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June 16, 2021

Bedrock Group LLC agreed to pay $3.5 million to Massachusetts to resolve allegations that the company violated the Massachusetts False Claims Act by failing to fully and timely refund the state following the company's failure to deliver one million N95 masks ordered by the state.  Massachusetts placed an emergency purchase order with the company, agreeing to pay $3.6 million for the one million masks, which were to be delivered by April, 2020.  The company delivered fewer than 100,000 masks and, after the state cancelled the purchase order, failed to refund the state's payment. Bedrock also agreed to a voluntary debarment from contracting with the state or any political subdivision for five years.   MA

Tagged in: Contract Non-Compliance, COVID-19, FCA State, Government Procurement Fraud,

June 14, 2021

Centene Corp. will pay a total of $143.8 million to resolve claims by Ohio and Mississippi that it overbilled the states' Medicaid programs in its role as a pharmacy benefit manager.  The states alleged that Centene engaged in practices including "spread pricing," charging more than allowed price caps based on industry standards, inflation of dispensing fees, failure to disclose discounts received, and claiming reimbursement for prescriptions already paid for by third parties.  Ohio will receive $88.3 million, and Mississippi will receive $55.5 million.  OH; MS

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

June 4, 2021

Mark Sand & Gravel Co., a contractor on federally-funded road construction projects administered by the Minnesota Department of Transportation, has agreed to pay $1.75 million to settle claims under the federal and Minnesota False Claims Acts.  On three separate projects, Mark Sand & Gravel allegedly failed to follow contract specifications, used substandard gravel materials without authorization, and made false claims and statements regarding those materials.  USAO MN

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

May 25, 2021

Upper Allegheny Health System (UAHS), which operates dental clinics in New York and Pennsylvania, has agreed to pay $2.7 million to resolve whistleblower-brought allegations of submitting false claims to Medicaid in violation of the federal and New York False Claims Acts.  Between 2010 and 2015, UAHS had billed Medicaid for dental services performed using improperly sterilized handpieces, which are considered semi-critical devices and need to be properly heat sterilized between patients.  AG NY; USAO WDNY; USAO WDPA

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Medicaid, Medical Devices and DME, Provider Fraud, Whistleblower Case,

May 19, 2021

Latisha Harron of North Carolina has been sentenced to over 14 years in prison and ordered to pay over $13 million in restitution after pleading guilty to charges of defrauding the North Carolina Medicaid Program, aggravated identity theft, and money laundering.  Together with husband Timothy Harron, the defendant scoured obituaries for recently deceased Medicaid recipients and billed Medicaid for up to a year of home health services that were allegedly provided to the deceased by her company, Agape Healthcare Services, Inc.  By concealing the fact that both Harrons were previously convicted felons, the defendant was able to obtain millions in reimbursements, which she then laundered into expenses such as business properties, a private jet, clothing and jewelry, and gym equipment.  NC AG; Subsequent proceeding

Tagged in: Criminal Proceedings, FCA State, Healthcare Fraud, Home Health and Hospice, Medicaid,

May 19, 2021

In one of the first settlements to resolve allegations under both the False Claims Act and the Open Payments Program (formerly the “Sunshine Act”), French medical device manufacturer Medicrea International and its American affiliate, Medicrea USA Inc., have agreed to pay $2 million to resolve whistleblower Dory Frain’s allegations that the companies violated the Anti-Kickback Statute while entertaining U.S.-based physicians at a conference in France in 2013.  The settlement also resolves allegations that the companies violated the Open Payments Program by failing to report those expenses to the Centers for Medicare & Medicaid Services.  USAO EDPA; CA AG; FL AG

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

May 14, 2021

Texas dentists Gunjan Dhir and Gaurav Puri and their affiliated management companies and practice groups will pay $3.1 million to resolve allegations that they fraudulently charged the Texas Medicaid program for pediatric dental services.  The investigation was initiated by the filing of a qui tam complaint by whistleblowers Sandy Puga, Nelda Torres-Brown, and Sonia Cardoso, who were former employees of defendants and will receive an undisclosed share the settlement.  Defendants allegedly billed for services that were not actually provided and/or misreported the provider of services by using erroneous Medicaid provider numbers.  USAO ND Texas

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

May 12, 2021

Wireless communications provider Assurance Wireless, a subsidiary of Sprint (now T-Mobile), will pay $1.6 million to resolve claims under the Oregon False Claims Act that it overcharged low-income Oregonians purchasing voice and broadband service under the Oregon Lifeline program, which is funded with federal and state subsidies.  The settlement follows an FCC enforcement action that resulted from the state's investigation.  OR

Tagged in: FCA State, Government Programs Fraud,

April 21, 2021

Tennessee-based Anesthesia Services Associates, PLLC d/b/a Comprehensive Pain Specialists (CPS) and its four majority owners have agreed to pay a total of $4.1 million to resolve allegations of violating the federal False Claims Act and Tennessee Medicaid False Claims Act.  According to the government, CPS billed Medicare and TennCare for medically unnecessary or non-reimbursable genetic tests, psychological tests, specimen validity tests, and urine drug tests, as well as medically unnecessary or non-reimbursable acupuncture.  For bringing a successful qui tam suit, the whistleblowers in this case will receive a relator’s share of over $610,000.  USAO MDTN

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Laboratory and IDTF, Medicaid, Medicare, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

April 5, 2021

New York's Service Station Vending Equipment, Inc., which provides self-service, coin-operated air machines used to inflate automobile tires, and its principal, William McCabe, will pay $4.25 million to resolve an action initiated by a whistleblower under the New York State False Claims Act alleging that they evaded sales taxes, under-reported sales, and paid workers off the books.  NY

Tagged in: FCA State, Tax Fraud, Whistleblower Case,

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