February 14, 2019

Compounding pharmacy Vital Life Institute LLC, formerly known as AgeVital Pharmacy LLC, will pay $775,000 to resolve claims that the company and its principals paid kickbacks to third-party marketing companies to solicit prospective patients, regardless of the patients' needs.  The investigation was initiated by the filing of a qui tam complaint under the False Claims Act by Manfred Knopf, who received unwanted compounded medications from AgeVital that were billed to...

February 12, 2019

Michael Frey of Ft. Myers, Florida, a physician specializing in pain management, was sentenced to 18 months in prison for his role in an illegal kickback scheme.  Frey was a co-owner of Advanced Pain Management Specialists, P.A., and received kickbacks from A&G Spinal Solutions, LLC (which made checks payable to his wife) for a share of its profits from patient referrals; from a compound pharmacy provider; and as "speaker fees"...

February 6, 2019

Abbott Labs has agreed to pay a total of $25 million to settle allegations of paying kickbacks to healthcare professionals in exchange for promotion of its drug, and inappropriately marketing its drug, TriCor, for cardiovascular events not approved by the FDA. The case was initiated by the State of North Carolina and joined by California, Illinois, Nevada, Maryland, Michigan, and Texas, as well as the federal government. NC AG

January 28, 2019

Avanti Hospitals LLC and six of its owners will pay $8.1 million to settle claims that they violated the False Claims Act by submitting, or causing Avanti’s subsidiary, Memorial Hospital of Gardena, to submit false claims to the Medicare and Medicaid programs for medical services referred by a physician who received kickbacks and other improper payments from Gardena and other Avanti affiliates. The settlement partially resolves allegations originally brought in...

January 28, 2019

Norma Zayas, of Miami, was sentenced to 51 months in prison for her role in a $4.66 million health care fraud scheme involving several Miami-area home health agencies, including Sunshine Home Health Services Inc., Empire Home Health Agency Inc., Mildred & Marce Home Health Care Services Inc., and Nursing Care PRN Inc., which purported to provide home health services to Medicare patients. Zayas must also pay $4,658,241.00 in restitution and...

Top Ten Federal False Claims Act Recoveries of 2018

The federal False Claims Act, under which whistleblowers can bring claims to report fraud and misconduct in government contracts and programs, is the foundation of the Department of Justice's fraud recovery and the U.S. whistleblower reward system.  In 2018, the U.S. recovered over $2 billion from defendants who sought to cheat the system. The top FCA settlements for calendar year 2018, based on the amount of the total recoveries, are...

Top Ten Whistleblower Awards of 2018

2018 was another banner year for whistleblowers. As the DOJ recently reported in its annual summary of False Claims Act recoveries, $2.1 billion of the $2.8 billion in settlements and judgments reported last year arose from lawsuits filed under the qui tam provisions of the False Claims Act. During the same period, the government paid out $301 million in whistleblower awards to the individuals who exposed the fraud by filing...

January 24, 2019

Mississippi recovered $26.6 million in settlements with private prison and correctional services contractors including for-profit correctional facilities operators Management and Training Corporation ($5.2 million) and Cornell Companies, Inc., now part of GEO Group ($4.6 million), correctional healthcare provider Wexford Health Sources, Inc. ($4 million); commissary management company Keefe Commissary Network, LLC ($3.1 million), and construction company C. N. W. Construction Company ($3.1 million).  The state's lawsuits against the companies alleged...

Top Ten Healthcare Recoveries of 2018

Consistent with the trend in prior years, the bulk of the Justice Department’s fraud and false claims recoveries in 2018 stemmed from healthcare fraud matters. And again, most of the funds recovered arose from cases originated by whistleblowers under the qui tam provisions of the False Claims Act. Here are the top ten healthcare recoveries of 2018 by the numbers: Amerisource Bergen Corporation - In October 2018, DOJ announced that wholesale...

Top Ten Financial and Healthcare Fraud Prison Sentences of 2018

Financial and healthcare fraud schemes can result not just in civil investigations and liability, but also in prison time for the individuals involved.  In 2018, the Department of Justice obtained substantial prison sentences in numerous cases involving healthcare and financial frauds, helping to bring justice to the patients, investors, or individuals harmed by criminal fraudsters.  Many of the fraudulent schemes involved in these convictions are of the type that whistleblowers report,...