By the C|C Whistleblower Lawyer Team
Sierra Nevada Corporation (“SNC”) agreed to settle False Claims Act allegations it misclassified costs—thus inflating its overhead—on several government contracts. The Nevada-based company has several defense and space contracts with the United States. The company’s current flagship project is the design and construction of the “Dream Chaser,” a NASA-funded...
By the C|C Whistleblower Lawyer Team
Yesterday, U.S. District Judge Christopher Cooper in Washington refused to throw out the $100 million lawsuit brought by the United States against former cycling icon Lance Armstrong, clearing the way for trial. The lawsuit was originally brought under the whistleblower provisions of the False Claims Act by Armstrong's former teammate Floyd Landis. Landis and the government...
By the C|C Whistleblower Lawyer Team
U.S. hospital service provider TeamHealth Holdings agreed to pay $60 million to settle charges its predecessor company IPC Healthcare Inc. violated the False Claims Act by billing Medicare, Medicaid, the Defense Health Agency and the Federal Employees Health Benefits Program for higher and more expensive levels of medical service than were actually performed. See DOJ Press...
By the C|C Whistleblower Lawyer Team
Dr. Robert Windsor, the owner of several Kentucky and Georgia pain management clinics operating under the umbrella of National Pain Care, Inc., agreed to a $20 million consent judgment resolving government allegations he billed federal health care programs for surgical monitoring services he did not perform, and for medically unnecessary diagnostic tests. To satisfy the...
By the C|C Whistleblower Lawyer Team
A recently-released report from Department of Health and Human Services Office of the Inspector General (HHS-OIG) revealed potentially serious problems related to Medicare beneficiary stays in inpatient rehabilitation hospitals. Such hospitals—either standalone or included as distinct units within general-purpose hospitals—are designed to address the needs of patients who...
By the C|C Whistleblower Lawyer Team
We’ve covered Medical Loss Ratio (MLR) minimum requirements before. The MLR is, generally, the percentage of premium revenues an insurer spends on clinical services and quality improvements as opposed to on things like executive salaries, overhead, or marketing. Requiring a minimum MLR standard, something that the Federal Medicare Program does and several State Medicaid...
By Hallie Noecker
Last Thursday, the Ninth Circuit issued United States ex rel. Kelly v. Serco, Inc., the latest in a series of False Claims Act decisions—including in the First, Seventh, and Eighth Circuits—wrestling with the Supreme Court’s holding on materiality in Universal Health Services, Inc. v. United States ex rel. Escobar. Citing Escobar’s “rigorous” and “demanding” materiality standard,...
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to Ireland-based Shire Pharmaceuticals LLC. On Wednesday, the company and certain subsidiaries agreed to pay $350 million to settle charges that Shire and the company it acquired in 2011, Advanced BioHealing (ABH), violated the False Claims Act and Anti-Kickback Statute by using kickbacks and other unlawful methods to...
By the C|C Whistleblower Lawyer Team
Here is our look-back at the top-10 Department of Justice False Claims Act recoveries in 2016 for violations of the Anti-Kickback Statute and/or the Stark Law. Click here for a full chronological listing of all the DOJ False Claims Act recoveries in 2016.
By the C|C Whistleblower Lawyer Team
Here is our look-back at the top-10 Department of Justice False Claims Act recoveries for 2016.
10. Vibra Healthcare -- The Pennsylvania-based hospital chain agreed to pay $32.7 million to resolve claims it violated the False Claims Act by billing Medicare for medically unnecessary services by admitting patients to its long term care hospitals and rehab facilities who did not...