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Defendants

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May 21, 2019

DeKalb County, Georgia has agreed to pay the federal government $750,000 to settle claims that the county misused Department of Labor On-the-Job Training program grant funds.  OTJ funds are required to be used to reimburse employers that hire individuals with identified skills gaps.  The government alleged that DeKalb county falsely certified that it was complying with OTJ regulations, and used the funds to subsidize the wages of highly qualified county employees, allegedly requiring some to sign paperwork saying that they had received OTJ services when they had not.  USAO ND GA

Question of the Week — Should the CEO Be Held Accountable?: Lessons from the Insys verdict.

Posted  05/10/19
By Jessica T. Moore
Handcuffed business-leader walking through jail.
In a shocking first, a federal jury has convicted an opioid-company CEO and other top executives of a criminal racketeering conspiracy. Insys founder and chairman John Kapoor and four other executives bribed doctors to overprescribe a highly addictive fentanyl painkiller, and ran a phony call-center to defraud insurance companies into paying for the expensive drug. Although the company itself had already paid over...

April 30, 2019

The former CEO of hospital chain Health Management Associates LLC, Gary D. Newsome, has agreed to pay $3.46 million to resolve claims in a whistleblower lawsuit that he personally caused HMA to submit false claims to federal healthcare programs in violation of the False Claims Act.  Newsome was alleged to have caused HMA to pressure emergency department physicians to increase inpatient admissions without regard to medical necessity, so that the hospital chain could bill for more costly inpatient services.  In addition, Newsome was alleged to have caused HMA to make bonus payments to emergency department physicians, and contract concessions to the company, EmCare, that provided emergency department physician staffing, to increase inpatient admissions.  Newsome was the CEO from 2008 through 2013, prior to HMA's acquisition by Community Health Systems Inc.  HMA settled related claims in September 2018, and EmCare settled related claims in December 2017.  Two whistleblowers, Jacqueline Meyer, a former employee of EmCare, and J. Michael Cowling, a former employee of HMA, will receive approximately $725,000 from this settlement.  DOJ

September 19, 2018

A nonprofit organization and its management company have agreed to pay $528,575.82 to settle False Claims Act-based allegations of grant fraud in connection with the Department of Justice's National Justice Information Sharing Initiative. In applying for grants, the National Association of State Chief Information Officers, Inc. (NASCIO) allegedly failed to follow rules requiring the disclosure of conflicts of interest relating to American Management Resources, Inc. (AMR), which if disclosed would have disqualified NASCIO from receiving any grants. USAO EDKY

Catch of the Week -- Prime Healthcare

Posted  08/9/18
upcoding
Prime Healthcare, a nationwide healthcare provider that operates 45 hospitals and employs over 40,000 people, has settled allegations under the False Claims Act that 14 of its California hospitals improperly billed Medicare for admitting patients who only required outpatient care, and billed Medicare for treating more severe diagnoses than patients actually had. The company will pay just under $62 million to settle...

August 3, 2018

A former subcontractor, Andrew Nolan, has pleaded guilty to falsifying quality testing results for the concrete used on the Dulles Metrorail Project. The actual results would have caused the concrete to be rejected in the project, which is partially funded by the Department of Transportation. Nolan is being prosecuted under both the federal False Claims Act and the Virginia Fraud Against Taxpayers Act and faces a maximum of five years in prison. USAO EDVA

March 29, 2018

Louisville-based skilled nursing facility New Oaklawn Investments, LLC (d/b/a Oaklawn Health and Rehabilitation Center and Elmcroft Senior Living, Inc.) agreed to pay roughly $5 million to resolve allegations it violated the False Claims Act by submitting false claims to Medicare for patient rehabilitation services at the resource utilization (“RUG”) Code Series Rehabilitation Ultra High and Rehabilitation Very High, for certain services that were not reasonably or medically necessary. DOJ (WDKY)

United States Targets a Private-Equity Firm and Pharmacy in a Whistleblower Case

Posted  02/26/18
By the C|C Whistleblower Lawyer Team On Friday the Wall Street Journal reported on the U.S. government’s decision to intervene in a False Claims Act qui tam case against pharmacy Diabetic Care Rx LLC and the private equity firm that holds a controlling stake in the pharmacy, Riordan Lewis & Haden Equity Partners (“RLHEP”). Diabetic Care is a compounding pharmacy that mixes different ingredients to create...

October 3, 2017

Pennsylvania garment wholesaler Notations, Inc. agreed to pay $1 million to settle charges of violating the False Claims Act by repeatedly ignoring warning signs that its business partner, which imported garments from China, was engaged in a scheme to underpay customs duties owed on the imported garments it sold to Notations.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act.  The whistleblower will receive an award from the proceeds of the government's recovery.  DOJ (SDNY)

September 28, 2017

Vermont-based contractor J.A. McDonald, Inc., and its owner and president Eric Boyden, agreed to pay $270,000 to resolve allegations that JAM violated the False Claims Act by causing the State of Vermont to present false claims for payment to the United States in connection with the federally-funded construction of a two-span bridge on Vermont Route 116 in Bristol, Vermont.  Specifically, the settlement resolves allegations that JAM employees intentionally altered critical bridge components such that the bridge no longer conformed to specified safety standards, and that JAM employees took affirmative steps to conceal the alterations from the Vermont Agency of Transportation. DOJ (DVT)
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