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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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May 14, 2021

Texas dentists Gunjan Dhir and Gaurav Puri and their affiliated management companies and practice groups will pay $3.1 million to resolve allegations that they fraudulently charged the Texas Medicaid program for pediatric dental services.  The investigation was initiated by the filing of a qui tam complaint by whistleblowers Sandy Puga, Nelda Torres-Brown, and Sonia Cardoso, who were former employees of defendants and will receive an undisclosed share the settlement.  Defendants allegedly billed for services that were not actually provided and/or misreported the provider of services by using erroneous Medicaid provider numbers.  USAO ND Texas

Catch of the Week: University of Miami to Pay $22 Million to Resolve Allegations of Lab Test Fraud

Posted  05/14/21
By Leah Judge
University of Miami logo
The University of Miami will pay $22 million to resolve three False Claims Act lawsuits, the first of which was filed in 2013.  The government alleged that UM, which operates a medical school out of Jackson Memorial Hospital and an extensive health system spanning four south Florida counties, fraudulently billed government health care programs to boost declining revenues.  Jackson Memorial will separately pay $1.1...

May 10, 2021

The University of Miami, which operates multiple hospitals and other healthcare facilities, will pay $22 million to resolve claims arising from allegedly fraudulent billing submitted to federal healthcare programs for laboratory services.  The university was alleged to have billed certain laboratory tests as having been provided at hospital facilities instead of at physician offices, without satisfying the requirements for that more costly hospital facility billing, including notice requirements.  In addition, the university was alleged to have performed and billed for a pre-set panel of tests for all kidney transplant patients, although not all included tests were medically necessary.  Finally, the university and Jackson Memorial Hospital, which jointly operated the kidney transplant program, were alleged to have violated related party restrictions by billing for pre-transplant laboratory tests ordered by JMH from the university, and JMH will pay an additional $1.1 million to settle these allegations.  The settlement resolves claims made in three separate qui tam lawsuits; the whistleblower's share has not yet been determined.  DOJ; USAO SD FL

Listen to James Glenn, Cybersecurity Whistleblower and Constantine Cannon Client, on Tech & Main Podcast

Posted  05/10/21
Cybersecurity whistleblower James Glenn and Constantine Cannon whistleblower attorney Mike Ronickher spoke to the Tech & Main cybersecurity podcast about the experience Glenn had discovering and reporting a security flaw in Cisco’s Video Surveillance Manager software.  Glenn, who was represented by Constantine Cannon, brought a whistleblower lawsuit that resulted in the first government recovery under the False...

Catch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation

Posted  05/7/21
By Edward Baker
pills scattered around
The Department of Justice announced this week that Incyte Corporation, a Delaware pharmaceutical company, has agreed to pay $12.6 million to resolve allegations that it violated the False Claims Act by paying kickbacks to a charitable foundation to increase prescriptions for the drug Jakafi, which is used to treat myelofibrosis, a form of leukemia that causes extensive scarring in bone marrow and leads to severe...

Whistleblower Reward Programs Work, Harvard Business School Study Says

Posted  05/7/21
Clear Light Bulb Placed on Chalkboard
A team of researchers from Harvard Business School published study results showing whistleblower incentive programs work to expose corporate misconduct. Financial rewards also help to compensate whistleblowers for costs flowing from their decision to come forward, the paper said. The study contradicts various claims by critics of programs that offer cash incentives for blowing the whistle, according to its authors....

May 5, 2021

Neurosurgical Associates, LTD and Dignity Health, d/b/a St. Joseph’s Hospital, have agreed to a $10 million settlement and five-year corporate integrity agreement to resolve allegations of violating the federal False Claims Act.  According to whistleblower Dr. Bruce P. Kingsley, Neurological Associates and St. Joseph’s Hospital improperly billed Medicare for certain doubly and triply concurrent and overlapping surgeries.  USAO AZ

May 4, 2021

Delaware-based pharmaceutical company Incyte Corporation has agreed to pay $12.6 million to resolve allegations of violating the Anti-Kickback Statute and False Claims Act in connection with its myelofibrosis drug, Jafaki.  Despite federal laws against illegal remuneration to federal healthcare program beneficiaries, Incyte allegedly wielded its influence as the sole donor of a foundation to coerce the foundation into illegally covering the copays of Medicare and TRICARE patients taking Jafaki.  The misconduct continued from 2011 through 2014 before it was revealed in a qui tam suit by former compliance executive turned whistleblower, Justin Dillon.  Dillon will receive approximately $3.59 million for his efforts.  DOJ; USAO EDPA

May 4, 2021

After being convicted of running a $11 million healthcare fraud scheme, Brenda Rodriguez, the owner and operator of Texas-based QC Medical Clinic, has been ordered to spend 25 years in prison, followed by 3 years of supervised release.  As shown by evidence presented at trial, Rodriguez’s scheme involved paying doctors to approve Medicare beneficiaries for home health services, selling the approvals to various home health providers, and causing the providers to bill Medicare for services that were medically unnecessary, never provided, and/or arose from illegal inducements.  USAO SDTX

May 3, 2021

Two medical device distributorships, Medical Designs LLC and Sicage LLC, and their neurosurgeon owner, Wilson Asfora, have agreed to pay $4.4 million to resolve allegations of illegally inducing the use of certain medical devices, submitting false claims to federal healthcare programs for medically unnecessary procedures, and failing to disclose Asfora’s ownership interests or illegal payments made to him.  The settlement was not the first involving Asfora; the United States previously settled with Sanford Health for $20.25 million and Medtronic for $9.21 million on similar claims.  The whistleblowers in this case, Drs. Carl Dustin Bechtold and Bryan Wellman, will receive a $800,000 share of the settlement proceeds, while the defendants will all be excluded from participating in federal healthcare programs for six years.  DOJ; USAO SD
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