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January 21, 2020

Patient Services, Inc., a foundation that operated pharmaceutical patient assistance programs, will pay $3 million to resolve claims that it unlawfully enabled pharmaceutical companies to pay kickbacks to Medicare patients in the form of co-payment assistance for patients who took the companies’ drugs.  PSI was alleged to have worked with the drugmakers to funnel their “contributions” to patients who took the company’s drugs, instead of using the contributions for purposes not tied to specific drugs and patients.  PSI was alleged to have worked with Insys on copayment assistance for Subsys patients; with Aegerion on copayment assistance for Juxtapid patients; and, with Alexion on copayment assistance for Soliris patients.  USAO Mass

January 15, 2020

ResMed Corp. has agreed to pay $37.5 million to resolve five whistleblower-brought lawsuits alleging that the durable medical equipment (DME) manufacturer paid illegal kickbacks to suppliers, sleep labs, and other health providers, in violation of the Anti-Kickback Statute and False Claims Act.  $6.2 million of the settlement will be split amongst the whistleblowers, who had revealed that ResMed improperly provided or helped provide free or below cost call center services, patient outreach services, medical equipment and installation, and interest-free loans, in exchange for business.  DOJ; USAO EDNY; USAO NC; USAO NDIA; USAO SC; USAO SDCA

January 15, 2020

TMJ & Orofacial Pain Treatment Centers of Wisconsin has agreed to pay $1 million to settle a qui tam suit alleging submissions of false claims to Medicare and TRICARE.  According to the anonymous whistleblower, who will receive an undisclosed share of the settlement, TMJ billed the government health programs for prosthetic devices as if they had been fabricated by in-house surgeons, when in fact they had been fabricated by an outside laboratory.  USAO EDWI

January 10, 2020

The owner of two Philadelphia-based testing laboratories has pleaded guilty and agreed to pay more than $77 million in restitution for participating in an illegal kickback scheme.  At his plea hearing, Ravitej Reddy admitted that his laboratories, Personalized Genetics, LLC and Med Health Services Management, LP, participated in a fraudulent scheme that took advantage of the labs' location in a high reimbursement area for Medicare cancer and pharmacogenetic testing the labs actually sent for testing to a laboratory that was located outside of the lucrative coverage area, because the labs lacked equipment to perform the tests themselves.  To secure the lab orders, Reddy admitted paying kickbacks to co-conspirators, including marketers that solicited specimens from Medicare beneficiaries, and a telemedicine practice that improperly authorized the tests without regard to medical necessity.  In addition to the restitution order, Reddy faces a maximum of 25 years in prison at his sentencing in February.  USAO WDPA

January 9, 2020

After being charged with defrauding brokerage customers in May 2018 and pleading guilty in December 2018, a former registered investment advisor, Steven Pagartanis, has been sentenced to over 14 years in prison and ordered to pay $6.5 million for orchestrating the 18-year, $13 million fraud.  Pagartanis had targeted elderly women and promised an 8% return on investments.  However, he secretly laundered their investments and used the money on personal expenses, causing investors to lose over $9 million in total.   USAO EDNY

January 7, 2020

Behavioral Consulting of Tampa Bay (BCOTB) has agreed to pay $675,000 to settle claims alleging the autism service provider submitted false or fraudulent claims to TRICARE.  Following an audit by TRICARE's managed care support contractor, the United States launched an investigation into BCOTB's claims that revealed it had misrepresented the services that were provided, misrepresented the identity of service providers, requested payment on more units of time than reflected by records, and requested payment on services that were not substantiated by records.  USAO MDFL

January 7, 2020

After self-disclosing to the government about grant accounting errors in 2011, the University of North Carolina at Chapel Hill (UNC) has agreed to pay back $4.5 million in excess funds received from the National Institutes of Health (NIH).  The errors had been in effect between two different periods, from 2007 to 2011 and from 2014 to 2017, and had caused the University to inadvertently charge salary costs to grants after the grant terms had ended.  USAO MDNC

January 6, 2020

A now defunct behavioral health clinic, Tree of Life, Inc., and its owners and operators, Ada and Victor Vidal, have agreed to pay $1.65 million to settle a whistleblower's claims that they violated the False Claims Act and Anti-Kickback Statute in claims to Pennsylvania's Medicaid program.  According to Erika Desjardins, the former Clinical Director, Tree of Life billed for therapy sessions where either the patient or therapist could not possibly have attended (in some cases due to a patient’s hospitalization or death), as well as therapy sessions provided by unqualified individuals.  To facilitate the fraud scheme, it created fake records, including forged signatures, and improperly paid a social worker for patient referrals.  As part of the settlement, the Vidals have been excluded from future participation in federal healthcare programs, and Desjardins, who had been fired for reporting internally, will receive $330,000 as their share of the recovery.  USAO EDPA

January 6, 2020

NASA contractor United Paradyne Corporation has agreed to pay $375,000 to settle a lawsuit filed by a former employee, Steven Walker, which alleged the company violated the False Claims Act by submitting claims for work it failed to perform.  According to the settlement agreement, United Paradyne had agreed to fabricate ground support equipment to NASA's Space Launch System (SLS), but failed to maintain certain cleanliness standards and falsely certified to having conformed to NASA's contractual requirements.  For his role exposing the fraud, Walker will receive $75,000.  USAO MDFL

January 3, 2020

Following a qui tam lawsuit alleging fraud against the Post-9/11 GI Bill in violation of the False Claims Act, Caldwell University has agreed to pay more than $4.8 million to the United States.  The alleged misconduct occurred between 2011 and 2013 and involved falsely claiming to the Department of Veterans Affairs that classes were developed and taught by the university, when in fact they were developed and taught by an unapproved subcontractor.  Caldwell had also charged the Post-9/11 GI Bill up to 30 times the prices charged to others for the same courses, leading the government to pay over $24 million in tuition.  USAO NJ
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