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Government Enforcement Actions

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Page 22 of 533

April 14, 2023

Rudean Weir and Jerome Weah will spend 30 and 46 months in prison, respectively, for defrauding the Enhanced One Shot Deal, a New York City Human Resources Administration program which provides cash assistance to homeless veterans seeking permanent housing. Weir and Weah submitted over 340 fraudulent EOSD applications using fake documentation and residency information and received approximately $5.4 million from the program as a result. Both defendants were ordered to pay $5.4 million in restitution. Weir will forfeit nearly $3.8 million, including his interest in two bank accounts, and six real estate properties. Weah will forfeit nearly $2.2 million, including his interest in two bank accounts and one real estate property. SNDY

Tagged in: Criminal Proceedings, FCA Federal, Government Programs Fraud,

April 14, 2023

Nine defendants will spend a combined 70 years in prison for their respective roles in a $126 million compounding fraud scheme. The co-conspirators defrauded the Department of Labor’s Office of Workers’ Compensation Programs and TRICARE by submitting false claims and paying kickbacks to patient recruiters and physicians for prescribing certain medications, based not on medical necessity but instead on the drugs’ hefty reimbursement rates. The patients received the compounded medications via mail, despite never requesting, wanting, or needing them. DOJ

Tagged in: Compounding Pharmacy Fraud, Criminal Proceedings, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Other Government Health Programs, Pharma Fraud, Provider Fraud,

April 13, 2023

Adobe Inc. will pay $3 million to resolve false claims allegations it paid kickbacks under its Solution Partner program to companies that had a relationship with the government, potentially influencing federal purchases of Adobe software. Over a ten-year period, Adobe allegedly paid companies a percentage of the purchase price, running afoul of the anti-kickback provisions, and causing false claims to be submitted to federal agencies. The three whistleblowers—all former Adobe managers—will receive $555,000 for exposing the fraud. DOJ

Tagged in: FCA Federal, Government Procurement Fraud, Whistleblower Case, Whistleblower Rewards,

April 11, 2023

Rishi Shah, Shradha Agarwal, and Brad Purdy, all former executives of Outcome Health, were convicted in a $1 billion scheme to fraudulently obtain funds from their clients, lenders, and investors. Outcome installed tv screens and tablets in physicians’ offices around the US, and then sold non-existent advertising inventory to be shown on the installed screens. Outcome billed clients in full, despite under-delivering on the contract, and inflated metrics to lie about the frequency in which patients accessed the tablets. Using inflated engagement data and revenue numbers, they raised $110 million in debt financing in April 2016, $375 million in debt financing in December 2016, and $487.5 million in equity financing in early 2017. The trio faces decades in prison because of their fraud. DOJ

Tagged in: Accounting Fraud, Financial and Investment Fraud, Misrepresentations,

April 4, 2023

From 2014 to 2022, medical testing company Genotox Laboratories Ltd. paid kickbacks to their “1099” representatives, calculated as a percentage of the revenue Genotox received from Medicare, the Railroad Retirement Board, and TRICARE billings for testing orders facilitated or arranged for by these representatives. In addition to the kickbacks, Genotox also allowed providers to create “custom profiles” to pre-select the tests to order for their patients, often resulting in medically unnecessary testing, such as definitive drug testing for 22 or more drug classes. Genotox will pay $5.9 million, and Genotox’s former billing manager—the whistleblower in this qui tam action—will receive approximately $1 million. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicare, Other Government Health Programs, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

March 30, 2023

Siblings John and Jonatina Barksdale offered unregistered crypto asset “Ormeus Coin” securities through their multilevel marketing scheme called Ormeus Global. The pair produced social media posts, YouTube videos, and other promotional materials, while John held roadshows around the world to promote the securities. Defendants claimed Ormeus Coin had a quarter-billion-dollar mining operation, mining $5.4 to $8 million per month, but the mining operation generated less than $3 million in total revenue, and mining operations ceased. The Barksdales were ordered to pay over $46 million in disgorgement, prejudgment interest of $10 million, and a civil penalty of $23 million each. SEC

Tagged in: Financial and Investment Fraud, Misrepresentations, Ponzi Schemes,

March 30, 2023

Pharmacist Gisele Nguyen will pay over $3.9 million for fraudulently billing Medicare for medications that were never dispensed. For at least a 5-year period, from 2014 to 2018, Nguyen, dba Natico Pharmacy, submitted fraudulent claims for prescriptions that were never dispensed, and inventory records reflected that the pharmacy did not purchase enough of the medications from wholesalers to meet the fraudulent demand. DOJ

Tagged in: FCA Federal, Healthcare Fraud, Medicare, Pharma Fraud,

March 29, 2023

Michigan-based Covenant Healthcare System and two physicians, neurosurgeon Dr. Mark Adams and electrophysiologist Dr. Asim Yunus, have agreed to pay $69 million and about $406,500 and $346,000 respectively to resolve allegations of violating the Anti-Kickback Statute, Stark Law, and False Claims Act.  Covenant allegedly provided Dr. Yunus and five other physicians medical directorship roles, employed Dr. Adams, forgave rent payments from another physician, and permitted a physician group to secure a lease on advantageous terms in exchange for referrals.  Covenant then submitted false claims based on those referrals to Medicare, Medicaid, and TRICARE.  The claims were first raised by Dr. Stacy Goldsholl in a qui tam suit; Goldsholl will receive over $12 million from the three settlements.  USAO EDMI

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medicaid, Medicare, Other Government Health Programs, Whistleblower Case, Whistleblower Rewards,

March 29, 2023

A man who led a scheme to defraud New York’s Medicaid program has been sentenced to almost 8 years in prison, ordered to pay $8.5 million in restitution, and ordered to forfeit $8.5 million in ill-gotten gains.  While supervising more than a dozen others affiliated with KJ Transportation C Services Inc. (“KJ”), Julio Alvarado submitted or caused to be submitted false claims for transportation services to Medicaid beneficiaries, for which KJ was ultimately paid $20 million.  However, in many of those cases, the beneficiary was deceased or out of the country at the time of the alleged transport, or had never heard of or taken rides with KJ.  In other instances, the beneficiary received kickbacks from KJ in exchange for their Medicaid information.  USAO SDNY

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

March 28, 2023

One of the largest iron ore producers in the world, Brazilian mining company Vale S.A., has agreed to pay $55.9 million to settle charges of making false and misleading disclosures concerning the stability of its dams.  One of the dams in particular, Brumadinho, failed to meet international safety standards and subsequently collapsed in January 2019, killing 270 people.  The settlement consists of $25 million in civil penalties and disgorgement, and $30.9 million in pre-judgment interest.  SEC

Tagged in: Financial and Investment Fraud,

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