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State Enforcement Actions

Each state enforces its laws and defends its interests, and states often work with the federal government in investigating and prosecuting corporate frauds.  Whistleblowers with knowledge of fraud or wrongful conduct that involves state or local funds or programs may be able to bring a claim under a state or local False Claims Act, and may be eligible to receive a monetary reward and protection against retaliation.

Below are summaries of recent settlements, successful prosecutions, and enforcement actions by states. If you believe you have information about fraud which could give rise to a claim under a State or Local False Claims Act or other whistleblower reward provision, please contact us to speak with one of our experienced whistleblower attorneys.

August 26, 2021

Nonprofit organization the Florida Coalition Against Domestic Violence, its former CEO Tiffany Carr, and other former officers and directors, have entered into a settlement agreement with the State of Florida to pay $5 million to resolve civil claims arising from the alleged misuse of state grant funds and excessive compensation to Carr.  The entity will be dissolved.  FL

August 25, 2021

A California-based provider of home respiratory services and durable medical equipment has agreed to pay $3.3 million to the United States and States of California and Nevada to settle allegations of defrauding Medicare and Medicaid.  The claims against SuperCare Health, Inc. were brought in a 2018 qui tam suit by respiratory therapist Benjamin Martinez, who alleged that the provider billed for non-invasive ventilators (NIVs) that were no longer needed or being used by patients.  CA AG; USAO CDCA

August 17, 2021

Bristol Myers Squibb (BMS) has agreed to pay $75 million to a resolve a whistleblower’s allegations that it underpaid drug rebates owed to state Medicaid programs nationwide.  In order to ensure states pay competitive prices, federal law requires pharmaceutical companies to return a portion of payments from state Medicaid programs, calculated based on the average price paid by drug wholesalers.  The misconduct involved BMS underreporting their drugs’ Average Manufacturer’s Price by treating wholesaler fees as discounts, thus decreasing the amount it supposedly owed to the healthcare programs.  CA AG; NJ AG

August 12, 2021

United Behavioral Health and United Healthcare Insurance Co. will pay $2 million in penalties to resolve claims that the insurer unlawfully denied coverage for mental health and substance use disorder treatment in violation of laws that require health insurance plans to cover mental health and substance use disorder treatment the same way they cover physical health treatment. New York and the federal Department of Labor alleged that United reduced allowed amounts for mental health and substance abuse services provided by non-physicians, but not for medical treatments provided by non-physicians, and conducting utilization reviews for psychotherapy that were not conducted at the same rate for medical/surgical services.  In addition the penalty, United agreed to pay $13.6 million to affected participants and beneficiaries.  DOL; NY

August 5, 2021

Pipeline company Summit Midstream Partners LLC, Meadowlark Midstream Company LLC, and Summit Operating Services Company LLC, have agreed to pay $35 million in fines and penalties to settle criminal and civil cases arising from the discharge of 29 million gallons of “produced water” – a waste product of hydraulic fracturing – from Summit’s pipeline near Williston, North Dakota, over the course of nearly five months in 2014-2015.  As part of the settlement, Summit admitted that it operated the pipeline without a reliable leak detection system and made incomplete and misleading reports to federal and state authorities about the spill.  DOJ; EPA

August 4, 2021

For causing more than $100 million in losses to employers, employees, financial institutions, and financing companies and laundering more than $1 billion in stolen funds, Michael Mann, the owner of shuttered payroll service companies ValueWise and MyPayrollHR, has been sentenced to 12 years in prison.  In addition to misappropriating payroll funds and money laundering, Mann was also found to have fraudulently obtained tens of millions of dollars in loans from three financing companies, as well as fraudulently obtained lines of credit from several banks in the New York area.  NY AG; USAO NDNY

August 3, 2021

Trucking operator Complete Logistics Company, LLC (CLC) has agreed to a $2.38 million settlement to resolve allegations of falsely certifying compliance with California’s emissions regulations in order to obtain $2.2 million in state grants under the state’s Goods Movement Emission Reduction Program, which incentivizes trucking companies to reduce emissions by offering grants for newer, cleaner trucks.  The alleged misconduct occurred during a health-related absence by CLC’s owner; upon the owner’s return in 2017, immediate remedial measures were taken.  CA AG

August 3, 2021

In the largest prevailing wage criminal case in the country, one of the largest contractors to complete projects on behalf of the State of Pennsylvania, Glenn O. Hawbaker, Inc., has agreed to pay more than $20 million in wages stolen from over a thousand of its workers.  Between 2003 and 2018, Hawbaker disguised wage theft on an estimated $1.7 billion in state contracts by artificially inflating costs by millions of dollars annually, and by claiming credits for prohibited costs.  PA AG

July 21, 2021

For their part in creating and fueling the opioid epidemic, three of the nation’s largest drug distributors—McKesson Corporation, Cardinal Health Inc., and AmerisourceBergen Drug Corporation—as well as one of the nation’s largest drug manufacturers, Johnson & Johnson, have agreed to pay $26 billion over the next 18 years to resolve claims from nearly 4,000 lawsuits, including multiple state and local governments.  In addition to the monetary settlement, the companies have signed onto a 10-year injunctive relief agreement that will require them to implement certain data-driven oversight measures and not fund or lobby to promote opioids, among other things.  CA AG; FL AG; MI AG; NY AG; PA AG

July 19, 2021

Prime Healthcare Services, one of the largest hospital systems in the nation, its founder and CEO Dr. Prem Reddy, and interventional cardiologist Dr. Siva Arunasalam have agreed to pay $37.5 million to resolve two suits filed by former executive Martin Mansukhani, and former employees Marsha Arnold and Joseph Hill.  In violation of the federal and California False Claims Acts, certain Prime hospitals had allegedly submitted inflated invoices to Medi-Cal and other government health programs, or submitted claims to Medi-Cal and Medicare under Arunasalam’s provider number for services provided by an excluded physician.  Additionally, in acquiring Arunasalam’s physician practice and surgery center, Prime allegedly paid above fair market value for referrals from Arunasalam to one of their hospitals.  For being the first to file, one of the whistleblowers, Mansukhani, will receive a relator’s share of nearly $10 million.  CA AG; USAO CDCA
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