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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.

				

			

			
						
					
			

	
		
		

			

				
				
October 14, 2015

				 The Maryland Attorney General announced a $13.5 million settlement with NuVasive, Inc, resolving allegations brought in a whistleblower suit that the California medical device company improperly marketed its spine surgery products and provided kickbacks to doctors through speaking fees and other payments.  MD				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 9, 2015

				 12 states, the District of Columbia, and the federal government, reached a $26.75 million multistate settlement with Stericycle, Inc., an Illinois-based medical waste disposal company, resolving allegations that Stericycle imposed improper fuel and energy surcharges on governmental customers.  FL; IN; IL; NJ; MA; RI; VA				 					 

						
Tagged in:
													  Falsifying Invoices, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 8, 2015

				 43 states joined the federal government in a $9.25 million dollar settlement with PharMerica over allegations in two separate whistleblower actions that PharMerica conspired with Abbott Laboratories, a drug manufacturer, through a number of disguised kickback arrangements to increase overall utilization of the drug Depakote and to promote misbranded Depakote.  FL; MA; NH				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Off-Label and Unapproved Use, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 7, 2015

				 In New York, two individuals who owned and operated two transportation companies, were arrested for allegedly violating the Workers’ Compensation law and illegally obtaining over $1 million from the Medicaid system.  Yellow Medi-Van and Taxi, Inc. received payments from the Medicaid Program for transporting Medicaid beneficiaries to medical appointments.  The defendants are alleged to have knowingly operated the company in violation of transportation regulations, including not having worker’s compensation insurance.  During the time the company was operated unlawfully, the companies obtained over $1 million in Medicaid payments.  NY				 					 

						
Tagged in:
													  Medicaid, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 29, 2015

				 The New Jersey Medicaid Fraud Control Unit and Office of the Insurance Fraud Prosecutor obtained an indictment against a doctor, Syed Jaffery, for accepting kickbacks in exchange for patient referrals.  The indictment alleges that from 2010 to 2013, Jaffrey participated in a scheme by which he agreed to refer patients needing MRI and CT scans to Diagnostic Imaging Services of South Jersey in exchange for monetary kickbacks.  Over the course of the scheme, Jaffrey allegedly accepted approximately $195,000.  In an attempt to disguise the arrangement, the kickback checks were made payable to Jaffrey’s alleged shell company Mask Realities and purported to be for a rental space for billing services.  NJ				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Medicaid, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 23, 2015

				 The Florida Attorney General announced a $3.5 million settlement with Adventist Health System Sunbelt Healthcare Corporation and Adventist Health System/Sunbelt, Inc. to resolve two suits brought by whistleblowers alleging that Adventist maintained improper financial relationships with physicians and submitted claims to Florida Medicaid for services and items the physicians referred.  The settlement resolves claims that Adventist submitted false Medicaid claims and awarded referring doctors based on the number of tests and procedures the doctors ordered.  Adventist also entered into separate civil settlements with the federal government, North Carolina and Texas, agreeing to pay more than $115 million. FL.				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 10, 2015

				 The Washington Attorney General announced a suit against CareOne Dental Corporation and related individuals for Medicaid fraud.  The suit alleges that the defendants systematically billed Medicaid for non-covered services which they misrepresented in their billings, “upcoded” services (more expensive versions of what they actually performed), and services they simply didn’t provide.   The Attorney General’s Office currently estimates at least 20 percent of the claims CareOne Dental presented to Medicaid from January 2011 to June of 2015 were fraudulent, which would amount to approximately $1 million in single damages.  WA				 					 

						
Tagged in:
													  Medicaid, 
													  Upcoding, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 24, 2015

				 The New York Attorney General announced a $6 million dollar settlement with Empire State Home Care Services, Inc. (Empire), a home care agency operating out of Brooklyn, NY. The settlement resolves claims that Empire improperly reported its home health aide hours as well as administrative and general expenses on cost reports filed between 2002 and 2005. These cost reports were used to set the reimbursement rates that Empire received from the state for the years 2004 through 2007 and resulted in over $3 million in reimbursements to which Empire was not entitled.  NY				 					 

						
Tagged in:
													  Government Investigation, 
													  Home Health and Hospice, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 24, 2015

				 The New York Attorney General announced settlement agreements with five defendants in a False Claims Act case that will return more than $8 million to the Medicaid and Medicare programs. The agreements resolve claims that SpecialCare Hospital Management Corporation defrauded Medicaid and Medicare by illegally referring patients to unlicensed drug and alcohol treatment programs in exchange for kickbacks.  Investigation of the defendants began after whistleblowers Mathew I. Gelfand, M.D. and Enrico Montaperto filed complaints under New York’s False Claims Act.  NY				 					 

						
Tagged in:
													  FCA State, 
													  Improper Medical Facility, 
													  Improper Medical Personnel, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 20, 2015

				 Three construction companies have agreed to settle for a total of $1.4 million to resolve allegations they falsely certified compliance with minority-owned subcontractor requirements on multiple public construction contracts in Massachusetts.  The Commonwealth’s complaint alleges that CTA Construction Company, Inc., MDR Construction Company, Inc., and minority-owned business enterprise Luxor Equipment Corporation, Inc., now known as Margen, Inc. violated the Massachusetts False Claims Act in connection with three contracts.  MA				 					 

						
Tagged in:
													  Contract Non-Compliance, 
													  Government Investigation, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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