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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 26 of 182

November 22, 2021

Home health provider PruittHealth, Inc. has agreed to pay $4.2 million to resolve allegations that they knowingly submitted false claims for services that were not eligible for reimbursement because, among other things, they did not have the required face-to-face certifications or plans of care, and they did not document the beneficiary’s homebound status or need for the home health services.  Tina Peery, who initiated the government action by filing a qui tam complaint, will receive an award of $700,000.  USAO ND Ga

Tagged in: FCA Federal, Healthcare Fraud, Home Health and Hospice, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

November 22, 2021

South Carolina chiropractor Daniel McCollum has consented to judgment of $9 million to resolve charges that he submitted false claims to federal healthcare programs in violation of the Anti-Kickback Statute and Stark Law.  McCollum admitted that his laboratory, Labsource (which was a party to a related action), gave referring providers an opportunity to earn revenue generated from their commercially-insured referrals for urine drug testing as an inducement for those providers to refer all of their federally-insured urine drug testing patients to Labsource.  McCollum also caused medically unnecessary prescriptions for pain creams often without the knowledge or approval of the patients’ healthcare providers.  In addition to the civil settlement, McCollum pleaded guilty to criminal kickback and healthcare fraud charges and will be sentenced at a later date.  DOJ; USAO SC

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

Catch of the Week: Archdiocese of New Orleans pays $1 million to Resolve Katrina-Related Allegations, Highlighting Importance of Enforcement in Disaster Recovery Fraud

Posted  11/19/21
New Orleans Jackson Square
We’ve covered this before: natural disasters and fraud against the government often go hand in hand. The government, through agencies and programs such the FEMA and the federally-backed flood and crop insurance programs, can distribute enormous sums of money very quickly in the wake of hurricanes, floods, tornadoes, and the like. Distributing lots of money quickly after natural disasters gets immediate help to...

Tagged in: Catch of the Week, Certifications, FCA Federal, Flood Insurance, Government Programs Fraud,

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Recent Settlements Show Kickbacks are Always a DOJ Enforcement Priority

Posted  11/15/21
Person Handing Hundred Dollar Bill to Another Person
The Department of Justice regularly highlights the areas of fraudulent conduct it intends to target as enforcement priorities.  These identified enforcement priorities tend to cover burgeoning areas of fraud or particular misbehavior especially ripe or prevalent because of the particular times we live in.  As might be expected, DOJ's current listing of priorities includes fraud related to the pandemic, opioids, the

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Importance of Whistleblowers, Medical Devices and DME, Pharma Fraud, Provider Fraud,

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November 15, 2021

The Roman Catholic Archdiocese of New Orleans will pay $1.05 million to resolve allegations that it falsely certified damage description and repair estimates in connection with claims for federal funds for the repair of facilities damaged by Hurricane Katrina.  Claims against federal contractor AECOM, which prepared the estimates, are continuing.  The Archdiocese is in bankruptcy, and the settlement amount is based on an “ability to pay” determination.  The action was initiated by the filing of a whistleblower complaint by AECOM employee Robert Romero, who will receive a whistleblower award of approximately $200,000.  DOJ; USAO EDLA  See earlier settlement

Tagged in: Certifications, FCA Federal, Government Programs Fraud, Whistleblower Case, Whistleblower Rewards,

Next Up: Infrastructure Oversight Week?

Posted  11/12/21
freeway bridge and crane
More than four years after “Infrastructure Week” was first announced by President Trump back in June 2017, Congress has finally passed an infrastructure bill and President Biden will soon sign it into law.  A staggering $1.2 trillion in taxpayer money will soon start flowing from the U.S. Treasury to private contractors to upgrade the nation’s roads, bridges, power grid, and other public works.  Is it too soon...

Tagged in: FCA Federal, Government Procurement Fraud,

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November 9, 2021

Numerous anesthesia providers and outpatient surgery centers in Georgia, including Ambulatory Anesthesia of Atlanta, LLC and Northside Anesthesiology Consultants, LLC, have agreed to pay over $28 million to resolve kickback allegations by whistleblowers Kathleen Hartney-Velazco, M.D., Jan Kersey, and Capitol Anesthesiology, P.C., who will receive a $4.7 million cut of the settlement.  According to the whistleblowers, the anesthesia providers made payments and provided free staffing to the outpatient surgery centers in order to obtain exclusivity contracts over a ten-year period.  USAO NDGA

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

November 9, 2021

Kaléo, Inc., a pharmaceutical manufacturer in Virginia, has agreed to pay $12.7 million to resolve a whistleblower’s allegations that it violated the Anti-Kickback Statute and False Claims Act in claims submitted to Medicare, TRICARE, and the Federal Employees Health Benefits Program.  Between 2017 and 2020, kaléo allegedly provided kickbacks to physicians and their staff to induce and reward them for prescribing Evzio, a higher-priced version of a drug used to reverse opioid overdoses and which often requires prior authorization.  Kaléo also allegedly directed pharmacies to submit false prior authorizations and dispense Evzio without collecting required co-pays.  USAO MA

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

November 8, 2021

Florida-based medical device company Arthrex Inc. has agreed to pay $16 million and enter into a five-year corporate integrity agreement to resolve allegations of paying kickbacks to a Colorado-based orthopedic surgeon in exchange for the surgeon’s use and recommendation of its products.  According to a qui tam suit by whistleblower Joseph Shea, the kickbacks were disguised as royalty payments for the surgeon’s contributions to Arthrex’s SutureBridge and SpeedBridge products.  For his role in the case, Shea will receive a relator’s share of $2.5 million.  USAO MA

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

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