Whistleblower Group

October 30, 2014

San Francisco based hospital system Dignity Health (formerly known as Catholic Healthcare West) agreed to pay $37M to settle False Claim Act charges that 13 of its hospitals in California, Nevada and Arizona submitted false claims to Medicare and TRICARE by admitting patients for inpatient services who could have been treated on a less costly, outpatient basis. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Kathleen Hawkins, a former employee of Dignity. She will receive a whistleblower award of $6.25M. DOJ

October 29, 2014

Jigar Patel, a physical therapist assistant was sentenced to serve 50 months in prison and pay $1.9M in restitution for his role in a $14.9M scheme through which he and others billed Medicare for home health services they never provided, and provided beneficiaries with prescriptions for unnecessary painkillers and other narcotics to induce them to sign false medical documents to support the fraudulent billings. Patel and his co-conspirators carried out their scheme using five home health care companies – Physicians Choice Home Health Care LLC, Quantum Home Care Inc., First Care Home Health Care LLC, Moonlite Home Care Inc., and Phoenix Visiting Physicians. DOJ

October 29, 2014

North Florida Shipyards and its president, Matt Self, agreed to pay $1M to resolve allegations they violated the False Claims Act by creating a front company, Ind-Mar Services Inc., to improperly secure Coast Guard contracts that were designated for Service Disabled Veteran Owned Small Businesses (SDVOSBs). The allegations originated in a whistleblower lawsuit filed by Robert Hallstein and Earle Yerger under the qui tam provisions of the False Claims Act. They will receive a whistleblower award of $180,000.DOJ

October 29, 2014

Medical device maker EBI LLC, doing business as Biomet Spine and Bone Healing Technologies and Biomet Inc., agreed to pay $6M to resolve allegations it violated the False Claims Act by paying kickbacks to induce use of its bone growth stimulators, which are used to repair fractures that are slow to heal. Specifically, the government alleged that from 2001 to 2008 EBI paid staff at doctors’ offices (through personal service agreements) to influence doctors to order its bone growth stimulators. The allegations originated in a whistleblower lawsuit filed by former EBI product manager Yu Yue under the qui tam provisions of the False Claims Act, who will receive an undisclosed whistleblower award. DOJ

October 28, 2014

Columbia University agreed to pay $9M to settle allegations it defrauded the government of grant funding for AIDS and HIV related work. Specifically, the government charged that as the grant administrator for ICAP (formerly known as International Center for AIDS Care and Treatment Programs), Columbia was required but failed to verify for nearly 200 ICAP employees that they performed the work for which they received grant funding. This resulted in Columbia obtaining grants for work that was not actually performed on the project being funded. Whistleblower Insider

October 27, 2014

Laura Leyva, the former president and owner of rehabilitation therapy services clinic American Rehab of Kissimmee Inc., pleaded guilty to health care fraud and money laundering. Specifically, from June 2007 through November 2009, American Rehab submitted approximately $2.5M in false and fraudulent claims for reimbursement to Medicare seeking payment for rehabilitation therapy services that were not legitimately prescribed and not provided. Co-conspirators falsified and forged medical records used to give the appearance that therapy services were rendered when, in fact, they were not. DOJ

October 24, 2014

Boulder, Colorado-based antenna and radio system company First RF Corporation agreed to pay $10M to settle allegations it violated the False Claims Act by submitting inflated claims for electronic warfare antennas sold to the US Army to combat Improvised Explosive Devices. Specifically, the government alleged that First RF knowingly submitted false data to the Army that misrepresented First RF’s cost to manufacture the antennas, and thereby inflated the price for the antennas and the payments First RF received for them. DOJ

October 22, 2014

Tayyab Aziz, founder of three Detroit-area home health agencies Prestige Home Health Services Inc., Royal Home Health Care Inc., and Platinum Home Health Services Inc. pleaded guilty for his role in a $22M home health care fraud scheme. Specifically, Aziz admitted he and his co-conspirators submitted fraudulent claims to Medicare for services that were medically unnecessary or never performed. They also submitted claims for services purportedly provided to Medicare beneficiaries who were recruited through illegal kickbacks paid to the patients and recruiters. DOJ

October 21, 2014

Kentucky-based cardiologists Satyabrata Chatterjee and Ashwini Anand, who jointly owned cardiologist physician group Cumberland Clinic, agreed to pay $380,000 to resolve allegations they violated the False Claims Act by entering into sham management agreements with Saint Joseph Hospital in exchange for the referral of cardiology procedures and other healthcare services to Saint Joseph. The government alleged that St. Joseph Hospital entered into sham agreements with Chatterjee and Anand, under which the physicians were paid to provide management services but did not in fact do so and that in exchange Chatterjee and Anand agreed to enter into an exclusive agreement with Saint Joseph to refer Cumberland Clinic patients to the hospital for cardiology and other services in violation of the Stark Law and the Anti-Kickback Statute. The government previously entered into a $16.5M settlement with Saint Joseph for the allegedly sham management contracts for unnecessary and excessive cardiology procedures. The allegations originated from a whistleblower lawsuit filed by three Lexington, Kentucky cardiologists under the qui tam provisions of the False Claims Act. The three whistleblowers, Drs. Michael Jones, Paula Hollingsworth and Michael Rukavina, will collectively receive a whistleblower award of $68,400. DOJ

October 21, 2014

Science Applications International Corporation(SAIC), now known as Leidos Holdings Inc., agreed to pay $1.5M to resolve False Claims Act allegations that it knowingly engaged in prohibited conflicts of interest as a contractor for the U.S. Nuclear Regulatory Commission (NRC) between 1992 and 2000. SAIC provides scientific, engineering and other technical services for government and commercial customers. Between 1992 and 2000, SAIC held two contracts with the NRC to provide scientific and technical services, including assisting the NRC in its consideration of a rule that could have permitted the release or recycling of certain types and quantities of material with very low levels of radioactivity below regulatory safety limits. According to the government, SAIC repeatedly and falsely certified it had no conflicting business relationships when in fact it actually engaged in multiple business relationships with entities that had a financial interest in the outcome of the NRC’s rulemaking effort. DOJ