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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.

				

			

			
						
					
			

	
		
		

			

				
				
June 14, 2021

				 Centene Corp. will pay a total of $143.8 million to resolve claims by Ohio and Mississippi that it overbilled the states' Medicaid programs in its role as a pharmacy benefit manager.  The states alleged that Centene engaged in practices including "spread pricing," charging more than allowed price caps based on industry standards, inflation of dispensing fees, failure to disclose discounts received, and claiming reimbursement for prescriptions already paid for by third parties.  Ohio will receive $88.3 million, and Mississippi will receive $55.5 million.  OH; MS				 					 

						
Tagged in:
													  Drug and DME Pricing, 
													  FCA State, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 26, 2021

				 HEAG Pain Management Center, P.A. (HEAG) and its owner, Dr. Kwadwo Gyarteng-Dakwa (Dr. Dakwa), have agreed to pay $500,000 to settle allegations of defrauding Medicare and Medicaid.  According to the government, the defendants knowingly submitted or caused the submission of claims for medically unnecessary diagnostic testing between 2011 and 2016.  AG NC; USAO MDNC				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Improper Medical Personnel, 
													  Lack of Medical Necessity, 
													  Medicaid, 
													  Medicare, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 25, 2021

				 Upper Allegheny Health System (UAHS), which operates dental clinics in New York and Pennsylvania, has agreed to pay $2.7 million to resolve whistleblower-brought allegations of submitting false claims to Medicaid in violation of the federal and New York False Claims Acts.  Between 2010 and 2015, UAHS had billed Medicaid for dental services performed using improperly sterilized handpieces, which are considered semi-critical devices and need to be properly heat sterilized between patients.  AG NY; USAO WDNY; USAO WDPA				 					 

						
Tagged in:
													  FCA Federal, 
													  FCA State, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medical Devices and DME, 
													  Provider Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 19, 2021

				 Latisha Harron of North Carolina has been sentenced to over 14 years in prison and ordered to pay over $13 million in restitution after pleading guilty to charges of defrauding the North Carolina Medicaid Program, aggravated identity theft, and money laundering.  Together with husband Timothy Harron, the defendant scoured obituaries for recently deceased Medicaid recipients and billed Medicaid for up to a year of home health services that were allegedly provided to the deceased by her company, Agape Healthcare Services, Inc.  By concealing the fact that both Harrons were previously convicted felons, the defendant was able to obtain millions in reimbursements, which she then laundered into expenses such as business properties, a private jet, clothing and jewelry, and gym equipment.  NC AG; Subsequent proceeding				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  FCA State, 
													  Healthcare Fraud, 
													  Home Health and Hospice, 
													  Medicaid, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 19, 2021

				 In one of the first settlements to resolve allegations under both the False Claims Act and the Open Payments Program (formerly the “Sunshine Act”), French medical device manufacturer Medicrea International and its American affiliate, Medicrea USA Inc., have agreed to pay $2 million to resolve whistleblower Dory Frain’s allegations that the companies violated the Anti-Kickback Statute while entertaining U.S.-based physicians at a conference in France in 2013.  The settlement also resolves allegations that the companies violated the Open Payments Program by failing to report those expenses to the Centers for Medicare & Medicaid Services.  USAO EDPA; CA AG; FL AG				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  FCA State, 
													  Healthcare Fraud, 
													  Medical Devices and DME, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 12, 2021

				 Wireless communications provider Assurance Wireless, a subsidiary of Sprint (now T-Mobile), will pay $1.6 million to resolve claims under the Oregon False Claims Act that it overcharged low-income Oregonians purchasing voice and broadband service under the Oregon Lifeline program, which is funded with federal and state subsidies.  The settlement follows an FCC enforcement action that resulted from the state's investigation.  OR				 					 

						
Tagged in:
													  FCA State, 
													  Government Programs Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 27, 2021

				 Indivior plc and Indivior Inc., will pay $300 million to settle claims from all 50 states, the District of Columbia, and Puerto Rico, alleging they caused the misuse of state Medicaid funds by falsely marketing the drug Suboxone.  Suboxone is used by recovering opioid addicts to reduce withdrawal symptoms.  According to the governments, Indivior promoted the sale and use of Suboxone for unsafe, ineffective, and medically unnecessary purposes, including by claiming it was less susceptible to abuse even though the active ingredient, buprenorphine, is a powerful opioid itself.  Additionally, the company took steps to fraudulently delay the entry of generic alternatives in order to control pricing.  The settlement resolves six whistleblower suits pending in New Jersey and Virginia.  Indivior previously paid $600 million to resolve federal claims, and former parent company Reckitt Benckiser previously paid $1.4 billion to resolve the same.  CA AG; FL AG; MI AG				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medicaid, 
													  Misrepresentations, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 5, 2021

				 New York's Service Station Vending Equipment, Inc., which provides self-service, coin-operated air machines used to inflate automobile tires, and its principal, William McCabe, will pay $4.25 million to resolve an action initiated by a whistleblower under the New York State False Claims Act alleging that they evaded sales taxes, under-reported sales, and paid workers off the books.  NY				 					 

						
Tagged in:
													  FCA State, 
													  Tax Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
March 25, 2021

				 The eighth highest grossing casino in California, Artichoke Joe’s Casino, has agreed to pay $5.3 million in the largest agreed-upon penalty in California’s gambling regulation history.  According to the Attorney General’s Office, Artichoke Joe’s failed to accurately or timely report an investigation by the federal Financial Crimes Enforcement Network (FinCEN) to California’s Bureau of Gambling Control, as required under the Gambling Control Act of 1998.  As a result of the federal investigation, Artichoke Joe’s admitted that it failed to implement and maintain an effective anti-money laundering program and failed to report certain suspicious activity, in violation of the Bank Secrecy Act; the casino will pay a separate $5 million penalty to resolve those charges.  CA AG				 					 

						
Tagged in:
													  Money Laundering, 
													  Reporting to Government, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
March 23, 2021

				 Medical device manufacturer Boston Scientific Corporation has agreed to pay $188.6 million to 47 states and the District of Columbia to resolve allegations concerning its transvaginal surgical mesh, which were found to be deceptively marketed in violation of consumer protection laws and allegedly caused serious complications for thousands of women nationwide.  As part of the settlement, Boston Scientific also agreed to implement various marketing, training, and clinical trial reforms.  Similar settlements were previously reached with other medical device manufacturers, including Johnson & Johnson, which paid $116.9 million in 2019, and C.R. Bard, which paid $60 million in 2020.  CA AG; FL AG; NY AG				 					 

						
Tagged in:
													  Defective Products, 
													  Medical Devices and DME, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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