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August 15, 2019

Alabama-based Baldwin Bone & Joint, P.C. (BB&J) has settled a False Claims Act action for $1.2 million.  According to the whistleblower who initiated the action, former BB&J employee John Seddon, BB&J submitted claims to Medicare and TRICARE for physical therapy services performed by unauthorized providers, and compensated shareholder physicians based on the volume of physicians’ internal referrals.  As part of the settlement, Seddon will receive a $200,000 relator’s share.  USAO SDAL

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medicare, Other Government Health Programs, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

August 8, 2019

California-based Beaver Medical Group LP and one of its physicians, Dr. Sherif Khalil, have agreed to pay $5 million to resolve allegations of violating the False Claims Act.  According to another physician formerly employed at Beaver, the defendants allegedly submitted false diagnoses to Medicare Advantage Organizations (MAOs) for the Medicare beneficiaries under its care, which caused Medicare to pay a needlessly inflated rate of reimbursement.  The whistleblower, Dr. David Nutter, will receive a relator’s share of $850,000 from the settlement proceeds.  DOJ

Tagged in: FCA Federal, Healthcare Fraud, Medicare, Whistleblower Case, Whistleblower Rewards,

August 1, 2019

Tennessee-based telemarketer Scott Roix and his companies have agreed to pay $2.5 million to settle two whistleblowers’ False Claims suit alleging the submission of false claims to Medicare, TRICARE, and other federal health benefit programs.  Roix and his companies allegedly procured fraudulent insurance information from patients around the country in order to arrange prescriptions for medically unnecessary pain creams; they then sold these prescriptions to pharmacies, labeling proceeds as earned through marketing services.  The whistleblowers in this case, Jennifer Silva and Jessica Robertson, will receive $287,500 for revealing the fraudulent scheme.  USAO MDFL

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medicare, Other Government Health Programs, Whistleblower Case, Whistleblower Rewards,

July 24, 2019

Pennsylvania-based Eagleville Hospital has agreed to pay $2.85 million to settle allegations of defrauding Medicare, Medicaid, and the Federal Employees Health Benefits Program.  According to an anonymous relator, Eagleville violated the False Claims Act between 2011 and 2018 by submitting claims for substance abuse patients improperly admitted for high paying, hospital-level detoxification treatments.  The whistleblower will receive $500,000 of the recovery.  USAO EDPA

Tagged in: FCA Federal, Healthcare Fraud, Hospital Fraud, Medicaid, Medicare, Other Government Health Programs, Upcoding, Whistleblower Case, Whistleblower Rewards,

July 23, 2019

An international whistleblower has been awarded half a million dollars for helping the SEC with a successful enforcement action.  Pursuant to the Dodd-Frank Act, the whistleblower’s identity was not revealed.  SEC

Tagged in: SEC Whistleblower Reward Program, Whistleblower Rewards,

July 16, 2019

A government contractor has agreed to pay $11 million to settle False Claims allegations of directly and indirectly supplying improperly tested electrical connectors to the U.S. military.  According to Ralph Tatgenhorst, a former regional quality manager for ITT Cannon, the company repeatedly failed to test six different models of connectors even after the government learned of the failure, and even after the company promised it would conduct remedial testing.  For coming forward with a successful qui tam case, Tatgenhorst will receive a relator’s share of $2 million.  DOJ; USAO CDCA

Tagged in: Contract Non-Compliance, Defense Contract Fraud, Government Procurement Fraud, Whistleblower Case, Whistleblower Rewards,

July 10, 2019

Overstock.com has been ordered by a Delaware court to pay $7.3 million following a jury verdict against it on claims that the online retailer misrepresented its disposition of abandoned gift card balances to Delaware's revenue agency in order to avoid obligations under the Delaware escheat law, which requires that Delaware-chartered companies turn over unclaimed assets to the state.  The case was brought by whistleblower William Sean French, a former employee of a gift card company, under the Delaware False Claims and Reporting Act. DEL (note: the trial court judgment was reversed by the Delaware Supreme Court in an opinion issued June 24, 2020)

Tagged in: FCA State, Government Programs Fraud, Whistleblower Case, Whistleblower Rewards,

July 10, 2019

Rural Metro of Southern Ohio, Inc. has agreed to pay $275,116 to resolve allegations of submitting, or causing the submission of, false claims to Medicare.  In a qui tam suit brought by Nicholas Ratterman, a former employee, Rural Metro was alleged to have billed Medicare for medically unnecessary overnight hospital discharge ambulance transports between 2013 to 2017.  As part of the settlement, Ratterman will receive about $44,000.  USAO EDKY

Tagged in: Ambulance, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Medicare, Whistleblower Case, Whistleblower Rewards,

July 1, 2019

Two whistleblowers have been jointly awarded $2 million for their significant contributions to the CFTC.  In addition to coming forward and providing numerous interviews and documents, the whistleblowers also reported the violations to another agency, which conducted its own investigation and shared its findings with the CFTC.  CFTC

Tagged in: CFTC Whistleblower Reward Program, Whistleblower Rewards,

June 28, 2019

Following a whistleblower suit, defense contractor PAE Applied Technologies, LLC has agreed to pay $4.2 million to settle charges that it knowingly defrauded the U.S. Air Force in violation of the False Claims Act.  The alleged fraud occurred between government fiscal years 2009 to 2014 and involved charging for employee wages that were above the applicable wage caps listed on a government contract.  USAO WDOK

Tagged in: Defense Contract Fraud, Falsifying Invoices, FCA Federal, Whistleblower Case, Whistleblower Rewards,

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