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...

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...

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...

Top Ten Federal Financial and Healthcare Fraud Prison Sentences of 2022

Financial and healthcare fraud often can carry stiff monetary penalties for entities facing government enforcement, as shown on our other Top Ten Lists. Whistleblowers reporting wrongful conduct under one of the federal whistleblower reward laws sometimes find that criminal authorities are as interested in their allegations as civil enforcement agencies and authorities. Fraud can also result in criminal charges and prison sentences for the individual perpetrators of the fraud. The...

Top Ten Whistleblower Awards of 2022

2022 was a big year for whistleblowers, who once again recouped billions of government dollars and in turn received hundreds of millions in whistleblower rewards.  This year’s top rewards came from various government whistleblower programs, including the qui tam provisions of the federal False Claims Act, various state False Claims Act programs, and the Dodd-Frank SEC Whistleblower Program. Below is a compilation of the Top Ten publicly-announced whistleblower awards of 2022, which collectively amount to $470...

January 30, 2023

A doctor in Michigan who was involved in a $250 million fraud scheme against Medicare, Medicaid, and other insurers, has been sentenced to 16.5 years in prison.  Along with 21 co-conspirators, Dr. Francisco Patino took advantage of patients suffering from addiction by forcing them to receive medically unnecessary, painful, but lucrative spinal injections in exchange for opioid prescriptions.  Additionally, Patino knowingly violated the Anti-Kickback and Stark laws by receiving kickbacks...

Top Ten Non-Healthcare False Claims Act Recoveries of 2022

This year’s Top Ten Non-Healthcare False Claims Act Recoveries exhibit the False Claim Act’s (FCA) enduring ability to combat corporate misconduct across distinct industries.  In 2022, the United States recovered hundreds of millions in taxpayer funds falsely obtained by defendants through bribery and bid-rigging schemes, mortgage underwriting fraud, fraudulent loan applications, fraud in the energy sector, and an array of contracting fraud schemes including manipulating small business set-aside contracts, misrepresenting...

January 20, 2023

DePuy Synthes, Inc., a subsidiary of Johnson & Johnson that manufactures medical devices, has agreed to pay $9.75 million to resolve allegations of defrauding Medicare and Medicaid.  According to former sales representative Aleksej Gusakovs, DePuy gave a Massachusetts-based orthopedic surgeon thousands of dollars’ worth of free implants and instruments for use in overseas surgeries.  The illegal kickbacks induced the surgeon to use DePuy products in surgeries performed in the United...

Top Ten State Fraud Recoveries of 2022

State and local governments play a critical role in ensuring that businesses and individuals are held accountable if they commit healthcare fraud, financial fraud, government contract fraud, and more. For whistleblowers, state governments can offer additional opportunities to report wrongdoing. Where government funds are at stake – and state and local government spending reaching $3 trillion annually – more than 30 states have False Claims Acts that are modeled after...

Top Ten Healthcare Fraud Recoveries of 2022

Consistent with the trend in prior years, 2022 saw government enforcement agencies taking aim at fraud and false claims in healthcare.  As the cost of healthcare rises along with its share of the U.S. economy, the enforcement focus on healthcare fraud is likely to accelerate. And, as always, the role of whistleblowers will be critical, as demonstrated by the dominance of cases originated by whistleblowers under the qui tam provisions...