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March 19, 2021

Following an earlier federal settlement, construction management company V.J. Associates, Inc., and its affiliates, will pay a total of $1.875 million to resolve claims brought in a whistleblower complaint on behalf of Massachusetts, New Jersey, and New York.  Defendants provided cost estimating and scheduling services on public works projects, and admitted to submitting false bills to prime contractors by inflating employee hours on contracts on which they were paid on a time-and-expense basis.  Employees internally referred to this overbilling as “juicing” and “tagging” hours.  NY; MA

Tagged in: Falsifying Invoices, FCA State, Government Procurement Fraud, Whistleblower Case,

March 2, 2021

Hedge fund manager Thomas E. Sandell has paid $105 million to resolve claims first brought by a whistleblower under the New York False Claims Act alleging that Sandell evaded tens of millions in state and local taxes by falsely claiming that $450 million in management and performance fees he recognized in 2017 were not earned for services performed in New York, despite the fact that his fund, Sandell Asset Management Corporation, operated in New York and represented to the SEC that New York City was its principal place of business.  In his effort to evade NY taxes, Sandell moved to London for a period of time, opened an office in Florida, and managed SAMC expenses through a shell company that he also owned and controlled, all while continuing to perform the investment services that generated the fee income in New York.  When Sandell’s accountant informed him that he would have to pay NY state taxes, he terminated them and retained a firm that took his preferred position.  The whistleblower will receive an award of $22.05 million, which is 21% of the government’s recovery. NY

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

January 15, 2021

The Colonial Automotive Group, Inc., a chain of automobile dealerships, will pay $1 million to resolve allegations that they defrauded the Massachusetts state Department of Unemployment Assistance.  The dealership allegedly encouraged employees who were furloughed as a result of the state’s COVID-19 in-person business closures to sign up for unemployment benefits. and then requested those workers continue to perform dealership work, without pay, while they were collecting state benefits.  MA

Tagged in: COVID-19, FCA State, Government Programs Fraud,

January 4, 2021

Three providers, James P. Anderson, as owner of Affiliated Neurologists, PLC; Charles F. Spencer, as owner of Total Family Physicians Center PLLC; and Mitchell P. Shea, as owner of Chiro2Med of Tennessee P.C., have agreed to pay the United States and Tennessee a total of $1.72 million to resolve allegations under the False Claims Act for improperly billing Medicare and TennCare for “P-Stim” electro-acupuncture devices that do not qualify for reimbursement.  The defendants billed for the disposable P-Stim devices using a code reserved for neurostimulator devices that are implanted during a surgical procedure. USAO MDTN

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

December 21, 2020

Substance abuse treatment provider A.R.E.B.A.-CASRIEL, Inc. d/b/a Addiction Care Interventions Chemical Dependency Treatment Centers (“ACI”) and its owner, Steven Yohay, agreed to pay a total of $6 million to resolve federal and New York state claims that they defrauded Medicaid including through the payment of kickbacks and other fraudulent conduct in connection with the enrollment of Medicaid beneficiaries into ACI’s inpatient treatment program.  Defendants allegedly employed drivers who were compensated in part based on the number of patients they recruited, to target homeless individuals to enroll in ACI’s inpatient treatment program by offering food, cash, and money to purchase drugs, and/or alcohol. In addition, ACI unlawfully paid a patient recruiter, and enrolled Medicaid patients who had not been evaluated by a qualified healthcare professional, including by copying a physician’s signature.  The government’s investigation was initiated by a whistleblower complaint filed by a former employee, who will receive an undisclosed amount of the settlement.  USAO SDNY; NY

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Healthcare Fraud, Lack of Medical Necessity, Medicaid, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

December 21, 2020

Government contractor Schneider Electric Buildings Americas Inc. will pay a total of $11 million to resolve criminal and civil claims that it overcharged the government on eight separate energy savings performance contracts under which the company was to install energy upgrades including solar panels, LED lighting, and insulation, in federal buildings.  The company admitted to wrongdoing including the disguising of unauthorized design costs by charging them to unrelated contract components and the receipt of kickbacks from subcontractors on the ESPCs. $9.3 million of the settlement resolves civil liability under the False Claims Act and Anti-Kickback Act; $1.7 million is denominated as criminal forfeiture.  DOJ

Tagged in: Bribery and Bid-Rigging, Criminal Proceedings, Defense Contract Fraud, Environmental Fraud, Falsifying Invoices, FCA State, Government Procurement Fraud,

December 7, 2020

A chain of supermarkets in the New York area has been ordered to pay $4.7 million to settle claims under the state False Claims Act that alleged the chain operated a series of tax avoidance schemes from 2012 to 2018.  The case against Food World entities Pine Tree Meat & Produce Inc., Food Jungle, Inc., Sonamoo, Inc., and CNI Meat & Produce, and owner Hi Jong Lee was sparked by a qui tam whistleblower and involved three schemes: the use of separate cash registers so cash purchases would not be recorded for tax purposes, the use of fake merchandise returns to underreport actual sales, and the payment of a majority of its employees in cash and off the books.  AG NY

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

December 3, 2020

Workrite Ergonomics LLC and its parent company, Knape & Vogt Manufacturing Co., have agreed to pay $7.1 million to resolve a qui tam suit brought by a former sales manager, Michael Franchek, which alleged that Workrite overcharged the federal government for office furniture purchased under General Services Administration (GSA) contracts.  Workrite allegedly failed to provide GSA, and state agencies that relied on GSA's pricing, with accurate information during contract negotiations, and failed to extend lower prices to government customers as required by contract provisions.  As part of the settlement, Franchek will receive a relator’s share of $1.27 million.  DOJ; USAO NDCA; CA

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

December 2, 2020

The owner and operator of Atlanta-based Elite Homecare has been sentenced to over five years in prison and ordered to pay $999,999 in restitution for defrauding Medicaid of nearly $1 million.  As a provider under the Georgia Pediatric Program (GAPP)—an in-home nursing program for Medicaid-eligible children with severe physical and cognitive disabilities—Diandra Bankhead allegedly submitted thousands of claims for services that were fraudulent in a myriad of ways.  Some of the claims falsely represented that employees provided more than 24 hours of services in a given day to multiple children simultaneously (including to children whose families had not retained Elite, and by RNs who did not know their credentials were being used), while other claims contained fraudulent credentialing information and fraudulent supporting documentation, or were upcoded to induce higher payments from Medicaid.  Additionally, Bankhead allegedly “sold” information about twenty of Elite’s former clients to another Atlanta-based home health provider in exchange for a percentage of the reimbursements from Medicaid.  USAO NDGA

Tagged in: Anti-Kickback and Stark, FCA State, Healthcare Fraud, Home Health and Hospice, Medicaid, Medical Billing Fraud, Provider Fraud, Upcoding,

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