executive-level manager personally certify to disclosures until October 2022.  USAO WDMI

Tagged in: Certifications, FCA Federal, Grant and Research Fraud,

August 30, 2021

Northern California healthcare provider Sutter Health and its affiliated entities will pay $90 million to resolve a False Claims Act case initially filed by whistleblower Kathy Ormsby alleging that defendants submitted unsupported diagnosis codes for patients enrolled in Medicare Advantage.  Sutter contracts with Medicare Advantage Organizations to provide care to Medicare Advantage beneficiaries enrolled in their plans, and allegedly caused those MAOs to submit to Medicare inaccurate and invalid diagnosis codes that inflated the risk scores of those beneficiaries and were not supported by the medical records, thereby resulting in overpayments by CMS.  Sutter also allegedly failed to take sufficient corrective action when it became aware of the submission of these unsupported diagnosis codes.  Sutter also entered into a five-year corporate integrity agreement.  Sutter previously entered into a partial settlement of $30 million, which will be credited against the $90 million total settlement.  DOJ; USAO ND Cal

Tagged in: FCA Federal, Healthcare Fraud, Managed Care, Provider Fraud, Risk Adjustment Fraud, Upcoding, Whistleblower Case,

August 27, 2021

John Peter Smith Hospital (JPS) in Texas has agreed to pay more than $3.3 million to resolve a qui tam suit filed by its former Director of Compliance, Erma Lee, which alleged that the hospital routinely applied billing modifiers that essentially double-billed federal healthcare programs for certain aspects of patients’ care.  Even after raising the issue internally, JPS allegedly failed to reimburse payors, prompting Lee to file the case in 2018.  For doing so, Lee will receive over $900,000 of the settlement proceeds.  USAO NDTX

Tagged in: FCA Federal, Healthcare Fraud, Medical Billing Fraud, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

August 26, 2021

The owner of jet charter company All in Jets dba JetReady, Seth Bernstein, has agreed to pay $287,055 to resolve allegations that he misappropriated company Paycheck Protection Program loan proceeds for his personal use.  Whistleblower Victoria Hablitzel, a former JetReady employee, reported defendant’s conduct by filing a qui tam action, and will receive a relator’s share of $57,411.  DOJ; USAO SD FL

Tagged in: COVID-19, FCA Federal, Government Loan Programs, Whistleblower Case, Whistleblower Rewards,

August 26, 2021

Mental health and addiction services provider Connections Community Support Programs, Inc. has consented to the entry of judgment ordering payment of $15.3 million to resolve claims that it billed federal healthcare programs for mental health services performed by individuals without required professional qualification, billed using incorrect procedure codes, and failed to keep proper records regarding controlled substances.  Connections has filed for bankruptcy, and the government recovery will be limited by the availability of funds in the bankruptcy estate.  The settlement resolves claims brought in a qui tam lawsuit by two former Connections employees.  USAO Del

Tagged in: FCA Federal, Healthcare Fraud, Improper Medical Personnel, Medical Billing Fraud, Provider Fraud, Whistleblower Case,

August 26, 2021

SuperCare Health, Inc., which provides home respiratory services and DME, will pay $3.3 million to resolve claims that the company submitted false claims for non-invasive ventilators in cases where those patients were no longer using the NIVs.  The case was initiated by the filing a whistleblower complaint by a former SuperCare respiratory therapist, Benjamin Martinez.  Mr. Martinez will receive a $612,000 whistleblower reward from the federal government.  USAO CD Cal

Tagged in: FCA Federal, Healthcare Fraud, Medical Billing Fraud, Medical Devices and DME, Whistleblower Case, Whistleblower Rewards,

August 25, 2021

A California-based provider of home respiratory services and durable medical equipment has agreed to pay $3.3 million to the United States and States of California and Nevada to settle allegations of defrauding Medicare and Medicaid.  The claims against SuperCare Health, Inc. were brought in a 2018 qui tam suit by respiratory therapist Benjamin Martinez, who alleged that the provider billed for non-invasive ventilators (NIVs) that were no longer needed or being used by patients.  CA AG; USAO CDCA

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Lack of Medical Necessity, Medicaid, Medicare, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

August 25, 2021

Georgia-based psychotherapy provide Carenow Services, LLC, together with its CEO Leena Karun, will pay $2 million to resolve allegations of FCA violations through their billing for services at nursing homes that were not medically necessary, that were improperly documented, and at higher intensity levels than justified.  The investigation was initiated when a former Carenow employee filed a qui tam complaint; the whistleblower will receive an undisclosed whistleblower reward.  USAO ND Ga

Tagged in: FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Provider Fraud, SNF, Upcoding, Whistleblower Case,

August 19, 2021

Nevada Advanced Pain Specialists agreed to pay $1 million to resolve allegations that it submitted false claims for confirmatory urine drug testing performed without regard to the results of presumptive tests that had been performed. The allegations were first brought in a qui tam lawsuit filed by an whistleblower Omni Healthcare, Inc., which will receive a relator’s share of $150,000 of the settlement.  USAO MA

Tagged in: FCA Federal, Healthcare Fraud, Laboratory and IDTF, Medical Billing Fraud, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

1 … 19 20 21 22 23 24 25 … 129

Newsletter

Subscribe to receive email updates from the Constantine Cannon blogs

Sign up for: