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Whistleblower Successes

Whistleblower reward laws and whistleblower reward programs enable qualifying whistleblowers to recover anywhere from 10 to 30 percent of the government’s recovery. These whistleblower reward laws include: the federal False Claims Act; State False Claims Acts; the Securities and Exchange Commission Whistleblower Program; the Commodity Futures Trading Commission Whistleblower Program; and, the Internal Revenue Service Whistleblower Program. We have collected summaries of recent successes in cases brought by whistleblowers, and you can read them below. You can also review our annual Top Ten Lists.

Members of the Constantine Cannon Whistleblower Lawyer Team have served as lead counsel on cases that have recovered roughly $1.3 billion for the government and hundreds of millions in whistleblower awards. You can read more about the results we have achieved for our clients in Our Successes.

If you believe you have information about fraud which could give rise to a claim for a whistleblower reward, please contact us to speak with one of our experienced whistleblower attorneys.

December 15, 2022

Florida-based Ocenture LLC and its subsidiary, Carelumina LLC, have agreed to pay $3 million to settle allegations of submitting claims to Medicare that were tainted by illegal kickbacks.  Two marketers approached by Ocenture to participate in the kickback scheme, Christopher Improta and Peter Brandt, filed a qui tam suit against Ocenture which alleged the company provided kickbacks to physicians to have them falsely attest that genetic tests Ocenture solicited directly from Medicare beneficiaries was medically necessary.  The whistleblowers also alleged that Ocenture arranged for laboratories to process those tests and pay it a portion of the laboratories’ Medicare reimbursements.  For instigating a successful enforcement action, Improta and Brandt will share a $570,000 award.  DOJ

December 14, 2022

In a False Claims Act case pursued on a non-intervened basis, Academy Mortgage Corporation agreed to pay $38.5 million to resolve allegations that it improperly originated and underwrote mortgages insured by the Federal Housing Administration.  The whistleblower, Gwen Thrower, who was an underwriter at Academy, alleged that the Academy had an inadequate underwriting process that led to false certifications of compliance with underwriting requirements and, ultimately, to the government having to pay insurance claims on loans improperly underwritten by Academy.  Thrower will receive a whistleblower award of $11.5 millionDOJ

December 12, 2022

The SEC approved a whistleblower award of $20 million to an anonymous individual who voluntarily provided original information to the Commission that significantly contributed to an investigation that had been previously opened based on a referral from the Division of Examinations.  While noting that much of the information provided by the whistleblower was already known to Enforcement staff, the individual provided some helpful new information, met with Enforcement Division staff multiple times, and remained cooperative throughout the investigation.  SEC

December 7, 2022

Dignity Health and the Tenet Healthcare hospitals Twin Cities Community Hospital and Sierra Vista Regional Medical Center will pay a total of $22.5 million to resolve allegations that they submitted false claims to Medi-Cal in connection with the ACA’s Medicaid Adult Expansion program.  The defendants, who contracted with Medi-Cal, agreed to provide healthcare services to this newly-insured population and return surplus funds if they did not spend at least 85% of the specified funds on eligible services.  The government alleged that the hospitals falsely billed for “Enhanced Services,” which allowed them to overstate AE spending, including by billing for services that were duplicative of services already required. The settlements resolve claims brought in a whistleblower action by Julio Bordas, who previously served as a Medical Director for CenCal Health, the County Organized Health System through which Medi-Cal contracted with the hospitals. Bordas will receive $3.9 million as his share of the federal recovery.  DOJ; USAO CD Cal; CA

December 5, 2022

Optical lens manufacturer Essilor Laboratories of America, Inc. will pay $23.8 million to California to resolve allegations that the company violated the state’s Insurance Frauds Prevention Act when it allegedly provided kickbacks and other unlawful incentives to eye care providers in exchange for these providers’ promises to send business to Essilor. The state’s action was initiated by a whistleblower complaint filed by Christie Rudolph, who will receive a whistleblower reward of approximately $11.1 million. (see earlier settlement) CA

November 28, 2022

An anonymous whistleblower received a $20 million award from the SEC, with the SEC finding that the whistleblower provided significant information and continuing helpful assistance in the Commission’s investigation.  The award order notes that the individual did not have information relating to one part of the enforcement action, and delayed reporting for two years after being involved for a short period in the conduct underlying part of the enforcement action, at the direction of their supervisor.  Four other claimants were denied any award related to the covered action.  SEC

November 14, 2022

The Florida Birth-Related Neurological Injury Compensation Association and a related entity, which were created by the State of Florida to provide compensation for the medical, rehabilitative and custodial care of children who suffered certain categories of birth-related neurological injuries, will pay $51 million to resolve a whistleblower’s qui tam lawsuit, pursued on a non-intervened basis, alleging that they fraudulently caused NICA participants to submit their healthcare claims to Medicaid rather than NICA, in violation of Medicaid’s status as the payer of last resort under federal law.  The relators, Veronica Arven and the estate of Theodore Arven III, will receive $12,750,000 as their share of the recovery.  DOJ

November 1, 2022

Electronic health record technology vendor Modernizing Medicine, Inc. (“ModMed”) has agreed to pay $45 million to resolve allegations, including by its former VP of Product Management, that it both received and provided illegal kickbacks in exchange for referrals.  According to the government and whistleblower Amanda Long, ModMed engaged in schemes with Miraca Life Sciences, Inc. (now known as Inform Diagnostics) to receive kickbacks in exchange for recommending its users for Miraca’s lab services, and to provide its EHR technology free to healthcare providers to entice them to direct lab orders to Miraca and add to ModMed’s user base.  Long will receive about $9 million of the settlement with ModMed. DOJ

October 31, 2022

The SEC has awarded more than $10 million to a whistleblower who provided critical information and assistance that contributed significantly to a successful enforcement action.  In addition to providing important documents, the whistleblower also met twice with agency staff, resulting in charges that closely mirrored the whistleblower’s allegations, as well as significant funds being returned to harmed investors.  SEC

October 18, 2022

Carter Healthcare LLC, affiliates CHC Holdings and Carter-Florida, president Stanley Carter, and Chief Operations Officer Bradley Carter have agreed to pay $23 million and $7.2 million to settle two whistleblower cases alleging violations of the False Claims Act.  The first case, filed in the Western District of Oklahoma, alleged that the Oklahoma-based home health company paid illegal kickbacks to physicians under the guise of medical directorships in order to induce referrals.  The second case, filed in the Southern District of Florida by former therapists Sharon Mahaffey and Mark Brimer, alleged that Carter Healthcare billed Medicare for medically unnecessary therapy and upcoded patient diagnoses for higher reimbursements.  As part of the settlements, defendants Stanley and Bradley Carter have agreed to be excluded from participating in government healthcare programs for 5 years, and whistleblowers Mahaffey and Brimer will split a $1.3 million relator’s share.  USAO WDOK; USAO SDFL
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