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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 Recoveries for 2023

Posted  01/22/24
Top Ten Blue Stamp
2023 was another big year for whistleblowers, helping the government recover billions of dollars in dozens of fraud enforcement actions.  As usual, virtually all these whistleblower-prompted recoveries were under the government's three primary whistleblower rewards programs -- the False Claims Act, the SEC Whistleblower Program, and the CFTC Whistleblower Program.  Successful whistleblowers under each of these...

Tagged in: CFTC Whistleblower Reward Program, FCA Federal, SEC Whistleblower Reward Program, Top 10, Whistleblower Case, Whistleblower Rewards,

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January 16, 2024

Silver Lake Hospital, a long-term care hospital in New Jersey, will pay $18.6 million, and its principal investors Dr. Richard Lipsky and Columbus Management South LLC will pay another $12 million, to resolve allegations of violating the False Claims Act and Federal Debt Collection Procedures Act (FDCPA).  The hospital allegedly claimed excessive cost outlier payments from Medicare, well in excess of its needs or ability to repay, and transferred millions of dollars to investors without receiving equivalent value in return.  DOJ

Tagged in: FCA Federal, Healthcare Fraud, Medicare, Provider Fraud,

Testing Lab and Owner/CEO Settle False Claims Act Case for $13.25 Million

Posted  01/12/24
Laboratory Analysis. Scientist Measuring Sample
RDx Bioscience Inc. (“RDx”), a clinical laboratory that operated in New Jersey, and its owner and CEO agreed to pay $13.25 million to settle a False Claims Act case alleging kickbacks and unnecessary testing schemes, according to a recent DOJ press release.  The press release also notes that RDx and its owner/CEO agreed to cooperate with the DOJ’s “investigations of, and litigation against, other participants...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity,

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Top Ten False Claims Act Recoveries in 2023

Posted  01/11/24
It was another big year for DOJ enforcement under the False Claims Act, the government's primary fraud-fighting tool. As usual, most of the recoveries were in the healthcare space with seven of the Top-10 involving various schemes to defraud Medicare and Medicaid. Several of these Top-10 recoveries involved enforcement actions targeting violations of the Anti-Kickback Statute and Stark Law, which prohibit medical...

Tagged in: Anti-Kickback and Stark, Electronic Health Records, FCA Federal, Government Programs Fraud, Healthcare Fraud, Medicaid, Medical Billing Fraud, Medicare, Top 10, Whistleblower Case,

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January 10, 2024

Clinical laboratory RDx Bioscience Inc. and its owner and CEO Eric Leykin have agreed to pay over $10 million to the federal government and about $3 million to the State of New Jersey for violating the Anti-Kickback Statute and federal and state False Claims Acts.  From 2018 to 2022, RDx and Leykin were allegedly involved with five types of kickback schemes in order to induce referrals to RDx for laboratory testing, then submitted or caused false claims to be submitted to Medicare and Medicaid that were unnecessary or uncovered.  DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicaid, Medicare,

January 5, 2024

A Florida man, Karel Felipe, and Florida woman, Tamara Quicutis, have been sentenced to 8 years and 5 years respectively for their roles in a $93 million fraud scheme against Medicare.  Felipe and Quicutis were found guilty last October of submitting claims on behalf of three Michigan-based home health companies, for services never rendered, using stolen patient information, and then laundering the proceeds through dozens of shell companies and hundreds of bank accounts.  Their fellow co-conspirators—Jesus Trujillo, Didier Arcia, Alexey Gil, and Jeffrey Avila—have already been sentenced for their roles.  DOJ

Tagged in: FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, Money Laundering,

Catch of the Week: Moffitt Cancer Center

Posted  01/5/24
medicare dollars
This week's Department of Justice (DOJ) Catch of the Week goes to Tampa-based H. Lee Moffitt Cancer Center & Research Institute Hospital.  Yesterday (January 4), the non-profit cancer treatment and research center agreed to pay roughly $19.6 million to settle DOJ charges of violating the False Claims Act by billing Medicare for patient care services provided during research studies not eligible for...

Tagged in: Catch of the Week, FCA Federal, Healthcare Fraud, Improper Medical Facility, Medical Billing Fraud, Medicare,

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January 4, 2024

ChristianaCare has paid $42.5 million for violations of the federal False Claims Act and the Delaware False Claims and Reporting Act. In a qui tam whistleblower complaint filed in 2017, ChristianaCare's former chief compliance officer alleged illegal remuneration was provided to non-employee neonatologists and surgeons in the form of free or below fair market services by ancillary support providers, such as nurse practitioners, hospitalists, and physician assistants. These services were meant to induce referrals from the non-employees, creating a financial relationship. USAO DE

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Healthcare Fraud, Provider Fraud, Whistleblower Case,

January 4, 2024

Florida-based H. Lee Moffitt Cancer Center & Research Institute Hospital Inc. (Moffitt) has agreed to pay over $19.5 million to resolve allegations of violating federal and state False Claims Acts over a 6-year period.  A majority of the settlement proceeds, $18.2 million, will go to the federal government, while $1.3 million will go to the State of Florida.  The hospital allegedly billed the government for items and services that should have been billed to non-government sponsors.  DOJ

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Medicaid, Medicare, Provider Fraud,

December 22, 2023

Christiana Care Health System has agreed to pay over $7.6 million to the State of Delaware for violating the federal and state False Claims Acts, and Delaware’s Patient Brokering and Anti-Kickback laws.  According to a qui tam whistleblower, who filed a case in 2017, the healthcare system provided free or below-market rate support services to doctors in exchange for referrals of Medicaid patients, then submitted false claims stemming from those referrals to Delaware’s Medicaid program.  DE AG

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Healthcare Fraud, Medicaid, Provider Fraud, Whistleblower Case,

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