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FCA Federal

This archive displays posts tagged as relevant to the federal False Claims Act. You may also be interested in the following pages:

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Top Ten Whistleblower Awards of 2022

Posted  02/1/23
2022 was a big year for whistleblowers, who once again recouped billions of government dollars and in turn received hundreds of millions in whistleblower rewards.  This year’s top rewards came from various government whistleblower programs, including the qui tam provisions of the federal False Claims Act, various state False Claims Act programs, and the Dodd-Frank SEC Whistleblower Program. Below is a...

January 27, 2023

Walgreen Co. has paid $7 million to settle a False Claims Act lawsuit by the United States and State of Tennessee that alleged the company submitted claims to Tennessee’s Medicaid program for specialty medications that didn’t meet the program’s criteria for coverage.  According to the governments’ 2021 complaint, one of Walgreens’ former pharmacists falsified prior authorization requests and records for 65 Medicaid beneficiaries who didn’t meet program requirements.  The company then billed TennCare under those false prior authorization requests, and later failed to make repayments even after it discovered its employee’s misconduct.  USAO EDTN

Top Ten Non-Healthcare False Claims Act Recoveries of 2022

Posted  01/27/23
This year’s Top Ten Non-Healthcare False Claims Act Recoveries exhibit the False Claim Act’s (FCA) enduring ability to combat corporate misconduct across distinct industries.  In 2022, the United States recovered hundreds of millions in taxpayer funds falsely obtained by defendants through bribery and bid-rigging schemes, mortgage underwriting fraud, fraudulent loan applications, fraud in the energy sector, and...

January 20, 2023

DePuy Synthes, Inc., a subsidiary of Johnson & Johnson that manufactures medical devices, has agreed to pay $9.75 million to resolve allegations of defrauding Medicare and Medicaid.  According to former sales representative Aleksej Gusakovs, DePuy gave a Massachusetts-based orthopedic surgeon thousands of dollars’ worth of free implants and instruments for use in overseas surgeries.  The illegal kickbacks induced the surgeon to use DePuy products in surgeries performed in the United States, and caused false claims to be submitted to Medicare and the Massachusetts Medicaid program.  As the whistleblower in a successful qui tam action, Gusakovs will receive a $1.37 million share of the settlement.  DOJ

Top Ten Healthcare Fraud Recoveries of 2022

Posted  01/6/23
Healthcare fraud image showing stethoscope with gavel
Consistent with the trend in prior years, 2022 saw government enforcement agencies taking aim at fraud and false claims in healthcare.  As the cost of healthcare rises along with its share of the U.S. economy, the enforcement focus on healthcare fraud is likely to accelerate. And, as always, the role of whistleblowers will be critical, as demonstrated by the dominance of cases originated by whistleblowers under the...

December 21, 2022

Biotechnology companies iSense, LLC and Specific Diagnostics, Inc., together with their founder Paul Andrew Rhodes, will pay a total of $10.1 million to resolve allegations that they submitted false claims under grants from the DOD and HHS.  The government alleged that the firms improperly billed for costs incurred by another business, billed for compensation in excess of authorized federal limits, backdated services and cost-sharing agreements, and knowingly presented a backdated agreement to the government. USAO NDCal

December 20, 2022

Cochlear implant manufacturer Advanced Bionics LLC paid $11.4 million to resolve claims brought in a whistleblower action that the company falsely stated that the radio-frequency (RF) emissions generated by some of its cochlear implant processors met international standards when it submitted pre-market approval applications to the FDA.  The company allegedly knew that the devices did not meet standards, and manipulated testing conditions to obtain passing test results.  Whistleblower David Nyberg, a former engineer at Advanced Bionics, will receive a qui tam award of $1.9 million from the federal amount of the settlement.  DOJ; USAO ED PA

December 20, 2022

BioTelemetry Inc. and its subsidiary CardioNet LLC, which provide cardiac monitoring services (including Holter and mobile cardiovascular telemetry (MCT) tests), will pay $44.875 million to resolve claims that they submitted false claims to federal healthcare programs for cardiac monitoring services that were improperly performed overseas and by unqualified technicians.  CardioNet used an India-based contractor to perform diagnostic and analysis services of heart monitoring data, and while it had a formal policy of sending such data for federal healthcare beneficiaries to a U.S.-based independent diagnostic testing facility for review and analysis, in fact, substantial amounts of such data was sent to its Indian contractor.  The government further alleged that most of the offshore technicians tasked with reviewing ECG Data for federal healthcare program beneficiaries did not have the basic qualifications to perform the tests in question. The government’s investigation was initiated by a qui tam action filed by former CardioNet employees Christopher Strasinski and Philip Leone, who will share a whistleblower award of approximately $8.3 millionDOJ; USAO ED PA

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 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
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