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July 14, 2022

BioReference Health, LLC, formerly known as BioReference Laboratories, Inc. and OPKO Health, Inc., have agreed to pay nearly $10 million and enter into a five-year Corporate Integrity Agreement to settle a whistleblower-brought case alleging it violated the Anti-Kickback Statute, Stark Law, and False Claims Act.  The alleged misconduct involved making lease payments to healthcare providers that exceeded fair market value, and later failing to report or return any overpayments to federal healthcare programs.  USAO MA

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Healthcare Fraud, Laboratory and IDTF, Whistleblower Case, Whistleblower Rewards,

July 13, 2022

Solera Specialty Pharmacy and its CEO, Nicholas Saraniti, has agreed to pay $1.31 million and enter into a three-year integrity agreement to resolve allegations of defrauding Medicare.  Solera allegedly submitted fraudulent claims for Evzio—a high-priced version of naloxone, which reverses opioid overdoses—based on prior authorization requests that contained false clinical information, that were not actually approved by physicians, and that improperly listed Solera’s contact information as if it were the physician’s.  In connection with a criminal information, Solera has also entered into a deferred prosecution agreement.  The whistleblower in this case, a former employee of Evzio manufacturer kaléo Inc. named Rebecca Socol, will receive a $262,000 share of the settlement.  DOJ

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

July 8, 2022

Aerojet Rocketdyne Inc., which provides propulsion and power systems for vehicles belonging to the Department of Defense and NASA, has agreed to pay $9 million to resolve a whistleblower lawsuit.  According to Brian Markus, a former employee, the company misrepresented its compliance with the cybersecurity requirements of contracts with those agencies, in violation of the False Claims Act.  For bringing a successful qui tam case, Markus will receive a relator’s share of $2.61 million.  USAO EDCA

Tagged in: Certifications, Cybersecurity and Data Breaches, Defense Contract Fraud, FCA Federal, Whistleblower Case, Whistleblower Rewards,

June 10, 2022

A doctor who allegedly submitted claims to Medicare and Medi-Cal for unperformed procedures, services, and tests, in violation of the California and federal False Claims Acts, has agreed to pay $9.5 million to resolve a civil suit.  The qui tam case by Minas Kochumian’s former medical assistant Elize Oganesyan, and former IT consultant Damon Davies, alleged that claims for treatment of osteopathic issues that were submitted over a six year period were false.  The settlement includes $5.5 million that Kochumian already paid as criminal restitution in a separate case in the Central District.  As part of the civil settlement, Oganesyan and Davies will share a $1.75 million award.  CA AG; USAO EDCA

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

May 19, 2022

Retailer H&M will pay $36 million to New York State to resolve claims that the company violated a New York law which requires gift card issuers to turn over unused balances on gift cards to the state’s Abandoned Property Fund after five years of inactivity.  The retailer repeatedly lied to the state about its failure to transfer the unused gift card balances as required, and falsely told the state that an out-of-state company was handling its gift cards business. A whistleblower who filed a lawsuit under the New York False Claims Act will receive $7.74 million for bringing H&M’s misconduct to light.  NY

Tagged in: FCA State, Government Programs Fraud, Whistleblower Case, Whistleblower Rewards,

May 19, 2022

Healthcare testing company VirtuOx, Inc. agreed to pay $3.15 million to resolve claims brought in an action initiated by a whistleblower alleging that falsely billed Medicare for pulse oximetry testing.  VirtuOx allegedly reported San Francisco as the location for overnight pulse oximetry testing when, in fact, no services were performed at that location, but that location resulted in a higher Medicare reimbursement.  In addition, VirtuOx allegedly billed Medicare for both oxygen “spot checks” and overnight pulse oximetry testing, when only the overnight testing was performed.  The whistleblower, Amber Watt, will receive an award of $630,000.  USAO SD FL

Tagged in: Bundling and Unbundling, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

May 13, 2022

Hensel Phelps Construction Company has agreed to pay $2.8 million to resolve allegations of violating the False Claims Act in connection with a federal subcontract designated for service-disabled, veteran-owned small businesses (SDVOSB).  Under a 2011 contract with the General Services Administration to construct a building in Washington, D.C., Hensel Phelps was required to set aside subcontracts for SDVOSBs and other small businesses.  According to qui tam plaintiff Fox Unlimited Enterprises, LLP, the company instead made arrangements with another large business to provide equipment and installation services, and used a SDVOSB in name only.  USAO NDNY, USAO EDWA

Tagged in: FCA Federal, Government Procurement Fraud, Set-Asides and Preferences, Whistleblower Case, Whistleblower Rewards,

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,

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