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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.

				

			

			
						
					
			

	
		
		

			

				
				
November 6, 2018

				 An Indiana-based dental care practice and admin support company have agreed to pay a total of $5.139 million to settle allegations they violated the federal and Indiana state False Claims Acts. According to whistleblower and qui tam plaintiff Dr. Jihaad Abdul-Majid, between 2009 and 2013, ImmediaDent of Indiana, LLC and Samson Dental Partners, LLC allegedly billed Indiana's Medicaid program for procedures that were either upcoded (i.e. represented to be more serious and more expensive than they actually were), were not actually performed, or were not medically necessary. Samson Dental Partners is additionally accused of violating Indiana’s law prohibiting the corporate practice of dentistry. Because the companies refused oversight proposed during settlement, they have now been classified as "high risk" to federal healthcare programs. IN AG; USAO WDKY				 					 

						
Tagged in:
													  FCA Federal, 
													  FCA State, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medicaid, 
													  Medical Billing Fraud, 
													  Upcoding, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 26, 2018

				 Abbott Laboratories and AbbVie, Inc. have agreed to pay $25 million to settle a case initiated by a whistleblower alleging that the pharma companies paid unlawful kickbacks and engaged in unlawful off-label marketing for the drug TriCor.  The kickbacks took the form of gifts and payments for consulting and speaking engagements that were meant to induce or reward physicians for prescribing TriCor.  The off-label marketing consisted of Abbott's advertising the drug for conditions for which it was not FDA-approved.  The whistleblower, Amy Bergman, a former Abbott sales representative, will receive $6.5 million of the settlement.  USAO E.D.Pa.				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Off-Label and Unapproved Use, 
													  Pharma Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 23, 2018

				 Eye Centers of Florida, owned by Dr. David C. Brown, has agreed to pay $525,000 to settle claims of that it knowingly falsified the medical records of certain Medicare patients in order to submit qualifying reimbursement claims. In violation of the False Claims Act, Eye Centers allegedly altered the paperwork to make it appear that patients had worse vision than they actually did, allowing Eye Centers to bill for cataract surgeries that would ordinarily not have been reimbursable. The case was revealed through a lawsuit filed by two former employees, Patti Nilsson and Joann Smith, who are set to receive $115,500 from the settlement. USAO MDFL				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medical Billing Fraud, 
													  Medicare, 
													  Provider Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 23, 2018

				 Vascular Access Centers LP (VAC) and its 20+ related corporations in multiple states have agreed to pay $3.825 million over five years to settle whistleblower-brought allegations that VAC took part in an illegal patient referral kickback scheme and fraudulently billed Medicare for certain non-reimbursable procedures. The alleged fraud violated the Anti-Kickback Statute and False Claims Act and involved regularly scheduling, performing, and billing Medicare for certain vascular access procedures for End Stage Renal Disease (ESRD) beneficiaries that were not routinely necessary. Two whistleblowers will share in the relator's share of $612,000. DOJ; USAO EDLA; USAO SDNY				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medicare, 
													  Provider Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 19, 2018

				 Settling a case brought by a whistleblower, mortgage lender Universal American Mortgage Company will pay $13.2 million to the United States.  UAMC acted as a direct endorsement lender in the Federal Housing Administration insurance program, originating and underwriting mortgages with FHA insurance.  Because the federal government is liable for FHA loans that default, DELs such as UAMC are required to follow underwriting and quality control rules in issuing mortgages; UAMC allegedly did not follow those rules and knowingly submitted loans for FHA insurance that did not qualify.  The whistleblower, Kat Nguyen-Seligman, a former employee of a UAMC related entity, will receive $1,980,000 from the settlement.  DOJ; USAO W.D.Wa.				 					 

