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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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Community Health Network Pays $345 Million to Settle Stark Law Case

Posted  12/21/23
Handshake in room with dark window blinds
Community Health Network Inc., based in Indianapolis, recently settled with the U.S. government for $345 million, addressing allegations under the False Claims Act related to the Stark Law. This landmark case emphasizes the importance of whistleblowers to combat Medicare fraud. The Stark Law prevents hospitals from billing Medicare for services referred by physicians who have a financial relationship with the...

December 21, 2023

A Florida woman who submitted over $192 million in claims to Medicare for medically unnecessary and unprovided tests, equipment, and services, has been sentenced to 20 years in prison.  Elizabeth Hernandez ordered thousands of genetic testing and orthotic braces for patients she never spoke to or examined, ultimately ordering more cancer genetic tests than any other provider in the nation.  She also billed for thousands of telemedicine visits that she never performed, often billing for over 24 hours in a single day.  DOJ

December 21, 2023

Ultragenyx Pharmaceutical, Inc., maker of Crysvita, will pay $6 million for violating the False Claims Act. Crysvita is prescribed to treat a rare inherited blood disorder, which may require a genetic test to definitively diagnose. To induce purchases and referrals, Ultragenyx paid a laboratory to conduct genetic tests at no cost to healthcare providers or patients, and then provide the results reports to Ultragenyx. Ultragenyx then used the positive test results reports to target healthcare providers for Crysvita sales. Internally, Ultragenyx referred to this kickback scheme as their "sponsored" testing program. The program was exposed via a qui tam whistleblower, who will receive $1.07 million of the $6.7 million recovery. DOJ

December 19, 2023

Indiana-based Community Health Network Inc. has agreed to pay $345 million to resolve claims by its former CFO and COO Thomas Fischer, which alleged the healthcare system submitted claims to Medicare that were tainted by violations of the Stark Law.  In order to capture physicians’ downstream referrals, Community paid physicians salaries that were sometimes double market rate, and awarded them bonuses based on the number of referrals.  Community then submitted claims resulting from these referrals for reimbursement.  DOJ

December 18, 2023

Heart monitoring device manufacturer BioTelemetry Inc. and its subsidiary, LifeWatch Services Inc., have agreed to pay more than $14.7 million for causing false claims to be submitted to federal healthcare programs.  The claims were brought in two separate qui tam suits, one by an employee of one of LifeWatch’s customers, Michael Pelletier, and the other by SFP I LLC.  The whistleblowers alleged that the companies knew the design of their enrollment portal would steer clinical staff into enrolling patients in telemetry, which is reimbursed at a higher rate, rather than holter monitoring and event monitoring, which is reimbursed at a lower rate.  DOJ

Catch of the Week: King Kong Tools

Posted  11/30/23
Typewriter with Made in China Letters Typed Out
This week's Department of Justice (DOJ) Catch of the Week goes to King Kong Tools GmbH & Co KG.  On  Wednesday (November 29), the German-based supplier of recycling, forestry, construction, and agricultural equipment, along with its American subsidiary, agreed to pay $1.9 million to settle DOJ charges of violating the False Claims Act through customs fraud.  More specifically, the government alleged King Kong...

Alabama Court Reaffirms Constitutionality of False Claims Act

Posted  11/29/23
Supreme Court of Alabama
The False Claims Act is the government's primary tool to go after those committing fraud against the government.  One of the key features of the statute is the qui tam provisions, which allow private parties (whistleblowers) to bring suit on the government's behalf and in return, receive a hefty share of any government recovery.  The Constitutional muster of this feature has long been settled, with the statute...

Tactical Gear Company Settles $2.1 Million False Claims Act Allegations

Posted  11/22/23
Soldier Gear Piled Together

The U.S Attorney’s Office in the Southern District of Ohio has announced that London Bridge Trading Company, Ltd. (LBT), a Virginia headquartered manufacturer of tactical gear for military, law enforcement, and other organizations, has agreed to pay nearly $2.1 million to settle False Claims Act allegations.  The case, initiated by qui tam relator Ann Keating, involves accusations that LBT failed to comply with the...

$45.6 Million Settlement in False Claims Act Case Against Nursing Facility Defendants

Posted  11/17/23
Nurse Holding Clipboard in Front of Nursing Patient
The DOJ recently announced another settlement of a False Claims Act case against skilled nursing facilities (SNFs).  This time, it was a $45.6 million settlement of a False Claims Act case that the government brought against six SNFs; a management company called Paksn Inc.; and Prema Thekkek, the owner.  The six SNFs do business as (i) Bay Point Healthcare Center (Kayal Inc.); (ii) Gateway Care & Rehabilitation...

November 16, 2023

A Florida man who was the Chief Compliance Officer of pharmacy holding company A1C Holdings LLC has been ordered to pay $21.7 million in restitution for his role in a $50 million fraud scheme against Medicare.  Pharmacies associated with Steven King and his co-conspirators allegedly secured prescriptions and refills for medically unnecessary lidocaine and diabetic testing supplies, and took steps to avoid oversight by registering as brick-and-mortar pharmacies, concealing their ownership, and shipping expensive prescriptions without patient authorization.  DOJ
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