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Page 219 of 254

May 7, 2015

Health Management Associates Inc. (and 14 hospitals it previously owned), along with Community Health Systems and North Texas Medical Center, agreed to collectively pay $15.69 million to settle whistleblower charges they violated the False Claims Act by seeking and receiving Medicare reimbursement for Intensive Outpatient Psychotherapy (IOP) services that were not medically reasonable or necessary.  The IOP services in question were typically performed on the providers’ behalf by Louisiana-based Allegiance Health Management.  The allegations were first raised in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act.  The unidentified whistleblower will receive a whistleblower award of $2,667,300.  Whistleblower Insider

Tagged in: FCA Federal, Hospital Fraud, Lack of Medical Necessity, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

May 7, 2015

Tennessee-based Jackson-Madison County General Hospital agreed to pay $1,328,465 to resolve allegations it improperly billed Medicare and Medicaid for the placement of unnecessary cardiac stents and other unnecessary cardiac procedures including angioplasty, catheterization, and ultrasound imaging.  The allegations were first raised in a whistleblower lawsuit filed by Dr. Wood D. Deming under the qui tam provisions of the False Claims Act.  Mr. Deming will receive an undisclosed portion of the settlement as a whistleblower award.  DOJ

Tagged in: FCA Federal, Hospital Fraud, Lack of Medical Necessity, Medical Devices and DME, Whistleblower Case, Whistleblower Rewards,

May 1, 2015

Paris-based BNP Paribas S.A. was ordered to forfeit $8,833,600,000 and pay a $140,000,000 fine for conspiring to violate the International Emergency Economic Powers Act (IEEPA) and the Trading with the Enemy Act (TWEA) by processing billions of dollars of transactions through the US financial system on behalf of Sudanese, Iranian and Cuban entities subject to U.S. economic sanctions.  It is the largest financial penalty ever imposed in a criminal case and the first time a financial institution has been convicted and sentenced for violations of US economic sanctions.  DOJ  

Tagged in: Financial Institution Fraud,

May 1, 2015

Accredo Health Group, a unit of Express Scripts Holding Co., agreed to pay $60 million to settle False Claims Act and Anti-Kickback Statute charges that the company participated in a kickback scheme with Novartis Pharmaceuticals Corp. involving the prescription drug Exjade.  According to the government, Novartis provided kickbacks, in the form of patient referrals and related benefits, to Accredo in exchange for Accredo recommending refills to Exjade patients.  The government also intervened in a whistleblower lawsuit against Novartis for the same alleged scheme.  The government claims defendants allegedly understated the serious and potentially life-threatening side effects of Exjade when promoting the drug’s benefits to patients. FBI

Tagged in: Anti-Kickback and Stark, FCA Federal, Pharma Fraud,

April 30, 2015

South Korean industrial company Kolon Industries Inc. pleaded guilty to conspiracy to steal trade secrets involving E.I. DuPont de Nemours & Co.’s Kevlar technology and was sentenced to pay $85 million in criminal fines and $275 million in restitution.  DOJ

April 30, 2015

Miami-area doctor Barry Kaplowitz was sentenced to 60 months in prison and ordered to pay more than $2.9 million in restitution for his role in a $5.5 million Medicare fraud scheme involving fraudulent billings by Hollywood Pavilion, a psychiatric hospital in Hollywood, Florida.  According to evidence, Kaplowitz signed fraudulent medical records in order to make it appear that the hospital’s patients qualified for and received intensive outpatient services, even though they did not.  DOJ

Tagged in: Lack of Medical Necessity, Provider Fraud,

April 29, 2015

Black & Decker agreed to pay a $1.575 million penalty to settle allegations it knowingly violated the reporting requirements of the Consumer Product Safety Act with respect to cordless electric lawnmowers that started spontaneously and that continued to operate after consumers released the lawnmower handles and removed the safety keys.  Black & Decker has previously paid four civil penalties relating to Black & Decker’s untimely reporting of defects and risks presented by other Black & Decker products.  DOJ

April 29, 2015

The Hospital Authority of Irwin County (ICH) and several doctors agreed to pay $520,000 to settle charges they violated the False Claims Act, the Anti-Kickback Statute, the Stark Law and related Georgia Medicaid policies in connection with the amount of compensation paid by ICH to one of the doctors, ICH’s leases with the doctors, and the supervision of certain diagnostic imaging services at ICH.  The allegations first arose in a whistleblower lawsuit filed by Connie Brogdon and Summer Holland under the qui tam provisions of the False Claims Act and the Georgia False Medicaid Claims Act.  They will receive an undisclosed portion of the settlement payment.  DOJ

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

April 29, 2015

Chad, Chris and Craig Ducey pleaded guilty for their role in a multi-state scheme to defraud biodiesel buyers by fraudulently selling biodiesel incentives.  The Ducey brothers operated E-biofuels LLC and they sold over 35 million gallons of biodiesel to customers for more than $145 million by falsely claiming the fuel was eligible for federal renewable energy incentives, when they knew it was not.  In addition, Craig Ducey pleaded guilty to a related $58.9 million securities fraud, which victimized over 625 investors and shareholders of Imperial Petroleum, the publicly-traded parent company of E-biofuels.  DOJ

Tagged in: Environmental Fraud, Tax Credit and Deduction Fraud,

April 28, 2015

Japan-based Yamada Manufacturing Co. Ltd. agreed to plead guilty and pay a $2.5 million criminal fine for its role in a conspiracy to fix prices and rig bids for manual (non-electric or non-hydraulic-powered) steering columns installed in cars sold in the US and elsewhere.  DOJ

Tagged in: Bribery and Bid-Rigging,

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