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May 28, 2014

Medical device manufacturer Medtronic Inc. agreed to pay $9.9M to resolve allegations under the False Claims Act that the company used various types of illegal kickbacks to induce physicians to use pacemakers and defibrillators made and sold by Medtronic. Among the the illegal inducements the government charged Medtronic with using were: 1) paying implanting physicians to speak at events intended to increase the flow of referral business; 2) developing marketing/business development plans for physicians at no cost; and 3) providing tickets to sporting events. The settlement stems from a whistleblower complaint filed by former Medtronic employee Adolfo Schroeder under the qui tam provisions of the False Claims Act. He will receive a whistleblower reward of approximately $1.73M. DOJ  

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

April 23, 2014

Amedisys home health companies agreed to pay $150M resolve allegations they violated the False Claims Act by allegedly billing Medicare for nursing and therapy services not medically necessary or provided to patients who were not homebound, and by otherwise misrepresenting patients’ conditions to increase its Medicare payments. The allegations were first raised in several qui tam lawsuit filed by former Amedisys employees under the whistleblower provisions of the False Claims Act. DOJ

Tagged in: FCA Federal, Home Health and Hospice, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

April 16, 2014

CRC Health Corp., a nationwide provider of substance abuse and mental health treatment services, agreed to pay $9.25 million to settle allegations that CRC violated the False Claims Act by providing substandard treatment in its Tennessee facility to adult and adolescent Medicaid patients suffering from alcohol and drug addiction.  The allegations were first raised in a qui tam lawsuit filed by Angie Cederoth, a former billing clerk in the CRC facility, under the whistleblower provisions of the False Claims Act.  She will receive a whistleblower award of$1.5 million.  DOJ

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

April 16, 2014

Drug manufacturer Astellas Pharma US agreed to pay $7.3 million to resolve allegations it violated the False Claims Act in connection with its marketing and promotion of the drug Mycamine for pediatric use when the drug did not have FDA approval for such use.  The allegations were first raised in a qui tam lawsuit filed by Frank Smith, a former Astellas sales representative, under the whistleblower provisions of the False Claims Act.  He will receive a whistleblower award of $708,852.  DOJ

Tagged in: FCA Federal, Off-Label and Unapproved Use, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

April 14, 2014

Hope Cancer Institute, a cancer treatment facility in Kansas, and its owner Dr. Raj Sadasivan, agreed to pay $2.9M to resolve allegations they violated the False Claims Act by submitting claims to Medicare, Medicaid and the Federal Employee Health Benefits Program for chemotherapy drugs and services not actually provided.  The allegations were first raised in a qui tam lawsuit filed by former employees of the facility Krisha Turner, Crystal Dercher and Amanda Reynolds under the whistleblower provisions of the False Claims Act.  DOJ

Tagged in: FCA Federal, Medical Billing Fraud, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

April 9, 2014

Five California-based masonry subcontractors, Frazier Masonry, F-Y Inc., CTI Concrete & Masonry, Masonry Technology, and Masonry Works, agreed to pay nearly $1.9M to resolve allegations they violated the False Claims Act by misrepresenting their disadvantaged small business status in connection with military construction contracts.  The allegations were first raised in a qui tam lawsuit filed by Rickey Howard, a former employee of Frazier Masonry, under the whistleblower provisions of the False Claims Act.  Howard will receive a whistleblower award of $393,383.  DOJ

Tagged in: Defense Contract Fraud, FCA Federal, Set-Asides and Preferences, Whistleblower Case, Whistleblower Rewards,

March 21, 2014

Utah-based Okland Construction Co. agreed to pay $928,000 to resolve allegations it made false statements and submitted false claims under the Small Business Administration’s Section 8(a) Program for Small and Disadvantaged Businesses.  The allegations were first raised in a qui tam lawsuit filed by Section 8(a) participant Saiz Construction Co. and its owner Abel Saiz under the whistleblower provisions of the False Claims Act.  They will receive a whistleblower award of $148,480.  DOJ

Tagged in: FCA Federal, Financial and Investment Fraud, Set-Asides and Preferences, Whistleblower Case, Whistleblower Rewards,

March 18, 2014

American Family Care Inc., a network of walk-in medical clinics with offices in Alabama, Tennessee and Georgia, agreed to pay $1.2M to resolve allegations under the False Claims Act that it knowingly submitted claims to Medicare for outpatient office visits that were billed at a higher rate than was appropriate.  The settlement resolves a qui tam lawsuit filed by Anita C. Salters, a former employee of American Family Care under the whistleblower provision of the False Claims Act.  DOJ

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

March 11, 2014

Florida-based hospital system Halifax Hospital Medical Center agreed to pay $85M to resolve allegations that they violated the False Claims Act and Stark Law by executing contracts with six medical oncologists that provided an incentive bonus that improperly included the value of prescription drugs and tests that the oncologists ordered and Halifax billed to Medicare.  The allegations were first raised in a qui tam lawsuit filed by Halifax Hospital employee Elin Baklid-Kunz under the whistleblower provisions of the False Claims Act.  She will receive a whistleblower award of $20.8 million.  DOJ

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

March 7, 2014

Ocean shipping companies Sea Star Line and Horizon Lines agreed to pay $1.9M and $1.5M, respectively, to resolve allegations that they violated the False Claims Act by fixing the price of government cargo transportation contracts between the continental US and Puerto Rico, the Department of Justice announced today.  The allegations were first raised in a qui tam lawsuit filed by former Sea Star Line executive William B. Stallings under the whistleblower provisions of the False Claims Act.  He will receive a whistleblower award of $512,719.  DOJ

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

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