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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 18, 2023

				 A doctor who defrauded California’s Medicaid program of over $20 million has been sentenced to 5 years in jail, ordered to pay $2.3 million in restitution, and forced to surrender his medical license.  Mohamed Waddah El-Nachef had pleaded guilty to prescribing medically unnecessary anti-psychotics, HIV medications, and opioids to over a thousand Medi-Cal beneficiaries, many of whom then sold the drugs for cash.  CA AG				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medicaid, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 8, 2023

				 Pharmaceutical drug manufacturers Shire PLC, Baxter International Inc., Baxalta Inc., Viropharma Inc., Takeda Pharmaceuticals U.S.A., Inc., and Takeda Pharmaceuticals America have agreed to pay more than $42 million to settle a qui tam suit alleging violations of the Texas Medicaid Fraud Prevention Act.  According to an unnamed whistleblower, the companies allegedly directly or indirectly provided payments or nursing services to Medicaid providers in exchange for referrals or recommendations of a particular drug.  TX AG				 					 

						
Tagged in:
													  FCA State, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Pharma Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 4, 2023

				 Aspirar Medical Lab LLC and owner Pick Chay have agreed to pay almost $2 million to resolve allegations of defrauding the North Carolina Medicaid program.  The company allegedly paid two other companies for referring medically unnecessary urine drug tests to it, then submitted claims stemming from these illegal kickbacks to Medicaid.  NC AG				 					 

						
Tagged in:
													  FCA State, 
													  Healthcare Fraud, 
													  Laboratory and IDTF, 
													  Lack of Medical Necessity, 
													  Medicaid, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 11, 2023

				 The owner of one of California’s largest chains of pain management clinics has agreed to pay nearly $11.4 million to the federal government and the states of California and Oregon to settle allegations of defrauding Medicare and state Medicaid programs of millions of dollars.  A nearly four-year investigation by government data analysts found that Dr. Francis Lagattuta and his business, Lags Medical Clinics—which operates more than 20 facilities in California and Oregon—billed the healthcare programs for medically unnecessary tests and procedures that were provided to every patient as part of clinic protocols.  The investigation also found that patients who did not consent to such procedures had their pain medication reduced.  Furthermore, a respiratory therapist who was the spouse of an executive was recruited to interpret certain test results despite having no formal medical training.  In addition to the monetary penalty, Dr. Lagattuta is also barred from serving Medi-Cal beneficiaries for the next five years.  CA AG				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 29, 2023

				 Three healthcare providers—Community Health Centers of the Central Coast, Cottage Health System, and Sansum Clinic—and a California public health agency, CenCal Health, have agreed to pay a total of $68 million to settle allegations of submitting false claims to the state’s Medicaid program, in violation of state and federal False Claims Acts.  The defendants allegedly took advantage of a federal expansion of Medi-Cal coverage for previously uninsured adults by submitting duplicative or unallowed claims.  CA AG; DOJ				 					 

						
Tagged in:
													  FCA Federal, 
													  FCA State, 
													  Healthcare Fraud, 
													  Medical Billing Fraud, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 21, 2023

				 Skilled nursing facility Alta Vista Healthcare & Wellness Centre and its management company Rockport Healthcare Services have agreed to pay $3.8 million to resolve allegations that it paid kickbacks to physicians to induce referrals of Medicare and Medicaid beneficiaries to its center.  The violations of the federal Anti-Kickback Statute, federal False Claims Act, and California False Claims Act were uncovered during a government investigation, and showed illegal kickbacks in the form of cash, gifts, and salaries paid from 2009 through 2019.  CA AG; DOJ				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  FCA State, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medicare, 
													  SNF, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 15, 2023

				 Online intimate apparel retailer AdoreMe, Inc. has agreed to pay $2.35 million to settle allegations by 31 states and the District of Columbia that it deceptively marketed a discount membership program and made it difficult for consumers who bought it to cancel it.  Consumers were charged about $40 a month to be in the program, but Adore Me failed to properly disclose the amount of the monthly charge, that discounts were limited time only, and that the accrued value would be eliminated upon cancellation of the membership.  NC AG; PA AG				 					 

						
Tagged in:
													  Misrepresentations, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 13, 2023

				 The owner of Grace Healthcare Services, a home health company in Texas, has been sentenced to almost 5 years in prison and ordered to pay almost $1.5 million in restitution for defrauding the state’s Medicaid program.  Akintunde Oyewale was convicted of paying illegal kickbacks to medical clinics in exchange for false home health certifications and patient referrals, then billing the Texas Medicaid program for services that were medically unnecessary and not actually provided.  TX AG				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Home Health and Hospice, 
													  Medicaid, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 6, 2023

				 Coinbase, Inc. has been ordered to pay $5 million for offering unregistered securities through staking offerings, in violation of New Jersey’s securities laws.  Not registering offerings with the CFTC subjected Coinbase’s 3.5 million staking investors to increased risk. NJ AG				 					 

						
Tagged in:
													  Cryptocurrency, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 5, 2023

				 Indivior Inc., maker of Suboxone, agreed to a $102.5 million multi-state settlement with 42 state attorneys general for allegedly trying to preserve its drug monopoly by illegally switching the Suboxone market from tablets to film, attempting to destroy the market for tablets. As part of the settlement, Indivior is required to disclose all of the citizen petitions to the FDA, introduction of new products, or if there is a change in corporate control. NC DOJ, CA AG, WA AG, OR DOJ				 					 

						
Tagged in:
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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