Archive

July 17, 2017

Former Olympia Therapy Inc. employee Vladimir Trakhter and former Tridia Hospice Care Inc. employees Paula Bourne and La’Tasha Goodwin will collectively receive a whistleblower award of more than $3.6 million from the roughly $19.5 million Olympia, Tridia and Foundations Health Solutions Inc. agreed to pay to resolve allegations they violated the False Claims Act by submitting to Medicare claims for medically unnecessary rehabilitation therapy services and for hospice services to patients not eligible for the Medicare benefit, and by soliciting and receiving kickbacks to refer patients from their skilled nursing facilities to home health care provider Amber Home Care LLC.

July 6, 2017

Cathy Morris and Josie King, former employees of Compassionate Care Hospice of Atlanta, will receive a yet-to-be-determined whistleblower award from the $24 million the company and its parent Compassionate Care Hospice Group, Inc. agreed to pay to resolve charges they violated the False Claims Act and Stark Law by engaging in improper financial relationships with contracted physicians to induce them to refer patients.  DOJ (NDGA)

June 28, 2017

Paul Chan will receive a whistleblower award of more than $9.2 million from the $42 million to be paid by PAMC Ltd. and Pacific Alliance Medical Center Inc. (which together own and operate Los Angeles acute care hospital Pacific Alliance Medical Center) to settle charges they violated the False Claims Act and the Stark Law by engaging in improper financial relationships with referring physicians.  DOJ

June 20, 2017

New Jersey family doctor Bernard Greenspan was sentenced to 41 months in prison and to pay a $125,000 fine and a roughly $200,000 forfeiture for violating the Anti-Kickback Statute by accepting bribes in exchange for test referrals as part of a long-running scheme operated by Biodiagnostic Laboratory Services LLC, its president and numerous associates. Greenspan’s referrals generated approximately $3 million in lab business for BLS. DOJ (DNJ)

June 15, 2017

Magdiel Garcia and the durable medical equipment company he owned, MAK Healthcare PC (d/b/a Multicare Plus), agreed to pay $225,000 to settle claims they violated the False Claims Act and The Stark Law by improperly self-referring Medicare beneficiaries for services and equipment to MAK. DOJ (EDPA)

June 14, 2017

Mildrey Gonzalez and her daughter Milka Alfaro were sentenced to 135 and 151 months in prison, respectively, and to pay roughly $22.9 million in restitution for their roles in a $20 million Medicare fraud conspiracy that involved paying illegal health care kickbacks to patient recruiters and medical professionals. They previously admitted they secretly co-owned and operated seven home health agencies in the Miami area, yet failed to disclose their ownership interests in any of these agencies to Medicare, as required by relevant rules and regulations. They further admitted to paying illegal health care kickbacks to a network of patient recruiters in order to bring Medicare beneficiaries into the scheme, to paying bribes and kickbacks to medical professionals in return for providing home health referrals, and to directing co-conspirators to open shell corporations, into which millions of dollars’ worth of fraud proceeds were funneled. DOJ

May 18, 2017

Missouri health care providers Mercy Hospital Springfield and its affiliate Mercy Clinic Springfield Communities agreed to pay $34 million to settle charges they violated the False Claims Act by engaging in improper financial relationships with referring physicians.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Mercy physician Dr. Viran Roger Holden.  Dr. Holden will receive a whistleblower award of $5,440,000 from the proceeds of the government's recovery. DOJ

April 28, 2017

New Jersey-based Quest Diagnostics Inc. agreed to pay $6 million to resolve charges that Berkeley HeartLab Inc., which Quest acquired in 2011, violated the False Claims Act by paying kickbacks to physicians and patients to induce the use of Berkeley for blood testing services and by charging for medically unnecessary tests. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Dr. Michael Mayes. He will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery. DOJ

April 27, 2017

Indiana University Health Inc. (IU Health) and HealthNet Inc. agreed to pay a total of $18 million to resolve allegations they violated the False Claims Act by engaging in an illegal kickback scheme related to the referral of HealthNet’s OB/GYN patients to IU Health’s Methodist Hospital. According to the government, IU Health provided HealthNet with an interest-free line of credit, the balance of which consistently exceeded $10 million. The government further charged that HealthNet was not expected to repay a substantial portion of this loan and that this financial arrangement was intended to induce HealthNet to refer its OB/GYN patients to IU Health’s Methodist Hospital. DOJ

April 25, 2017

Braden Partners, L.P. (d/b/a Pacific Pulmonary Services) agreed to pay $11.4 million to resolve allegations against it and its general partner, Teijin Pharma USA LLC, for violating the False Claims Act by submitting claims for reimbursement to Medicare and other federal healthcare programs for oxygen and related equipment supplied in violation of program rules, and for sleep therapy equipment supplied as part of a cross-referral kickback scheme with sleep clinics. According to the government, Pacific Pulmonary submitted claims to the Medicare, TRICARE and Federal Employee Health Benefits programs for home oxygen and oxygen equipment without obtaining the required physician authorization. The government further charged that certain of the company’s patient care coordinators agreed to make patient referrals to sleep testing clinics in exchange for those clinics’ agreement to refer patients to Pacific Pulmonary for sleep therapy equipment in violation of the Anti-Kickback Act. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Manuel Alcaine, a former sales representative of Pacific Pulmonary. Mr. Alcaine will receive a whistleblower award of roughly $1.8 million from the proceeds of the government's recovery. DOJ