						
Tagged in:
													  FCA Federal, 
													  Housing and Mortgage Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 1, 2018

				 Pharmaceutical distributor AmerisourceBergen Corporation will pay $625 million to the federal government and 43 states to settle claims that between 2001 and 2014 a pre-filled syringe program at one of its subsidiaries, Medical Initiatives, Inc., violated federal law.  Despite lacking the proper licensing and registration, MII opened FDA-approved sterile vials of oncology drugs, and in a non-sterile environment, pooled the medicine and transfered it into non-FDA approved pre-filled syringes which were then sold to oncology practices and physicians.  This practice allowed Amerisource to capture the "overfill" in the original FDA-approved sterile vials and produce a larger number of pre-filled syringes.  AmerisourceBergen also resolved claims that it provided unlawful kickbacks to physicians to induce them to purchase pre-filled syringes rather than vials.  The settlement resolved three qui tam actions initiated by whistleblowers Michael Mullen, Daniel Sypula, Kelly Hodge, and Omni Healthcare, Inc.; a payment of over $93 million will be made to relators. Previously, in September, 2017, AmerisourceBergen Specialty Group pleaded guilty to illegally distributing misbranded drugs and agreed to pay $260 million in criminal fines and forfeitures. USAO E.D.N.Y.;  NY				 					 

						
Tagged in:
													  CGMP Violation, 
													  Dosage Fraud, 
													  FCA Federal, 
													  FCA State, 
													  FDA Fraud, 
													  Healthcare Fraud, 
													  Multiple Whistleblowers and First-to-File, 
													  Off-Label and Unapproved Use, 
													  Pharma Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 1, 2018

				 HealthCare Partners Holdings LLC, a DaVita entity, will pay $270 million to settle allegations arising from DaVita's collection and submission of diagnosis data for Medicare Advantage beneficiaries to whom DaVita provided healthcare services.  HealthCare Partners, an independent physician association, allegedly instituted practices that caused the submission of incorrect diagnosis codes - diagnosis codes that increased payments from CMS to the MAOs, and then from the MAOs to DaVita/HealthCare Partners.  DaVita had voluntarily disclosed some practices, including improper medical coding guidance provided to physicians.  In addition, a whistleblower, James Swoben, alleged in a False Claims Act qui tam case that HealthCare Partners had engaged in improper "one-way chart reviews," which added diagnosis codes identified from the review of patient charts, but did not delete previously-submitted diagnosis codes that were not supported by the patient charts. Swoben will receive a whistleblower reward of $10,199,100. DOJ				 					 

						
Tagged in:
													  FCA Federal, 
													  Managed Care, 
													  Medicare, 
													  Risk Adjustment Fraud, 
													  Upcoding, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 28, 2018

				 Kalispell Regional Healthcare System and six of its related entities agreed to pay $24 million to settle a False Claims Act case based on its compensation arrangements with physicians, which were alleged to violate the Stark Law, and other arrangements alleged to violate the Anti-Kickback Statute.  Between 2010 and 2018, KRH entities reportedly paid excessive and above-market full-time compensation to more than 60 physicians, even if those physicians worked far less than full-time.  In addition, some of the KRH entities were alleged to unlawfully seek referrals from physicians through excessive compensation arrangements and the provision of administrative services at below market rates.  Jon Mohatt, the former CFO of a related entity, initiated the action with a qui tam filing; Mohatt will receive $5.4 million dollars as a relator's share of the government's recovery.  DOJ				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Hospital Fraud, 
													  Provider Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 28, 2018

				 RS Compounding, Inc, and its owner, Renier Gobea, have agreed to pay $1.2 million to settle a False Claims Act-based lawsuit by whistleblower McKenzie Stepe that the now defunct compounding pharmacy had overcharged TRICARE, at times by as much as 10,000% more than it charged members of the general public. The alleged fraud occurred between 2012 and 2014. According to the DOJ, TRICARE's costs for compounded drugs have ballooned from $5 million to over $500 million in the span of ten years, then increased by over 150% between 2014 and 2015 alone. Tragically, the whistleblower passed away before the settlement was finalized, so her estate will receive her relator's share of $264,000. DOJ				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Other Government Health Programs, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 27, 2018

				 A New York-based hedge fund manager, Harbinger Capital Partners Offshore Manager LLC, has agreed to pay $30 million to settle charges that it used fraudulent means to avoid paying both New York State and City taxes. A related investment management company based in Alabama, Harbinger Management Corporation, had earlier settled for $40 million, bringing a total of $70 million recovered in a case first brought to light by a whistleblower filing under the New York False Claims Act. According to the New York Attorney General's office, the alleged fraud had involved listing an office in Alabama as the source of hundreds of millions of dollars earned through fees from successful trades, even though the trades had in fact been made through the New York office and were thus subject to New York taxes. For their role in exposing the fraud, the unnamed whistleblower is to receive a relator's share of $15.4 million. NY AG				 					 

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

					
	
							
	
		
		
	


 			


											

						

								

									
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