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Page 116 of 254

October 29, 2018

Three people have been indicted by a federal grand jury for deceiving a now defunct bank and the FDIC from 2009 to 2010. Joseph Natale, the former CEO of First State Bank, Albert Gasparro, an investment advisor, and Gary Ketchum, a business owner, allegedly duped the bank into paying them $715,000 in fees for a $7 million investment, which turned out to be primarily comprised of the bank's own funds. To further the fraud, Ketchum then took out loans amounting to $176,000 from the bank and, together with the other two defendants, misrepresented the misconduct to the bank and the FDIC. If convicted of all 13 counts of fraud, the three face decades in prison and millions of dollars in fines. USAO NJ

Tagged in: Criminal Proceedings, Financial and Investment Fraud,

October 29, 2018

Matthias Krull, a former executive of Swiss bank Julius Baer Group Ltd., was sentenced to ten years in prison following his guilty plea to charges arising from his involvement in an international scheme to launder more than a billion dollars embezzled from Venezuela’s national oil company, Petroleos de Venezuela SA or PDVSA.  DOJ

Tagged in: Criminal Proceedings, Financial and Investment Fraud, Money Laundering,

October 26, 2018

A former U.S. Department of Veterans Affairs official, James King, pleaded guilty to demanding and receiving bribes from three for-profit schools, Atius Technology Institute, Eelon Training Academy, and School A, in exchange for enrolling disabled military veterans in those schools.  All three school owners sent King and other VA officials false information about the education being provided to veterans.  King facilitated over $2 million in improper payments from the VA using the veterans’ federal benefits. DOJ

Tagged in: Bribery and Bid-Rigging, Education Fraud,

October 26, 2018

Abbott Laboratories and AbbVie, Inc. have agreed to pay $25 million to settle a case initiated by a whistleblower alleging that the pharma companies paid unlawful kickbacks and engaged in unlawful off-label marketing for the drug TriCor.  The kickbacks took the form of gifts and payments for consulting and speaking engagements that were meant to induce or reward physicians for prescribing TriCor.  The off-label marketing consisted of Abbott's advertising the drug for conditions for which it was not FDA-approved.  The whistleblower, Amy Bergman, a former Abbott sales representative, will receive $6.5 million of the settlement.  USAO E.D.Pa.

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

October 25, 2018

Passavant Memorial Homes and its pharmacy subsidiaries have agreed to pay $1,850,000 to resolve allegations that it billed federal healthcare programs, including Medicare and Medicaid, for improperly prescribed controlled substances, in violation of the False Claims Act and Controlled Substances Act. While the controlled substances were prescribed for a legitimate medical purpose, they were not deemed valid with only a doctor's order by Medicare and Medicaid rules. The company later self-disclosed to the government and has since changed its policy to comply with these rules. USAO EDPA; USAO WDPA

Tagged in: FCA Federal, Medicaid, Medical Billing Fraud, Medicare,

October 24, 2018

The owners and operators of two community mental health clinics in Pennsylvania and North Carolina have entered into a $3 million consent judgment with the United States to resolve allegations of violating the False Claims Act. In 2000, Melchor Martinez was convicted of Medicaid fraud by the State of Pennsylvania and subsequently banned from owning and operating health clinics or seeking reimbursement from all federally funded healthcare programs. Despite this, he allegedly continued to own and operate three chains of mental health clinics—including Northeast Community Health Centers, Lehigh Valley Community Mental Health Centers, and Carolina Community Mental Health Centers—by enlisting the help of his wife, Melissa Chlebowski, to act as the true owner and operator. In addition, the two allegedly failed to operate according to rules set by Medicare and Medicaid, including seeing patients for only 2-3 minutes and billing for 15, and billing for services provided by unqualified staff. They were eventually outed in a qui tam lawsuit filed by a former employee. USAO EDPA

Tagged in: FCA Federal, Healthcare Fraud, Improper Medical Personnel, Medicaid, Medical Billing Fraud, Medicare, Whistleblower Case,

October 24, 2018

Chevron entered in to a settlement agreement with the U.S. to resolve claims that it had violated Clean Air Act provisions aimed at preventing the release of hazardous chemicals from its facilities.  The settlement is valued at over $160 million, and includes: a $3 million civil penalty; Chevron's commitment to undertake approximately $150 million in safety improvements at its petroleum refineries; and, $10 million in funding for communities surrounding its refineries.  DOJ

Tagged in: Environmental Fraud,

October 23, 2018

Eye Centers of Florida, owned by Dr. David C. Brown, has agreed to pay $525,000 to settle claims of that it knowingly falsified the medical records of certain Medicare patients in order to submit qualifying reimbursement claims. In violation of the False Claims Act, Eye Centers allegedly altered the paperwork to make it appear that patients had worse vision than they actually did, allowing Eye Centers to bill for cataract surgeries that would ordinarily not have been reimbursable. The case was revealed through a lawsuit filed by two former employees, Patti Nilsson and Joann Smith, who are set to receive $115,500 from the settlement. USAO MDFL

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

October 23, 2018

Vascular Access Centers LP (VAC) and its 20+ related corporations in multiple states have agreed to pay $3.825 million over five years to settle whistleblower-brought allegations that VAC took part in an illegal patient referral kickback scheme and fraudulently billed Medicare for certain non-reimbursable procedures. The alleged fraud violated the Anti-Kickback Statute and False Claims Act and involved regularly scheduling, performing, and billing Medicare for certain vascular access procedures for End Stage Renal Disease (ESRD) beneficiaries that were not routinely necessary. Two whistleblowers will share in the relator's share of $612,000. DOJ; USAO EDLA; USAO SDNY

Tagged in: FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medicare, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

October 22, 2018

A Kentucky-based medical equipment supplier has agreed to pay $5,254,912 to settle claims based on the False Claims Act that it defrauded many government insurers, including Kentucky Medicaid, Medicare, and CHAMPVA (under the Department of Veterans Affairs), by submitting fraudulent claims relating to certain compounded creams that it produced. According to the DOJ press release, in order to be properly reimbursed, Cooley Medical Equipment, Inc. was required to obtain prior authorization from Kentucky Medicaid and CHAMPVA before using certain powdered ingredients. Instead, Cooley claimed to use cream-based versions of the same ingredients, then submitted thousands of false claims to the insurers, and received millions of dollars in reimbursements. The company eventually came clean and self-disclosed to the US Attorney's Office, allowing it to pay a fine of 1.5 times instead of the usual 3 times loss suffered by the government. USAO EDKY

Tagged in: Compounding Pharmacy Fraud, FCA Federal, Medicaid, Medicare, Other Government Health Programs, Pharma Fraud,

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