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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.

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

July 14, 2021

Diesel Direct, LLC of Stoughton, Massachusetts will pay $850,000 to resolve claims brought in a qui tam action alleging that the company knowingly delivered nonconforming petroleum diesel fuel to state agencies while charging for a higher-priced and more environmentally-friendly biodiesel fuel; improperly charged state agencies a federal fuel excise tax; and failed to comply with the state's Supplier Diversity Program requiring spending with women-owned, minority-owned, and veteran-owned businesses. Mass

July 13, 2021

A subsidiary of Teachers Insurance and Annuity Association of America (TIAA) has agreed to pay $97 million in restitution and make significant reforms to settle charges for making misleading statements and failing to disclose conflicts of interests to tens of thousands of customers.  Between 2012 and 2018, advisors with TIAA-CREF Individual & Institutional Services LLC (TC Services) pressured customers—many of them teachers and public sector employees—to move their investments from low-cost employer-sponsored retirement plans to higher-cost individually-managed accounts, which generated hundreds of millions of dollars in fees for TIAA.  NY AG; SEC

June 16, 2021

Bedrock Group LLC agreed to pay $3.5 million to Massachusetts to resolve allegations that the company violated the Massachusetts False Claims Act by failing to fully and timely refund the state following the company's failure to deliver one million N95 masks ordered by the state.  Massachusetts placed an emergency purchase order with the company, agreeing to pay $3.6 million for the one million masks, which were to be delivered by April, 2020.  The company delivered fewer than 100,000 masks and, after the state cancelled the purchase order, failed to refund the state's payment. Bedrock also agreed to a voluntary debarment from contracting with the state or any political subdivision for five years.   MA

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

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

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

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

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
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