Whistleblower Group

December 18, 2015

Ohio cardiologist Dr. Harold Persaud, with hospital privileges at Fairview Hospital, St. John’s Medical Center and Southwest General Hospital, was sentenced to 20 years in prison for performing unnecessary catheterizations, tests, stent insertions and causing unnecessary coronary artery bypass surgeries as part of a scheme to overbill Medicare and other insurers by $29 million.  DOJ

December 18, 2015

21st Century Oncology, a Florida-based provider of integrated cancer care services, agreed to pay $19.75 million to resolve allegations it violated the False Claims Act by billing federal health care programs for laboratory tests that were not medically necessary.  The tests involved were fluorescence in situ hybridization (or “FISH”) tests which are laboratory tests performed on urine that can detect genetic abnormalities associated with bladder cancer.  The government alleged that 21st Century submitted claims for unnecessary FISH tests that were ordered by four of its urologists, Dr. Meir Daller, Dr. Steven Paletsky, Dr. David Spellberg and Dr. Robert Scappa.  The government further alleged the company encouraged these physicians to order unnecessary FISH tests by offering bonuses that were based in part on the number of tests referred to 21st Century’s laboratory.  The allegations first arose in a whistleblower lawsuit filed by a former 21st Century medical assistant under the qui tam provisions of the False Claims Act.  The whistleblower will receive a whistleblower award of $3.2 million from the proceeds of the government’s recovery.  DOJ

December 18, 2015

Maryland-based splint supplier Dynasplint Systems Inc., and its founder and president, George Hepburn, agreed to pay roughly $10.3 million to resolve allegations they violated the False Claims Act by improperly billing Medicare for splints provided to patients in skilled nursing facilities.  According to the government, to circumvent Medicare rules which provide for bundled payment to these facilities that cover all of a patient’s needs, Hepburn and Dynasplint mispresented that patients were in their homes or other places that were not skilled nursing facilities.  The allegations first arose in a whistleblower lawsuit filed by former Dynasplint sales executive Meredith Deane under the qui tam provisions of the False Claims Act.  Ms. Deane will receive a whistleblower award of roughly $2 million from the proceeds of the government’s recovery.  DOJ

December 18, 2015

Iowa Hospice, LLC agreed to pay roughly $1.1 million to settle charges it violated the False Claims Act by submitting false bills to Medicare for hospice services. The Medicare hospice benefit is only available to patients who elect palliative care for a terminal illness and who have a life expectancy of six months or less.  The government alleged that Iowa Hospice knowingly submitted false claims to the government for payment of these services for patients that did not have such a medical prognosis.  DOJ (N.D. OH)

December 16, 2015

Amer Ehsan, the owner and operator of Detroit-area home health care agency Advance Home Health Care Services Inc., was sentenced to 80 months in prison for conspiring with physicians, physical therapists and patient recruiters to bill Medicare for unnecessary home health care and therapy services and paying kickbacks to physicians for referrals.  Ehsan also admitted that he owned and controlled Michigan Rehab and Management Services LLC, which he used to sell information about Medicare beneficiaries and corresponding fictitious patient files to other Detroit-area home health care agencies.  DOJ

December 16, 2015

Louisiana doctors Barbara Smith and Roy Berkowitz and registered nurse Beverley Breaux were sentenced to 80 months, 64 months and 50 months in prison, and to pay $9,484,939, $4,952,816 and $2,057,179 in restitution, respectively, for their roles at the center of a $50 million health care fraud scheme.  Specifically, Smith and Berkowitz falsely certified that thousands of Medicare recipients were homebound and required nursing or therapy services to be provided in their homes, and Breaux falsely certified that these patients were homebound and falsely claimed to have treated patients she had not seen.  DOJ

December 16, 2015

Qualitest Pharmaceuticals, the company’s corporate shell, Vintage Pharmaceuticals, its parent Endo Pharmaceuticals, and seven of their affiliates, agreed to pay $39 million to 48 states and the federal government to settle charges they violated federal and state False Claims Acts by selling understrength chewable fluoride tablets.  As part of the settlement, Qualitest admitted the drug labeling for its chewable fluoride tablets represented fluoride amounts in line with guidelines of the American Dental Association and the American Academy of Pediatrics when in reality it used less than half of these represented amounts.  The allegations were first raised in a whistleblower lawsuit brought Dr. Stephan Porter under the qui tam provisions of the False Claims Act.  He will receive a whistleblower award of roughly $4.71 million from the proceeds of the government’s recovery.  Whistleblower Insider, NY, NH

December 10, 2015

Tishman Construction Corporation agreed to pay more than $20 million to settle charges of overbilling customers over a ten-year period.  Starting from at least 1999, Tishman Construction allegedly billed clients for large construction projects for hours never worked or for rates not agreed upon.  Tishman Construction carried out the scheme by, among other things, padding hours of unworked or unnecessary “guaranteed” overtime; and submitting time for certain foremen who were actually absent for sick days, major holidays and vacation days.  The government claims the company also billed clients at wage rates that exceeded those specified in the governing contracts.  Whistleblower Insider

December 9, 2015

Louisiana-based Bollinger Shipyards agreed to pay $8.5 million and release the government from contract claims to settle False Claims Act charges it misrepresented the longitudinal strength of patrol boats it delivered to the Coast Guard that resulted in the boats buckling and failing once they were put into service.  Bollinger was the subcontractor that performed design and conversion work on the Coast Guard’s existing fleet of 110-foot patrol boats.  According to the government, Bollinger provided the Coast Guard with engineering calculations that falsely represented the longitudinal strength of the boats and was two times greater than their actual longitudinal strength. The government further alleged Bollinger failed to follow the quality control procedures that were mandated by the contract that would have ensured against such engineering miscalculations.  DOJ

December 8, 2015

Vermont-based dairy farm Correia Farm Limited Partnership (d/b/a Wynsum Holsteins) and its co-owners Anthony and Barbara Correia and their son and limited partner Stephen Correia, agreed to a permanent injunction to prevent violations of the federal Food, Drug and Cosmetic Act (FDCA).  According to the government, the farm and its owners violated the FDCA by unlawfully administering new animal drugs for uses not approved by the FDA and unlawfully selling livestock for slaughter and human consumption despite the presence of unsafe drug residues in the animals’ edible tissues. DOJ