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July 17, 2017

New York-based home health care company Visiting Nurse Service of New York and its subsidiaries VNS Choice and VNS Choice Community Care agreed to pay roughly $4.4 million to settle charges of violating the False Claims Act by improperly collecting monthly Medicaid payments for 365 Medicaid beneficiaries whom VNS Choice failed to timely disenroll from the VNS Choice Managed Long-Term Care Plan.  Once VNS disenrolled the members, it did not repay Medicaid for the funds it had improperly received. By knowingly retaining overpayments for many of these members for more than 60 days, the VNS entities violated both the federal and state false claim acts. As a result, New York State will receive $2.63 million as part of the settlement agreement.The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by an undisclosed whistleblower.  The whistleblower will receive an undisclosed whistleblower award from the proceeds of the government's recovery.  DOJ (SDNY)  NY

July 6, 2017

Cathy Morris and Josie King, former employees of Compassionate Care Hospice of Atlanta, will receive a yet-to-be-determined whistleblower award from the $24 million the company and its parent Compassionate Care Hospice Group, Inc. agreed to pay to resolve charges they violated the False Claims Act and Stark Law by engaging in improper financial relationships with contracted physicians to induce them to refer patients.  DOJ (NDGA)

July 6, 2017

Maureen Fox and Cathy Gonzales, former employees of now-defunct Home Care Hospice, Inc., will receive a yet-to-be-determined whistleblower award from the millions of dollars to be paid by the owners of the company to settle charges they falsely billed for hospice services that were either unnecessary or never provided.  DOJ (EDPA)

July 6, 2017

Whistleblowers will receive an award of more than $350,000 from the $2 million Pennsylvania hospice company Compassionate Care of Gwynedd Inc. agreed to pay to resolve allegations it violated the False Claims Act by providing unnecessary hospice services.  DOJ (DNJ)

June 30, 2017

Mark McGuire, a former laboratory director at Charlotte-Mecklenburg Hospital Authority (dba Carolinas Healthcare System) will receive a whistleblower award of roughly $1.4 million from the $6.5 million the company agreed to pay to resolve charges it violated the False Claims Act by “up-coding” claims for urine drug tests in order to receive higher payment than allowed for the tests.  DOJ (WDNC)

June 29, 2017

A whistleblower will receive an award of $488,700 from the $2.7 million to be paid by Innovative Therapies, Inc. and its parent company Cardinal Health, Inc. to settle charges they violated the False Claims Act by submitting false claims to Medicare through their marketing of certain negative pressure wound treatment devices as durable medical equipment when they knew these devices did not have the expected life of a durable device.  DOJ (MDTN)

June 28, 2017

Paul Chan will receive a whistleblower award of more than $9.2 million from the $42 million to be paid by PAMC Ltd. and Pacific Alliance Medical Center Inc. (which together own and operate Los Angeles acute care hospital Pacific Alliance Medical Center) to settle charges they violated the False Claims Act and the Stark Law by engaging in improper financial relationships with referring physicians.  DOJ

June 22, 2017

Dr. James M. Crumb, a physical medicine and rehabilitative specialist currently practicing in Alabama as Mobility Metabolism and Wellness, P.C.,and Coastal Neurological Institute, P.C., a local neurosurgeon physician group, agreed collectively to pay $1.4 million to resolve allegations they violated the False Claims Act by billing federal health care programs for medically unreasonable and unnecessary ultrasound guidance used with routine lab blood draws, and with Botox and trigger point injections. As a result of this billing scheme, the defendants sometimes billed 15 to 30 identical ultrasound guidance claims for a single patient office visit. DOJ (SDAL)

June 16, 2017

Pennsylvania-based skilled nursing facility operator Genesis Healthcare Inc. agreed to pay roughly $53.6 million to settle charges that companies and facilities acquired by Genesis violated the False Claims Act by causing the submission of false claims to government health care programs for medically unnecessary therapy and hospice services, and grossly substandard nursing care. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Joanne Cretney-Tsosie, Jennifer Deaton, Kimberley Green, Camaren Hampton, Teresa McAree, Terri West, and Brian Wilson, former employees of companies acquired by Genesis. They collectively will receive a whistleblower award of $9.67 million from the proceeds of the government's recovery. DOJ

June 15, 2017

Kentucky allergists Bruce Wolf and Kiro John Yun agreed to pay $740,578 to resolve allegations their medical practice group of otolaryngologists Wolf and Yun, P.S.C., specializing in allergy, asthma and immunology, violated the False Claims Act by billing the government for Sublingual Immunotherapy serum preparation and overstated units of serum preparation for injection vials. Sublingual immunotherapy is an alternative way to treat allergies without injections whereby an allergist prescribes a patient with an allergen that is sprayed under the tongue to boost tolerance to substances and reduce symptoms but it is not covered by Medicare because it is considered investigational. DOJ (WDKY)
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