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,...

Top Ten FCPA Recoveries of 2018

2018 saw substantial monetary settlements for violations of the Foreign Corrupt Practices Act (“FCPA”), which is the leading U.S. law barring bribery of foreign officials by companies subject to its reach.  Violations of the FCPA are investigated by DOJ as well as by the Securities and Exchange Commission.  The SEC has long recognized the FCPA as a high enforcement priority, and whistleblowers with knowledge of FCPA violations may be able...

December 20, 2018

Pain specialist Dr. Jonathan Daitch, a principal in Ft. Myers-based Advanced Pain Management Specialists, P.A., has agreed to pay more than $1.7 million to resolve allegations that he violated the False Claims Act.  Dr. Daitch caused Medicare and Tricare to be billed for medically-unnecessary urine drug testing performed at Advanced Pain's in-house laboratory.  In addition, Daitch received kickbacks for anesthesia services.  A co-owner of Advanced Pain, Dr. Michael Frey, previously...

December 19, 2018

Molecular Testing Labs, based in Vancouver, Washington, has agreed to settle claims that it violated the False Claims Act by paying local laboratories in exchange for referrals, in violation of the Anti-Kickback Statute.  The amount of the settlement will be determined in ongoing litigation between Molecular Testing Labs and CMS, and could be between $180,000 and $1,777,738. USAO WDWA

December 17, 2018

Margarita Palomino, of Homestead, Florida, has been sentenced to over six years in prison for her part in a health care scheme which defrauded Medicare out of $4.65 million. The scheme involved three home health agencies that claimed to provide services to Medicare patients. Palomino, licensed as a physician in Cuba, but not in the United States, admitted that she provided home health care nursing visits and prepared the accompanying...

When a Gift is Not a Gift: Pharma Companies Use Charities to Increase Drug Profits

Imagine if at the end of Charles Dickens’ “A Christmas Carol,” Ebenezer Scrooge announced that he was giving the prize turkey to the Cratchit family for Christmas dinner, but that this “gift” was conditional upon Bob Cratchit agreeing to work even longer hours in the new year, the turkey being cooked in a certain way, and only certain family members eating it. Would we consider Scrooge to have been truly...