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June 15, 2023

Wisconsin woman Kay Yang and her companies AK Equity Group LLC and Xapphire LLC have agreed to pay almost $13.7 million in restitution and over $10.4 million in civil monetary penalty in connection with a fraudulent scheme targeting the Hmong community.  Yang’s husband, Chao Yang, was also ordered to pay $1.42 million in disgorgement.  From 2017 until the pandemic hit in March 2020, the defendants solicited and received at least $15.7 million from 67 victim individuals or entities, many from the Hmong community.  The funds were intended for retail forex transactions, but the defendants misappropriated at least $4.8 million.  Under the settlement order, there is a permanent injunction against Kay Yang and her companies from participating in commodity exchange.  CFTC

Tagged in: Financial and Investment Fraud, Fraud in CFTC-Regulated Markets,

June 8, 2023

Billy Joe Taylor of Lavaca, Arkansas, will spend 15 years in prison and will pay nearly $30 million in restitution for submitting false and fraudulent claims to Medicare. During the COVID-19 pandemic, Taylor and his co-conspirators misused medical information and private personal information for Medicare beneficiaries, and then used that information to repeatedly submit fraudulent claims for medically unnecessary diagnostic laboratory testing. USAO WDAR

Tagged in: FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicare,

May 31, 2023

VHS of Michigan Inc., d/b/a, The Detroit Medical Center, Vanguard Health Systems Inc., and Tenet Healthcare Corporation will pay nearly $30 million for causing the submission of false or fraudulent claims to Medicare. From January 1, 2014 through December 31, 2017, DMC, Vanguard, and Tenet violated the Anti-Kickback Statute when they provided the services of mid-level practitioners to 13 physicians at no cost or below fair market value. The physicians were selected for their high number of referrals, which DMC hoped would cause an increase in referrals to their facilities. Whistleblower Dr. Jay Meythaler will receive $5.2 million as part of the settlement. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Hospital Fraud, Medicare, Provider Fraud, Whistleblower Case,

May 25, 2023

Vascular surgeon Vasso Godiali of Michigan has been ordered to pay $19.5 million in restitution and serve over 6 years in prison to resolve criminal allegations of defrauding Medicare, Medicaid, and Blue Cross/Blue Shield of Michigan. Godiali also agreed to pay up to $43.4 million to resolve civil allegations of violating the False Claims Act.  Although Godiali allegedly began submitting false claims in 2009, his misconduct did not come to light until a 2015 qui tam suit by Innovative Solutions Consulting LLC, which alleged Godiali billed government programs for arterial thrombectomies and stent placements that were not medically necessary and not actually performed.  Additionally, Godiali allegedly falsified medical records to justify the procedures, and improperly used a modifier code to increase his reimbursements. DOJ

Tagged in: Criminal Proceedings, FCA Federal, Healthcare Fraud, Medicaid, Medical Billing Fraud, Medicare, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

May 12, 2023

HSBC Bank USA, N.A. has been ordered to pay $45 million to settle charges involving a number of violations of the Commodity Exchange Act.  Over an eight-year period beginning in 2012, HSBC traders systematically structured their trading to move the market prices of issuer swaps in a direction that was favorable to HSBC and unfavorable to its counterparties.  Over several months beginning in 2015, HSBC’s supervisor for its U.S. dollar swap desk repeatedly engaged in spoofing.  Lastly, over a couple months beginning in 2020, HSBC failed to make or keep recordings of mobile phone calls involving swap transactions.  CFTC

Tagged in: Financial Institution Fraud, Fraud in CFTC-Regulated Markets,

May 12, 2023

HSBC Bank USA, N.A., HSBC Securities (USA) Inc., and HSBC Bank plc (collectively HSBC Affiliates) have been ordered to pay $30 million to the CFTC and $15 million to the SEC to settle charges of violating recordkeeping and supervisory requirements.  As part of the settlement, HSBC Affiliates admitted that it failed to stop employees from communicating internally and externally through unapproved mediums, and failed to preserve those messages as business records even if they pertained to the businesses.  CFTC; SEC

Tagged in: Financial Institution Fraud, Fraud in CFTC-Regulated Markets,

May 11, 2023

The Bank of Nova Scotia and Scotia Capital USA Inc. (collectively BNS Affiliates) have been ordered to pay $15 million to the CFTC and $7.5 million to the SEC to settle charges of violating recordkeeping and supervisory requirements.  BNS Affiliates admitted that its employees often communicated internally and externally through unapproved channels, and though some messages pertained to the businesses, failed to preserve those messages as records, and would be unable to produce them if requested.  CFTC; SEC

Tagged in: Financial Institution Fraud, Fraud in CFTC-Regulated Markets,

May 11, 2023

GCI Communications Corp. has agreed to pay $40 million to resolve a whistleblower case by its former Director of Business Administration, which alleged the company violated the False Claims Act by failing to comply with competitive bidding regulations for the FCC’s Rural Health Care Program.  In order to participate in the program—which awards $570 million in subsidies annually to bring critical telecommunications services to rural healthcare providers—GCI was subject to regulations governing the prices it could charge these providers.  However, GCI charged inflated rates to a provider in Alaska, thereby receiving higher subsidy payments than it was entitled to.  For launching a successful enforcement action, whistleblower Robert Taylor will receive a $6.4 million share of the settlement.  DOJ

Tagged in: FCA Federal, Government Procurement Fraud, Whistleblower Case, Whistleblower Rewards,

April 28, 2023

Joyce Agu, of Sugar Land, TX, will spend 60 months in prison and will pay over $3 million in restitution for conspiring to pay and receive kickbacks for services billed to Medicare. Agu paid others to certify that her clients were eligible for home health services, which they were not, but she used the certifications anyway as a basis to submit false claims to Medicare. TX AG

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medical Billing Fraud, Medicare, Provider Fraud,

April 20, 2023

Dr. Paul S. Koch, Koch Eye Associates, and Claris Vision violated the False Claims Act by paying kickbacks to optometrists who referred their patients to Koch and his companies for laser-assisted cataract surgery. Over a five-year period, from 2013 to 2017, Koch and his practices submitted false claims to Medicare based on those kickbacks. Koch will pay nearly $1.2 million to resolve the qui tam whistleblowers’ claims, and the two whistleblowers will receive $256,534.84 from the settlement. USAO RI

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medical Billing Fraud, Medicare, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

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