FCA Federal

June 28, 2018

Varicose vein treatment company Circulatory Centers of America, LLC agreed to pay $1,205,000 to settle allegations that it violated the False Claims Act. The allegations stemmed from a qui tam lawsuit filed by a whistleblower in Pittsburgh, PA that alleged claims were submitted to Medicare for services by non-physicians “incident to” the supervision by a physician when in fact no physician was present in the office. These types of claims are reimbursed at higher rates than when billed without the physician supervision component. USAO WDPA

June 27, 2018

The government settled fraud charges under the False Claims Act against Temple St. Clair LLC for allegations of systematically avoiding payment of customs duties on goods it imported from various countries including Thailand, Sri Lanka, and Italy. Temple St. Clair allegedly perpetuated the fraud by claiming the good it imported were of a lower value than the true value. Other Temple St. Clair employees also allegedly hand-carried jewelry into the United states without declaring it to Customs and Border Patrol. Temple St. Clair agreed to pay $796,000 to resolve the allegations and institute a number of changes to its practices. USAO SDNY

June 25, 2018

Caris Healthcare, L.P. agreed to pay $8.5 million to settle a False Claims Act lawsuit regarding improper billing for ineligible hospice patients. Caris was accused of admitting patients into hospice care that did not have medical records supporting a terminal diagnosis. Caris also allegedly recertified previous false submissions for payment related to hospice care. The case was filed in the United States District Court for the Eastern District of Tennessee by qui tam whistleblower Barbara Hinkle, a registered nurse who previously worked for Caris. As a result of the settlement, Hinkle will receive $1,402,500 as a relator’s share. DOJ

June 21, 2018

Livingston Regional Hospital, a healthcare provider outside of Nashville, has paid $784K to settle FCA allegations that it improperly billed Medicare Part A for inpatient psychiatric care that was not medically necessary. The allegations were first brought forward by two whistleblowers who will receive a $156K reward. USAO Middle District of Tennessee

June 20, 2018

Healogics, a Florida-based company which runs a chain of wound care centers, has settled FCA allegations that it improperly billed for hyperbaric oxygen therapy (a modality in which the entire body is exposed to oxygen under increased atmospheric pressure, as an adjunctive therapy to treat certain chronic wounds). The company paid $22.5M to settle allegations that it billed for unnecessary or unreasonable hyperbaric oxygen therapy. The allegations were brought to the government’s attention by four whistleblowers, James Wilcox, Dr. Benjamin Van Raalte, Dr. Michael Cascio, and John Murtangh. The whistleblowers will receive a $4.28M reward. Separately, Healogics also paid $398K to settle another FCA case alleging that it improperly applied Modifier 25, which signifies that a separate evaluation and management service was performed on the same day as another procedure, to claims that were sent to Medicare, Medicaid, and TRICARE. The allegations were brought to light by a whistleblower, who will receive a $91K reward. DOJ;  USAO Northern District of Iowa

June 11, 2018

Two Massachusetts landlords, Latchmin Nannan and David Nannan, and a property manager, Rhea Nannan, will collectively pay $57,000 to resolve whistleblower Kafer Nevins’s allegations they overcharged low income Section 8 tenants, and thus improperly collected housing subsidies from the government in violation of the False Claims Act. The whistleblower, one of the overcharged tenants, will receive a share of the government’s recovery. USAO MA

June 8, 2018

New Jersey couple Babu Metgud and Shubhada Kalyani, who operated defense contractor Shubhada Industries, were ordered to pay more than $232,000 for overcharging the Defense Logistics Agency for, and failing to disclose the origin of, munition vehicle light assemblies it had acquired from third parties and marked up by 5,400%. The case was decided on the government’s summary judgement motion. USAO EDPA

June 8, 2018

Skilled nursing facility company Signature HealthCARE, LLC will pay more than $30 million to the federal and Tennessee state governments to resolve False Claims Act allegations it placed patients in the highest therapy reimbursement level regardless of need; limited its therapy services to the minimum number of minutes required to bill at a given reimbursement level and discouraged the provision of care beyond that minimum; and pressured therapists to complete therapy even when patients were too ill or declined to participate. The suit was brought by two former employees and whistleblowers, who will receive a portion of the recovery. DOJ