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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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Attention Whistleblowers: DOJ Announces Cyber Fraud Initiative

Posted  10/7/21
On October 6, Deputy Attorney General Lisa Monaco announced that the Department of Justice will launch a Civil Cyber-Fraud Initiative to combat new cyber threats and hold accountable those “that put U.S. information or systems at risk by knowingly providing deficient cybersecurity products or services, knowingly misrepresenting their cybersecurity practices or protocols, or knowingly violating obligations to monitor...

October 6, 2021

Defense contractor Crane Company has agreed to pay over $4.5 million to resolve allegations of violating the False Claims Act.  According to a former Crane employee, Corla Jacobson, the failures occurred between 2011 and 2017 and involved selling the U.S. Navy high performance butterfly valves that did not conform to military specifications.  For initiating a successful qui tam action, Jacobson will receive a relator’s share of over $850,000.  USAO SDTX

Shining a Light on Fraud in the Energy Industry

Posted  10/1/21
This week brought not one but two newly announced False Claims Act (FCA) settlements with companies in the energy sector: (1) An Oklahoma-based energy company settled claims it underpaid royalties for natural resources, and (2) a utility company in New York settled claims it falsified reports to a local power authority to cover up mismanagement and wasted State electricity. The two settlements illustrate federal and...

September 27, 2021

Oklahoma-based Devon Energy Corporation and its affiliates, Devon Energy Corp. and Devon Energy Production Company, LP (collectively, “Devon”) have agreed to pay $6.15 million to resolve allegations under the False Claims Act.  As a lessee of federal land, the oil and natural gas exploration and production company was required to pay royalties on gas found and produced on that land, as well as put the gas in marketable condition on its own dime.  According to the allegations, however, Devon underreported and underpaid royalties to the Department of the Interior by improperly deducting payments made to third-parties, including payments made to put the gas in marketable condition.  USAO CO

Catch of the Week: CMS Suspends UnitedHealth and Anthem Medical Advantage Plans for Charging Too Much in Premiums

Posted  09/24/21
Medicare Card
CMS suspended three UnitedHealth Medicare Advantage (MA) plans and one Anthem MA plan this week for failing to meet federal Medical Loss Ratio requirements. The four plans – United of the Midwest, United of New Mexico, United of Arkansas, and Anthem’s MMM Healthcare – are prohibited from enrolling new members until 2023. MMM Healthcare is the largest MA plan in Puerto Rico, with more than 260,000...

September 23, 2021

Index Systems, Inc. and Capital Consulting Group, Inc. (CCG), two government contractors in Virginia, have agreed to pay nearly $1.2 million to settle allegations of violating the False Claims Act and Anti-Kickback Act.  In order to fraudulently obtain Small Business Administration contracts reserved for businesses owned by socially or economically disadvantaged citizens, CCG—which was not eligible—allegedly conspired with Index to use Index’s certification to bid on the contracts, in exchange for kickbacks.  USAO EDVA

September 21, 2021

The University of North Carolina at Chapel Hill (UNC-CH), East Carolina University (ECU), and the North Carolina Commission on Volunteerism and Community Service (NCCV), have agreed to pay a combined $842,500 to resolve allegations of fraud in connection with the AmeriCorps program.  An investigation by the United States had found that UNC-CH, ECU, and NCCV failed to comply with multiple grant requirements and regulations, including falsely certifying the service hours worked by AmeriCorps members, falsely certifying employee salaries required to administer the program, and failing to maintain proper internal controls.  USAO EDNC

Catch of the Week: Bayada Home Health Care Settles Kickback Allegations for $17 Million in Case Demonstrating that Kickbacks Come in Many Forms

Posted  09/17/21
business person stamping a paper
Last week, Bayada Home Health Care, Inc., a national home health company with more than $1.5 billion in reported revenues and offices in twenty-two states, agreed to pay the United States $17 million to settle allegations that it violated the federal Anti-Kickback Statute (AKS).  The AKS prohibits paying illegal remuneration in any form to induce business or referrals paid for with federal health care dollars, and...

U.S. Pursuit of Risk Adjustment Fraud Continues with Complaint in Intervention in Case Filed by Constantine Cannon Client against Independent Health and its Coding Subsidiary DxID

Posted  09/16/21
Western District of New York Birds-Eye View of Building
In July, we wrote that managed care enforcement had reached a “tipping point,” as the Department of Justice intervened in whistleblower cases against Kaiser Permanente alleging risk adjustment fraud, including a case brought by Constantine Cannon client Dr. James Taylor.  Just last month, we announced a $90 million settlement in a different Medicare Advantage risk adjustment fraud case brought by Constantine...

September 15, 2021

A cardiologist in Florida who allegedly billed Medicare and Medicaid for medically unnecessary procedures has agreed to pay $6.75 million to resolve claims under the False Claims Act.  Between 2013 and 2019, Dr. Ashish Pal allegedly made misrepresentations in patient medical records to justify ablations and vein stent procedures that were not reimbursable under program rules.  Additionally, some of the procedures were later found to have been performed primarily by unqualified ultrasound technicians.  As part of the settlement, Pal and Interventional Cardiology & Vascular Consultants, PLC, will enter in a multiyear integrity agreement and comply with training and reporting requirements, as well as a quarterly claims review by an independent organization.  USAO MDFL
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