DOJ Enforcement

October 17, 2013

Boston Scientific Corp. agreed to pay $30Mn to settle allegations that, between 2002 and 2005, its Guidant subsidiary knowingly sold defective heart devices to health care facilities that in turn implanted the devices into Medicare patients. The allegations were first raised in a qui tamlawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

September 25, 2013

Kan-Di-Ki LLC, d/b/a Diagnostic Laboratories and Radiology agreed to pay $17.5M to settle allegations that the California-based company violated the federal and California False Claims Acts by paying kickbacks for referral of mobile lab and radiology services subsequently billed to Medicare and Medi-Cal (the state of California’s Medicaid program). The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

September 16, 2013

The Macalan Group Inc., f/k/a NEK Advanced Securities Inc. agreed to resolve allegations that it submitted false claims in connection with a contract with the Joint Improvised Explosive Device Defeat Organization. NEK’s contract with JIEDDO required it to develop and deploy teams of specialized personnel to Iraq and Afghanistan to combat improvised explosive devices. DOJ

September 13, 2013

Gulf Region Radiation Oncology Centers, Sacred Heart Health System, West Florida Medical Center Clinic and others agreed to pay $3.5M to resolve allegations that they billed Medicare, Medicaid and TRICARE – the health care program for uniformed service members, retirees and their families worldwide – for radiation oncology services that were not eligible for payment. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

August 29, 2013

Conax Florida Corp. agreed to resolve allegations under the False Claims Act that the company submitted false claims to the government for improperly tested inertia reels and non-conforming voltage references. Inertia reels are part of a system designed to secure aircrew members in the event of a crash. Voltage references are electronic parts used in water-activated parachute releases. Both devices are used by the U.S. military and NASA. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

August 28, 2013

RPM International Inc. and its subsidiary, Tremco Inc. paid $61M to resolve allegations that Tremco filed false claims in connection with two multiple award schedule contracts with the General Services Administration for roofing supplies and services. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

August 27, 2013

Imagimed LLC and the company’s former owners and chief radiologist agreed to pay $3.57M to resolve allegations that they submitted to federal healthcare programs false claims for magnetic resonance imaging (MRI) services. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

August 22, 2013

ATI Enterprises Inc. will pay the government $3.7M to resolve False Claims Act allegations that it falsely certified compliance with federal student aid programs’ eligibility requirements and submitted claims for ineligible students. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

December 18, 2015

Thirty-two hospitals in 15 states agreed to pay more than $28 million to settle charges they violated the False Claims Act by submitting false claims to Medicare for minimally-invasive kyphoplasty procedures used to treat certain spinal fractures often arising from osteoporosis.  According to the government, the settling hospitals billed Medicare for these procedures on a more costly inpatient basis when they should have been billed on a less costly outpatient basis.  The government has now reached settlements with more than 130 hospitals totaling approximately $105 million to resolve allegations of overcharging Medicare for kyphoplasty procedures.  The 15 current settling hospitals include: The Cleveland Clinic (Ohio); Citrus Memorial Health System (Florida); Cullman Regional Medical Center (Alabama); Martin Memorial Medical Center (Florida); MultiCare Tacoma General Hospital (Washington); Norwalk Hospital (Connecticut); Princeton Community Hospital Association (West Virginia); Sacred Heart Medical Center (Washington); Sarasota Memorial Hospital (Florida); Spartanburg Regional Health Services District Inc. (South Carolina); St. Cloud Hospital (Minnesota); Tampa General Hospital (Florida); 5 hospitals affiliated with Community Health Systems Inc. (Tennessee); 5 hospitals affiliated with Tenet Health Care Corporation (Texas); 5 hospitals formerly owned and operated by Health Management Associates (Florida); 3 hospitals affiliated with BayCare Health System (Florida); and 2 hospitals affiliated with Banner Health (Arizona).  In addition, the government previously settled with Medtronic Spine LLC, the corporate successor to Kyphon Inc., for $75 million to settle allegations the company caused false claims to be submitted to Medicare by counseling hospital providers to perform kyphoplasty procedures as inpatient rather than outpatient procedures.  All but 3 of the current settlements originated in a whistleblower lawsuit filed by Craig Patrick, a former Kyphon reimbursement manager, and Charles Bates, a former Kyphon sales manager for Kyphon.  They will receive a whistleblower award of roughly $4.75 million from the proceeds of the government’s recovery.  DOJ

June 24, 2015

Dr. Alon Vanier and nurse Daniel Barbir will receive a very sizeable whistleblower award from the $450 million DaVita Healthcare Partners, Inc. agreed to pay to settle charges it violated the False Claims Act by purposely creating and then billing the government for unnecessary waste in administering the drugs Zemplar and Venofer to dialysis patients.