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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:

Page 25 of 182

Annual Inflation Adjustment Raises False Claims Act Penalties

Posted  12/16/21
As of December 13, 2021, each separate violation of the False Claims Act exposes defendants to a per-claim penalty between $11,803 and $23,607.  The increase is part of the Civil Monetary Penalties Adjustment for 2021, a rule issued by the Department of Justice in accordance with the Bipartisan Budget Act of 2015 as part of annual adjustment for inflation.  The increase is small – the prior range was $11,665 -...

Tagged in: Damages and Penalties, FCA Federal, Legislation and Regulation News,

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December 15, 2021

David Bellamah, and his business, Bellamah Vein & Surgery, PLLC, will pay $3.75 million to resolve allegations that they billed government healthcare programs for medically unnecessary venous procedures based on false medical records.  Defendants allegedly used improper techniques to conduct and analyze ultrasounds and used false ultrasound findings to diagnoses and treat venous reflux disease and varicose veins. The government’s claims were initiated by the filing a qui tam complaint by Lenore Lezanne, who previously worked as a sonographer at the Bellamah Vein Center; Lezane will receive a whistleblower award of 17% of the amounts recovered.  USAO MT

Tagged in: FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

December 14, 2021

Michigan-based Metna Co., a research and development firm which had contracts with the U.S. Army, has agreed to pay $500,000 to resolve claims that in improperly concealed its use of foreign nationals on Army Small Business Innovation Research contracts.  The government alleged that Metna employed foreign graduate students on F-1 student visas, misrepresenting their work to their university and paying them substantially less than the hourly labor rate that Metna quoted to the Army in its contract budget proposals.  USAO WD MI

Tagged in: Certifications, Defense Contract Fraud, FCA Federal, Government Procurement Fraud,

December 13, 2021

Kevin Cooper, M.D. and his practice, Cooper Family Medical Center, will pay $375,000 to resolve allegations that they fraudulently billed Medicare of non-reimbursable acupuncture devices by using billing codes for surgically implanted devices for the provision of P-Stim electro-acupuncture devices that are affixed behind a patient’s ear using an adhesive.  USAO SD MI

Tagged in: FCA Federal, Healthcare Fraud, Medical Billing Fraud, Provider Fraud, Upcoding,

December 8, 2021

The owner and medical director of Georgia’s Milton Hall Surgical Associates, Jeffrey M. Gallups, will pay $3 million, and medical device manufacturer Entellus Medical will pay $1.2 million, to resolve claims that they entered into an unlawful kickback arrangement.  The government alleged that Gallups received cash payments and all-expense paid trips from Entellus in return for directing MHSA physicians to utilize sinuplasty related medical devices exclusively from Entellus and increase the number of sinuplasty procedures performed.  In addition, Gallups was alleged to have received “commissions” from medical testing laboratory NextHealth, in exchange for directing MHSA doctors to order medically unnecessary toxicology and genetic tests from NextHealth.  The settlement resolves a qui tam action initiated by former MHSA physician Myron Jones, M.D., who will receive approximately $614,000 from the settlement.  USAO ND GA

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medical Devices and DME, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

December 8, 2021

Pharmacist Riad “Ray” Zahr and two pharmacies he owned and operated, Plymouth Towne Care Pharmacy Inc. and Shaska Pharmacy LLC will pay $1 million to resolve a lawsuit initiated by a whistleblower alleging that the pharmacies submitted false claims for Evzio, a naloxone hydrochloride product used for the rapid reversal of an opioid overdose.  The government alleged that the claims included false and misleading prior authorization requests, including forged physician authorizations.  In addition, defendants dispensed Evzio without collecting or attempting to collect co-payments. DOJ; USAO MA

Tagged in: Drug and DME Pricing, FCA Federal, Lack of Medical Necessity, Pharma Fraud, Whistleblower Case,

December 7, 2021

New Jersey-based Princeton Pathology Services P.A. will pay $2.4 million to resolve allegations that it overbilled Medicare by submitting claims using a Current Procedural Terminology (CPT) code that required written analysis by a pathologist, when no such analysis was required or had been prepared.  A whistleblower, Jayant Barai, M.D., initiated the matter by filing a qui tam complaint under the False Claims Act, and will receive an award of $456,000.  USAO NJ

Tagged in: FCA Federal, Healthcare Fraud, Medical Billing Fraud, Provider Fraud, Upcoding, Whistleblower Case, Whistleblower Rewards,

December 2, 2021

Texas-based Flower Mound Hospital Partners LLC has agreed to pay $18 million and enter into a five-year Corporate Integrity Agreement to resolve fraud allegations.  According to Leslie Jennings, M.D., one of many physician-owners, when Flower Mound repurchased shares from physician-owners nearing retirement age and resold them to younger physicians, the company allegedly improperly took into account the value of each physician’s referrals in selecting to whom and how many shares would be resold.  Claims arising from these referrals were then knowingly submitted to Medicare, Medicaid, and TRICARE, in violation of the Anti-Kickback Statute, Physician Self-Referral Law, and False Claims Act.  For initiating a lawsuit that resulted in a successful enforcement action, Jennings will receive a $3 million share of the settlement.  DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medicaid, Medicare, Other Government Health Programs, Whistleblower Case, Whistleblower Rewards,

December 1, 2021

A collection of hospices known as Crossroads Hospice has agreed to pay $5.5 million to settle allegations raised in two qui tam suits by former employees Leanne Malone, Jackie Burns, and Angela Heck, and a home health physician in Tennessee, Dr. David Weber.  In their lawsuits, the whistleblowers alleged that between 2012 and 2014, Crossroads billed Medicare for hospice care for patients who were not terminally ill, including patients with Alzheimer’s or dementia.  Malone, Burns, and Heck will divide a million-dollar relator’s share.  USAO WDTN

Tagged in: FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, Whistleblower Case, Whistleblower Rewards,

November 29, 2021

General contractor J.A. McDonald, Inc. has agreed to pay $637,500 to settle allegations of presenting false claims to the United States and State of Vermont in connection with the federally-funded construction of several bridges.  Employees at the company allegedly made material alterations, then took steps to conceal those alterations from the Vermont Agency of Transportation, which then caused the agency to submit false claims to the Federal Highway Administration.  USAO VT

Tagged in: FCA Federal, FCA State, Government Procurement Fraud,

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