Archive

May 9, 2022

Prism Behavioral Solutions has agreed to pay $650,000 to resolve allegations of violating the federal and California False Claims Acts by billing California’s Medicaid program for services not provided to autistic children and young adults. The whistleblower in this case, Diana Mason, is a behavioral analyst employed by Prism, and will receive a $170,000 share of the settlement. USAO SDCA; CA AG

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

April 12, 2022

Providence Health & Services Washington has agreed to pay $22.7 million to settle allegations of submitting false claims to Medicare, Medicaid, and TRICARE. According to an unnamed whistleblower, who will receive a $4.2 million relator’s share, the hospital allegedly gave their neurosurgeons volume-based financial incentives to perform complex surgeries, thereby incentivizing two neurosurgeons to perform an excessive number of complex surgeries on inappropriate candidates without regard to medical necessity or patient safety, and ultimately causing an excessive level of complications. USAO EDWA

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

March 25, 2022

Two New York-based home health agencies, All American Homecare Agency and Crown of Life Care NY LLC, have agreed to pay a total of $5.4 million to settle allegations of violating federal and state False Claims Acts. The agencies had allegedly paid their home health aides below minimum wage, despite claiming otherwise and receiving millions for said wages from Medicaid. In addition to the monetary penalties, the agencies will also pay back wages owed to current and former aides. NY AG; USAO EDNY

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Home Health and Hospice,

March 7, 2022

Redwood Toxicology Laboratory has agreed to pay nearly $4.8 million to settle allegations that the California-based urine drug testing service overcharged the Connecticut Medicaid program for certain laboratory services, in violation of Connecticut’s “Most Favored Nation” regulation, which provides that the state should not be charged more than the lowest price charged to third parties. The settlement covered claims submitted between January 2015 through February 2018. USAO CT

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Laboratory and IDTF, Medicaid, Medical Billing Fraud,

March 3, 2022

Multiple chemical companies agreed to pay a collective total of $11.7 million to resolve claims by state and local entities that from 1997 through at least 2011, they participated in a nationwide conspiracy to allocate territories and customers, unlawfully rig bids, and fix prices paid by government entities for the purchase of coagulant liquid aluminum sulfate, a chemical used in water treatment and purification. The defendants include General Chemical entities, GenTek, Inc., Chemtrade entities, GEO Specialty Chemicals, Inc., C&S Chemicals, Inc., USALCO, LLC, Delta Chemical Corporation, and American Securities, LLC. The Commonwealth of Virginia recovered $1.1 million in a whistleblower case initiated under the Virginia Fraud Against Taxpayers Act by Lawrence McShane. VA

Tagged in: Bribery and Bid-Rigging, FCA State, Government Procurement Fraud, Whistleblower Case,

February 11, 2022

Transportation company Academy Bus, LLC, together with related entities and individuals, will pay $20.5 million to resolve claims brought in a whistleblower lawsuit under New Jersey’s False Claims Act that the defendants defrauded New Jersey Transit, for whom defendants operated bus routes. Defendants were paid by NJ Transit based, in part, on miles and hours driven, with deductions for missed bus trips; they were alleged to have over-reported miles and hours driven, and underreported their missed bus trips to the state. The settlement also required Academy to implement specific compliance procedures. The whistleblower, former Academy employee Hector Peralta, will receive an award totaling $3.9 million. NJ

Tagged in: Certifications, Contract Non-Compliance, FCA State, Government Procurement Fraud, Whistleblower Case, Whistleblower Rewards,

January 6, 2022

Centene Corporation will pay $21.15 million to resolve claims that the pharmacy benefit manager inaccurately reported its services and costs to New Hampshire’s Medicaid Care Management Program, resulting in overcharges to the state. NH (related settlements with Ohio, Mississippi, and Kansas)

Tagged in: Drug and DME Pricing, FCA State, Healthcare Fraud, Medicaid, Pharma Fraud,

December 6, 2021

Pharmacy benefit manager Centene Corp. will pay $27.6 million to the State of Kansas to resolve allegations that it failed to satisfy its obligation to represent the state’s best interests in negotiations with companies that supply drugs to the state Medicaid program, failed to accurately report discounts it received from CVS-Caremark on certain retail pharmacy claims, and artificially inflated dispensing-fee amounts reported to state regulators. The state alleged that Centene used an opaque reporting system that made it difficult for the state to determine the nature and appropriateness of certain pharmacy transactions. As part of the settlement, Centene also agreed to change certain business practices to ensure greater transparency. KS

Tagged in: Drug and DME Pricing, FCA State, Healthcare Fraud, Pharma Fraud,

November 29, 2021

General contractor J.A. McDonald, Inc. has agreed to pay $637,500 to settle allegations of presenting false claims to the United States and State of Vermont in connection with the federally-funded construction of several bridges. Employees at the company allegedly made material alterations, then took steps to conceal those alterations from the Vermont Agency of Transportation, which then caused the agency to submit false claims to the Federal Highway Administration. USAO VT

Tagged in: FCA Federal, FCA State, Government Procurement Fraud,

November 22, 2021

Seven financial institutions – Barclays Capital Inc., Citigroup Global Markets Inc., Goldman Sachs & Co. LLC, J.P. Morgan Securities LLC, Merrill Lynch, Pierce, Fenner & Smith Incorporated, NatWest Markets Securities Inc., and Washington Mutual Mortgage Securities Corp. – have agreed to collectively pay $32.5 million to resolve claims by New Mexico that the banks did not adequately disclose the characteristics of certain mortgage-backed securities sold to New Mexico pension funds and a state-run investment council between 2003 and 2010. The settlement resolves a qui tam action under the New Mexico Fraud Against Taxpayers Act brought by Integra REC, LLC. NM

Tagged in: FCA State, Financial Institution Fraud, Housing and Mortgage Fraud, Whistleblower Case,

Contact

Click here for a confidential contact or call: