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February 7, 2023

Samsung C&T America, Inc., a U.S. subsidiary of the Korean conglomerate Samsung C&T Corporation, has agreed to pay $1 million after admitting that it deliberately misclassified and underpaid customs duties on imported footwear by inaccurately stating their materials and construction.  The violations of the False Claims Act occurred between 2016 and 2018, and involved footwear imported from China and Vietnam.  USAO SDNY

Tagged in: Customs Fraud, FCA Federal,

February 2, 2023

Central California medical provider Clinica Sierra Vista (CSV) has agreed to pay nearly $26 million to settle claims of violating the state False Claims Act.  Following an internal investigation, the company’s new management voluntarily disclosed to the government that former executives knowingly submitted false information on financial reports in order to receive higher payments from the state’s Medicaid program.  CA AG

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Medicaid, Provider Fraud,

January 31, 2023

New York-based High Life LLC, which designs and imports apparel, has agreed to pay $1.3 million after admitting that it underreported the value of 67 shipments into the United States to avoid paying customs duties.  After multiple shipments were detained for possibly fraudulent declared values, High Life switched from purchasing apparel on Landed Duty Paid (LDP) to Free on Board (FOB), which allowed it to use the price its vendors paid to manufacturers as the value of the shipment, rather than what High Life paid the vendors.  However, because there were other restrictions on declaring value, High Life developed a formula to calculate what it wanted the declared value to be, then instructed vendors to use it.  USAO SDNY

Tagged in: Customs Fraud, FCA Federal,

January 30, 2023

International Vitamins Corporation (IVC), which imports and sells vitamins and supplements from China, has agreed to pay $22.8 million to settle claims of defrauding the United States.  The U.S.-based company allegedly avoided U.S. customs duties by misclassifying over 30 of its products, then failed to pay back duties owed after realizing it had underpaid millions of dollars.  The alleged fraud occurred between 2015 and 2019, and only came to scrutiny through a whistleblower’s lawsuit.  USAO SDNY

Tagged in: Customs Fraud, FCA Federal, Whistleblower Case,

January 30, 2023

A doctor in Michigan who was involved in a $250 million fraud scheme against Medicare, Medicaid, and other insurers, has been sentenced to 16.5 years in prison.  Along with 21 co-conspirators, Dr. Francisco Patino took advantage of patients suffering from addiction by forcing them to receive medically unnecessary, painful, but lucrative spinal injections in exchange for opioid prescriptions.  Additionally, Patino knowingly violated the Anti-Kickback and Stark laws by receiving kickbacks from a laboratory in exchange for sending patient samples to that lab.  All told, Patino submitted more claims to Medicare for spinal injections than any other provider in the country between 2012 and 2017, prescribed more Oxycodone than any other provider in Michigan in 2016 and 2017, and was personally responsible for $120 million of the $250 million in false claims billed to insurers.  DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicaid, Medicare, Provider Fraud,

January 27, 2023

Walgreen Co. has paid $7 million to settle a False Claims Act lawsuit by the United States and State of Tennessee that alleged the company submitted claims to Tennessee’s Medicaid program for specialty medications that didn’t meet the program’s criteria for coverage.  According to the governments’ 2021 complaint, one of Walgreens’ former pharmacists falsified prior authorization requests and records for 65 Medicaid beneficiaries who didn’t meet program requirements.  The company then billed TennCare under those false prior authorization requests, and later failed to make repayments even after it discovered its employee’s misconduct.  USAO EDTN

Tagged in: FCA Federal, Healthcare Fraud, Medicaid, Pharma Fraud,

January 20, 2023

DePuy Synthes, Inc., a subsidiary of Johnson & Johnson that manufactures medical devices, has agreed to pay $9.75 million to resolve allegations of defrauding Medicare and Medicaid.  According to former sales representative Aleksej Gusakovs, DePuy gave a Massachusetts-based orthopedic surgeon thousands of dollars’ worth of free implants and instruments for use in overseas surgeries.  The illegal kickbacks induced the surgeon to use DePuy products in surgeries performed in the United States, and caused false claims to be submitted to Medicare and the Massachusetts Medicaid program.  As the whistleblower in a successful qui tam action, Gusakovs will receive a $1.37 million share of the settlement.  DOJ

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

January 12, 2023

Blue Water Shipping U.S. Inc. has agreed to pay $1.89 million to settle claims that one of its former employees billed the government for freight forwarding services that were never performed and charged the government unallowable markups for inland transportation, and imports and exports of ocean and air freight.  USAO NJ

Tagged in: FCA Federal, Government Procurement Fraud,

January 9, 2023

Doctor Aarti Pandya and her practice, Aarti D. Pandya, M.D. P.C., have agreed to pay $1.8 million to resolve a whistleblower suit that alleged they billed federal healthcare programs for medically unnecessary cataract surgeries and diagnostic tests, incomplete or worthless tests, and office visits that failed to provide the level of service claimed.  The allegations were brought in a 2013 qui tam suit by former employee Laura Dildine, which the government intervened on in 2018. In addition to the false claims listed above, Pandya also allegedly falsely diagnosed patients with glaucoma in order to justify claims for reimbursement.  USAO SDGA

Tagged in: FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medicare, Other Government Health Programs, Provider Fraud, Whistleblower Case,

December 21, 2022

Biotechnology companies iSense, LLC and Specific Diagnostics, Inc., together with their founder Paul Andrew Rhodes, will pay a total of $10.1 million to resolve allegations that they submitted false claims under grants from the DOD and HHS.  The government alleged that the firms improperly billed for costs incurred by another business, billed for compensation in excess of authorized federal limits, backdated services and cost-sharing agreements, and knowingly presented a backdated agreement to the government. USAO NDCal

Tagged in: Defense Contract Fraud, Falsifying Invoices, FCA Federal, Grant and Research Fraud, Healthcare Fraud,

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