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June 10, 2021

Three Texas-based healthcare providers who allegedly billed Medicare for non-reimbursable procedures involving electro-acupuncture devices have agreed to pay over $1 million in settle their liability under the False Claims Act.  For up to two years, each of the providers—Ledger Foot & Ankle, P.A., SPR Medical Group d/b/a Superior Physical Medicine, and Precision Spine and Pain Management—allegedly billed the application of two pain management devices, ANSiStim and STIVAX, as though they were implantable neurostimulators, when in fact their application was non-surgical and non-invasive.  Following a Medicare audit, Superior and Precision self-disclosed improperly billed claims and initiated refund payments to Medicare.  USAO WDTX

Tagged in: FCA Federal, Healthcare Fraud, Medical Billing Fraud, Medical Devices and DME, Medicare, Provider Fraud,

June 8, 2021

The chiropractor owner and operator of Texas-based Campbell Medical Group PLLC and Johnson Medical Group PLLC d/b/a Campbell Medical Clinic has agreed to pay $2.6 million to settle claims that she and the entities defrauded Medicare and TRICARE.  As part of the settlement, Suhyun An and her medical entities will be excluded from participating in federal healthcare programs for ten years.  Ms. An and the medical entities allegedly improperly obtained over $3.9 million in reimbursement for unbillable implantations of neurostimulator electrodes.  USAO SDTX

Tagged in: FCA Federal, Healthcare Fraud, Medical Billing Fraud, Medical Devices and DME, Medicare, Other Government Health Programs,

June 8, 2021

A North-Carolina-based company, Bio-Adhesive Alliance, Inc., has been ordered to pay nearly $900,000 in restitution for making false statements on grant applications submitted to the Environmental Protection Agency and National Science Foundation.  The false statements about employee roles and eligibility were made to obtain nearly $1.4 million in multiple Small Business Innovative Research (SBIR) and Small Business Technology Transfer (STTR) Program grants.  USAO MDNC

Tagged in: FCA Federal, Grant and Research Fraud,

June 4, 2021

Mark Sand & Gravel Co., a contractor on federally-funded road construction projects administered by the Minnesota Department of Transportation, has agreed to pay $1.75 million to settle claims under the federal and Minnesota False Claims Acts.  On three separate projects, Mark Sand & Gravel allegedly failed to follow contract specifications, used substandard gravel materials without authorization, and made false claims and statements regarding those materials.  USAO MN

Tagged in: Contract Non-Compliance, FCA Federal, FCA State, Government Procurement Fraud,

June 4, 2021

Virginia-based 360 Patriot Enterprises, LLC and its former minority shareholder, Delaware-based 360 Ventures LLC have agreed to pay $1.12 million to resolve allegations that they fraudulently obtained two U.S. Army contracts intended for service-disabled veteran-owned small businesses (SDVOSB).  At the time the contracts were awarded (between 2015 to 2017), 360 Patriot was not controlled by a qualified SDVOSB.  USAO EDVA

Tagged in: Defense Contract Fraud, FCA Federal, Government Procurement Fraud, Set-Asides and Preferences,

June 2, 2021

Pennsylvania-based fuel distributor Naughton Energy Corporation and two of its owners, Mariette and Joseph Naughton, have agreed to pay $692,000 over the next five years to settle claims of causing false claims to be submitted to the Department of Transportation (DOT).  As a subcontractor on the federally funded New NY Bridge Project, Naughton Energy, a Disadvantaged Business Enterprise (DBE), had represented to the prime contractor that it could deliver fuel to the worksite wholly independently.  However, lacking the requisite vehicle and employees to deliver fuel, and without the knowledge of the prime contractor, Naughton Energy arranged for a non-DBE subcontractor to supply the missing components in exchange for half of its profits from the project.  USAO SDNY

Tagged in: FCA Federal, Government Procurement Fraud, Misrepresentations, Set-Asides and Preferences,

May 27, 2021

Navistar Defense LLC, a manufacturer of military vehicles, will pay $50 million to resolve False Claims Act allegations that it fraudulently induced the U.S. Marine Corps to enter into a contract modification at inflated prices for a suspension system for armored vehicles known as Mine-Resistant Ambush Protected (MRAP) vehicles.  During negotiations for the modification, Navistar was asked to provide certain sales information to assess the reasonableness of Navistar’s proposed prices.  The U.S. alleged that Navistar provided the government with fraudulent sales invoices to justify the company’s prices, and that the government relied on these invoices during negotiations.  The investigation was initiated by a qui tam complaint filed by whistleblower Duquoin Burgess, a former Government Contracts Manager for Navistar, who will receive $11,060,000 from the settlement.  DOJ

Tagged in: Defense Contract Fraud, FCA Federal, Government Procurement Fraud, Pricing Fraud, Whistleblower Case, Whistleblower Rewards,

May 26, 2021

HEAG Pain Management Center, P.A. (HEAG) and its owner, Dr. Kwadwo Gyarteng-Dakwa (Dr. Dakwa), have agreed to pay $500,000 to settle allegations of defrauding Medicare and Medicaid.  According to the government, the defendants knowingly submitted or caused the submission of claims for medically unnecessary diagnostic testing between 2011 and 2016.  AG NC; USAO MDNC

Tagged in: FCA Federal, Healthcare Fraud, Improper Medical Personnel, Lack of Medical Necessity, Medicaid, Medicare, Provider Fraud,

May 25, 2021

Upper Allegheny Health System (UAHS), which operates dental clinics in New York and Pennsylvania, has agreed to pay $2.7 million to resolve whistleblower-brought allegations of submitting false claims to Medicaid in violation of the federal and New York False Claims Acts.  Between 2010 and 2015, UAHS had billed Medicaid for dental services performed using improperly sterilized handpieces, which are considered semi-critical devices and need to be properly heat sterilized between patients.  AG NY; USAO WDNY; USAO WDPA

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Medicaid, Medical Devices and DME, Provider Fraud, Whistleblower Case,

May 21, 2021

SavaSeniorCare LLC and related entities (“Sava”) will pay $11.2 million, plus potentially more pursuant to an “ability-to-pay” settlement, to resolve allegations that Sava violated the False Claims Act by causing its skilled nursing facilities to bill Medicare for rehabilitation therapy services that were not reasonable, necessary, or skilled, and that Sava billed the Medicare and Medicaid programs for grossly substandard (i.e., “worthless”) skilled nursing services.  The settlement stems from four separate qui tam complaints filed by whistleblowers Rita Hayward, Trammel Kukoyi, Terrence Scott, James Thornton, and Barbara Roberts, who will share an undisclosed portion of the government’s recovery.  In 2015, the United States intervened in the litigation and filed a consolidated False Claims Act complaint, alleging inter alia that Sava had exerted significant pressure on its skilled nursing facilities to meet unrealistic corporate targets for the highest Medicare reimbursement rates without regard to patients’ actual clinical needs, and improperly delayed the discharge of patients from its facilities in order to increase billings.  Sava will enter into a five-year Corporate Integrity Agreement as part of the settlement.  DOJ

Tagged in: FCA Federal, Healthcare Fraud, Improper Medical Personnel, Lack of Medical Necessity, Medicaid, Medicare, SNF, Upcoding, Whistleblower Case,

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