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November 23, 2020

A former Purdue University professor and his wife have been sentenced to 2 years’ probation each after pleading guilty to defrauding the National Science Foundation (NSF).  Additionally, Dr. Qingyou Han and Lu Shao have been ordered to pay over $1.6 million in restitution to NSF and the Indiana Economic Development Corporation, which had provided Shao’s company, Hans Tech, LLC with a matching grant.  As part of the guilty plea, Han and Shao admitted to devising a scheme to obtain grant money under NSF’s Small Business Innovation Research (SBIR) program and Small Business Technology Transfer (STTR) program by making false statements and material omissions.  Instead, they used the funds to enrich themselves and their children.  USAO NDIN

Tagged in: FCA Federal, Grant and Research Fraud,

November 20, 2020

Information technology contractor Cognosante, LLC will pay $19 million to resolve allegations that it violated the False Claims Act by overcharging the government under two GSA Multiple Award Schedule contracts.  The settlement came after Cognosante disclosed to the U.S. that it provided false information concerning its commercial discounting practices during contract negotiations and, during contract performance, charged the government for labor that failed to meet the qualifications set forth in the contracts.  DOJ; USAO DC

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

November 20, 2020

Mori, Bean and Brookes, P.A. (MBB), a Florida-based radiology practice, has agreed to pay $1.4 million to resolve allegations of violating the False Claims Act.  In a qui tam suit by Thomas Heyck, a radiologist formerly employed at MBB, the practice improperly billed Medicare and Medicaid for radiological images that were interpreted outside the U.S., which are not eligible for reimbursement.  MBB also submitted claims for images that were initially interpreted overseas, then reinterpreted and billed to a domestic radiologist.  For blowing the whistle, Heyck will receive a 19% relator’s share.  USAO MDFL

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

November 19, 2020

Johnson & Johnson (J&J) subsidiary Medical Device Business Services, Inc. (MDBS) has agreed to pay $10 million to settle allegations that a former J&J subsidiary, Therakos, Inc., promoted two medical devices for unapproved uses in pediatric patients.  A second entity, The Gores Group (TGG), agreed to pay $1.5 million to settle allegations of continuing to promote the devices for unapproved uses after it acquired Therakos in 2012.  In an action initiated by a whistleblower, the government alleged that between 2006 and 2015, Therakos improperly promoted its extracorporeal photopheresis (ECP) systems, used to treat cutaneous T-cell lymphoma, for use in children despite the fact that no ECP devices had been approved for that population.  In so doing, Therakos allegedly caused false claims to be submitted to Medicaid, the Federal Employee Health Benefits Program, and TRICARE, in violation of the False Claims Act.  The total settlement funds were divided between federal and state governments.  USAO EDPA; CA

Tagged in: FCA Federal, Medicaid, Medical Devices and DME, Off-Label and Unapproved Use, Other Government Health Programs, Whistleblower Case,

November 16, 2020

Seattle’s Group Health Cooperative, now part of Kaiser, will pay $6.375 million to settle allegations in a whistleblower suit that it falsely reported unsupported diagnosis codes to Medicare in order to receive inflated payments.  The suit alleges that GHC utilized the services of a coding review company, DxID, that proposed unsupported diagnosis codes, which GHC knowingly submitted to CMS as part of seeking higher payment for the affected Medicare Advantage beneficiaries.  Whistleblower Teresa Ross, represented by Constantine Cannon, will receive approximately $1.5 million.  DOJ

Tagged in: FCA Federal, Healthcare Fraud, Managed Care, Medical Billing Fraud, Medicare, Risk Adjustment Fraud, Whistleblower Case, Whistleblower Rewards,

October 30, 2020

Days and Towers, LLC will pay over $800,000 to resolve charges that it violated the False Claims Act between 2015 and 2019 through its submission of false tariff schedules to reduce its customs obligations on imported products.  USAO PR

Tagged in: Customs Fraud, FCA Federal,

October 29, 2020

Long Island construction company VJ Associates will pay $3.13 million to resolve criminal and civil charges alleging that the company overbilled government projects, including by adding bogus time charges on government billing and adding hundreds of thousands of unnecessary costs.  The company has agreed to permanent debarment from receipt of federal funds.  The investigation was initiated by an unnamed whistleblower, who will receive 22.5% of the recovery.  USAO MA; 2021 state settlement

Tagged in: Falsifying Invoices, FCA Federal, Government Procurement Fraud, Whistleblower Case, Whistleblower Rewards,

October 29, 2020

Medtronic has agreed to pay over $9.2 million to resolve allegations of violating the False Claims Act and CMS’s Open Payments Program by paying kickbacks to a South Dakota-based neurosurgeon, Wilson Asfora, M.D., in order to induce sales of its SynchroMed II implantable intrathecal infusion pumps.  According to the government, Medtronic allegedly sponsored nine years’ worth of events at a restaurant owned by Asfora, and to which Asfora would invite his acquaintances, business partners, trusted colleagues, and referral sources.  For his role in the kickback scheme, Asfora has been named in a separate FCA lawsuit, which the United States joined last November.  USAO SD

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medical Devices and DME, Medicare,

October 22, 2020

Guild Mortgage Company, based in San Diego, has agreed to pay $25 million to resolve whistleblower-brought allegations of knowingly breaching material program requirements in connection with mortgages insured by the Federal Housing Administration (FHA).  As a participant of the FHA’s mortgage insurance program, Guild had the authority to originate and underwrite mortgages without government review for compliance with program rules.  According to the former head of quality control, Kevin Dougherty, Guild failed to comply with those rules when it knowingly approved ineligible loans that later defaulted.  Dougherty will receive a relator’s share of nearly $5 million.  USAO SDCA

Tagged in: FCA Federal, Housing and Mortgage Fraud, Whistleblower Case, Whistleblower Rewards,

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