May 18, 2022

Pat Truglia will spend 120 months in prison, forfeit over $9.4 million, and will pay restitution of $33.7 million for conspiring to defraud Medicare, TRICARE, and CHAMPVA, among others, of approximately $50 million through their fraudulent billing scheme. The scheme involved offering, paying, soliciting, and receiving kickback for durable medical equipment—in this case, braces. Truglia and his conspirators obtained DME orders for Medicare and other federal healthcare program beneficiaries by...

April 12, 2022

Physician Partners of America LLC (PPOA), its founder Rodolfo Gari, and its former chief medical officer Dr. Abraham Rivera, have agreed to pay $24.5 million to settle allegations of violating the Stark Law, False Claims Act, and Financial Institutions Reform, Recovery and Enforcement Act (FIRREA).  The settlement resolved claims by whistleblowers Donald Haight, Dawn Baker, Dr. Harold Cho, Dr. Venus Dookwah-Roberts, and Dr. Michael Lupi, all currently or formerly employed...

March 30, 2022

Multiple sales representatives of Delaware-based pharmacy, Heritage Therapeutics, LLC have been ordered to forfeit and/or pay fines totaling over $8.7 million after they were found to have paid kickbacks to physicians in exchange for prescribing expensive compounded medications to TRICARE beneficiaries.  Additionally, Heritage and various executives have entered into a settlement agreement to resolve claims under the Anti-Kickback Statute and False Claims Act.  USAO EDPA

March 22, 2022

Ten doctors in Texas and a healthcare executive have agreed to pay nearly $1.7 million to resolve allegations of violating the False Claims Act, Anti-Kickback Statute, and Stark Law.  In exchange for ordering laboratory tests from Rockdale Hospital d/b/a A little River Healthcare, True Health Diagnostics LLC, and Boston Heart Diagnostics Corporation, the doctors allegedly received thousands of dollars in kickbacks disguised as investment returns.  USAO EDTX

March 21, 2022

Jonathan and Daniel Markovich, two brothers who operate addiction treatment facilities in Florida, have been sentenced to over 15 years and 8 years in prison respectively after being convicted of running a $112 million fraud scheme.  Through patient recruiters, the defendants paid illegal kickbacks to patients in the form of airline tickets, cash payments, and illegal drugs to entice them to visit their inpatient detox and residential facility, Second Chance...

March 7, 2022

MOX Services LLC, formerly known as CV&I AREVA MOX Services LLC (MOX), has agreed to a $10 million settlement to resolve allegations of violating the False Claims Act.  As the prime contractor for a federal facility in South Carolina, MOX was responsible for confirming receipt of materials from any subcontractors before presenting claims to the government.  According to the DOJ, however, MOX knowingly sought reimbursement from the Department of Energy...

Contract Set-Aside Fraud

Fraud in government contract preference and set-aside programs for small businesses and disadvantaged businesses can be reported by whistleblowers, who may be eligible to receive a reward Contract set-aside fraud is an abuse of programs designed to help small businesses and disadvantaged businesses.  While the government generally requires “full and open competition” for contracts, regulations under the Small Business Act and other laws permit, or even require, some procurements to...

February 10, 2022

Bradley Jason Kantor, 49, will spend 10 years in federal prison after being found guilty of paying kickbacks for referrals to his immunotherapy and antigen business, Mobile Diagnostic Imaging, Inc. (MDI). MDI received more than $12 million from the scheme in which MDI submitted approximately $42 million in false claims to United Healthcare, for which services were never rendered. USAO SDFL

January 31, 2022

Cardinal Health agreed to pay more than $13 Million to settle allegations it violated the Anti-Kickback Statute and False Claims Act by paying “upfront discounts” to its physician practices. According to the government, Cardinal Health recruited new customers by offering and paying cash bonuses that were not attributable to identifiable sales or were purported rebates which Cardinal Health’s customers had not actually earned. In connection with the settlement, the whistleblowers...

Top Ten State Fraud Recoveries of 2021

State enforcement of anti-fraud laws is an important deterrent and tool to create accountability.  In cases of healthcare fraud and financial fraud, including government contract fraud, unlawful kickbacks, and tax evasion, state governments act as critical enforcement authorities, including through state False Claims Acts. Whistleblowers with information about fraud that violates state laws, or involves state funds, should always consider reporting to state enforcement authorities.  Many state False Claims Acts...