Archive

January 30, 2018

Tampa’s largest ambulance providers AmeriCare Ambulance Service, Inc. and its sister company AmeriCare ALS, Inc. agreed to pay roughly $5.5 million to settle claims they violated the False Claims Act by billing Medicare for medically unnecessary ambulance transportation services. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former AmeriCare employee Ernest Sharp. He will receive a whistleblower award of roughly $1.15 million from the proceeds of the government’s recovery. DOJ (MDFL)

January 25, 2018

Primex Clinical Laboratories, LLC agreed to pay $3.5 million to settle claims it violated the False Claims Act and Anti-Kickbacks Statue by paying kickbacks in exchange for laboratory referrals for patient pharmacogenetic testing. The allegations originated by a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former sales reps Don Pyburn and David Choate. They will receive a whistleblower award of $754,000 from the proceeds of the government’s recovery. DOJ (NDTX)

January 24, 2018

Tennessee chiropractor Matthew Anderson agreed to pay $1.45 million to resolve allegations he violated the False Claims Act. Specifically, the government alleged that Anderson and his management company, PMC LLC, caused pharmacies to submit requests for Medicare and TennCare payments for pain killers dispensed based upon prescriptions written at the Cookeville Center for Pain Management, one of the pain clinics Anderson managed, which had no legitimate medical purpose. The government further alleged that Anderson caused four pain clinics he managed to bill Medicare for upcoded claims for office visits that were not reimbursable at the levels sought. The allegations originated in a whistleblower lawsuit filed by a former office manager for the Cookeville Center for Pain Management under the qui tam provisions of the False Claims Act. The whistleblower will receive a whistleblower award of $246,500 from the proceeds of the government's recovery. DOJ

January 19, 2018

San Diego-based health care system Scripps Health agreed to pay $1.5 million to resolve allegations it violated the False Claims Act by charging federal health care programs for physical therapy services that were rendered by therapists who did not have billing privileges for these programs and were not supervised by an authorized provider. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Scripps employee Suzanne Forrest. She will receive a whistleblower award of $225,000 from the proceeds of the government's recovery. DOJ

January 16, 2018

Virginia-based home furnishings company Bassett Mirror Company agreed to pay $10.5 million to resolve allegations it violated the False Claims Act by knowingly making false statements on customs declarations to avoid paying antidumping duties on wooden bedroom furniture imported from China. According to the government, Bassett Mirror evaded antidumping duties owed on wooden bedroom furniture imported from China by misclassifying the furniture as non-bedroom furniture which at the time of the alleged conduct was not subject to an antidumping duty. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Kelly Wells, an Alabama merchant who sells furniture on line. Ms. Wells will receive a whistleblower award of roughly $1.9 million from the proceeds of the government's recovery. DOJ

January 11, 2018

Textile importer American Dawn, Inc. and its executives Habib Rawjee, Mahmud Rawjee, and Adnan Rawjee, agreed to pay roughly $2.3 million to resolve allegations of violating the False Claims Act by intentionally misclassifying certain textiles such as bath and shop towels imported into the United States in order to pay lower tariff rates. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a former employee of American Dawn. The whistleblower will receive an award of roughly $400,000 from the proceeds of the government's recovery. DOJ (NDGA)

January 10, 2018

Dental management company Benevis LLC (formerly known as NCDR LLC), and more than 130 of its affiliated Kool Smiles dental clinics for which Benevis provides business management and administrative services, agreed to pay $23.9 million to settle allegations of violating the False Claims Act by submitting false claims for payment to state Medicaid programs for medically unnecessary dental services performed on children insured by Medicaid.  According to the government, Benevis and Kool Smiles clinics located throughout 17 states submitted false claims to state Medicaid programs for medically unnecessary pulpotomies (baby root canals), tooth extractions, and stainless steel crowns, in addition to seeking payment for pulpotomies that were never performed.  The government further alleged that Kool Smiles clinics routinely pressured and incentivized dentists to meet production goals through a system that disciplined “unproductive” dentists and awarded “productive” dentists with substantial cash bonuses based on the revenue generated by the procedures they performed.  The allegations originated in five whistleblower lawsuits filed under the qui tam provisions of the False Claims Act.  Three of the whistleblowers -- former Kool Smiles employees Adam Abendano, Poonam Rai, and Robin Fitzgerald -- will receive a whistleblower award of more than $2.4 million from the proceeds of the government's recovery. DOJ

December 5, 2017

The Securities and Exchange Commission announced an award of more than $4.1 million to a former company insider who alerted the agency to a widespread, multi-year securities law violation and continued to provide important information and assistance throughout the SEC’s investigation. The whistleblower is the third awarded by the SEC in the past week. “Company insiders often have valuable information that can help the SEC halt an ongoing securities law violation and better protect investors,” said Jane Norberg, Chief of the SEC’s Office of the Whistleblower. “The breadth of the SEC’s whistleblower program is demonstrated by this case, where the whistleblower, a foreign national working outside of the United States, affirmatively stepped forward to shine a light on the wrongdoing.” SEC

November 30, 2017

The Securities and Exchange Commission  announced awards of more than $8 million each to two whistleblowers whose critical information and continuing assistance helped the agency bring the successful underlying enforcement action. With this case, SEC enforcement actions involving whistleblower awards have now resulted in more than $1 billion in financial remedies ordered against wrongdoers. The first whistleblower alerted SEC enforcement staff of the particular misconduct that would become the focus of the staff’s investigation and the cornerstone of the agency’s subsequent enforcement action.  The second whistleblower provided additional significant information and ongoing cooperation to the staff during the investigation that saved a substantial amount of time and agency resources. SEC

January 4, 2018

Kmart Corporation agreed to a $1 million settlement with the California Department of Insurance to resolve a whistleblower claim brought under the California Insurance Fraud Prevention Act.  KMart contracted with insurance companies to be reimbursed at a rate based on the company's charges to cash-paying customers, but was alleged to have submitted claims to private insurers in amounts that exceeded the agreed-upon rates.  CA