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FCA State

This archive displays posts tagged as relevant to state and local False Claims Acts. You may also be interested in the following pages:

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Judiciary Committee Approves Amendments to California FCA

Posted  04/12/19
On Tuesday, the Judiciary Committee of the California State Assembly passed Assembly Bill 1270, which would make several important changes to the California False Claims Act, most notably eliminating the tax fraud loophole and clarifying materiality and damages standards. At the hearing, Martin Goyette, the head of the California Attorney General’s False Claims Unit, explained that the proposed changes would...

Constantine Cannon Attorneys Leah Judge and Chris McLamb Published in the Daily Journal on Proposed Amendments to the California FCA

Posted  04/12/19
man and woman attorney headshots
Constantine Cannon attorneys Leah Judge and Chris McLamb published an article in the Daily Journal highlighting proposed amendments to the California False Claims Act. Among other things, the bill would clarify the materiality requirement under the act and explicitly provide for consequential damages. The article explains how these changes will protect the government’s ability to punish and deter fraud and abuse in...

Bill aims to clarify the CFCA

Posted  04/10/19
CC Attorneys Leah Judge, Chris McLamb
Daily Journal publishes article by Leah Judge and Chris McLamb.  Click here to read the article.

April 4, 2019

Oral and Maxillofacial Surgical Associates P.C. of New Haven, Connecticut, and its former owner Robert Sorrentino DDS, have agreed to pay $252,000 to settle claims that they submitted false claims to Medicaid by billing for services that were not provided, were not medically necessary, or were covered under other claims submitted for the same date of service.  The fraudulently-billed services included deep sedation or general anesthesia and removal of bone or tissue.  USAO CT

March 29, 2019

Acacia Mental Health Clinic and its owner, Abraham Freud, have agreed to pay $4.1 million to the United States and the State of Wisconsin for submitting false claims to Medicaid in violation of the False Claims Act. According to a qui tam complaint filed by whistleblower Rose Presser, Acacia billed for urine drug screens in simple "cup" tests as if a more sophisticated test had been performed. Acacia also billed for medically unnecessary and duplicative urine drug tests and telemedicine services performed by foreign-based psychiatrists in violation of Medicaid regulations. USAO EDWI

March 11, 2019

Medical device manufacturer Covidien LP will pay $20 million to resolve False Claims Act cases initiated by three whistleblowers alleging that Covidien violated the Anti-Kickback Statute by providing remuneration to healthcare providers in California and Florida.  Covidien markets radiofrequency ablation catheters to providers including vein surgery practices for use in procedures for the treatment of varicose veins and underlying conditions, and allegedly provided its customers with substantial assistance in connection with marketing vein screening and related services in order to increase demand for such services and therefore induce purchases of Covidien's vein ablation products.  Covidien will pay $17.5 million to the United States; $1.5 million to California; and $1 million to Florida.  Two whistleblowers who were sales managers for Covidien, Erin Hayes and Richard Ponder, will share a $3.1 million whistleblower reward.  The settlement also resolves claims by whistleblower Shawnea Howerton, a former employee of one of Covidien's customers.  DOJ; USAO NDCal; FL

March 7, 2019

A Connecticut-based durable medical equipment supplier, Med Tech, and its owner, Thomas Macre, Sr., have agreed to pay more than $467,000 to resolve allegations of violating the federal and state False Claims Acts. The alleged misconduct involved billing Medicaid for unprovided and medically unnecessary back braces and electrical stimulation units. USAO CT

Constantine Cannon Attorneys Jessica Moore and Leah Judge Published in The Oklahoman on Helping to Curb Fraud in Oklahoma

Posted  02/28/19
Constantine Cannon attorneys Jessica T. Moore and Leah Judge published an op-ed piece in the Oklahoman advocating for the passage of House Bill No. 2386 (“the Oklahoma State Agency False Claims Act”). The proposed Oklahoma State Agency False Claims Act is modeled after similar state and local False Claims Act statutes that allow whistleblowers to bring lawsuits against companies and individuals who defraud the...

February 27, 2019

Tennessee-based skilled nursing facility chain Vanguard Healthcare LLC, along with former executives William Orand and Mark Miller, have agreed to pay upward of $18 million to resolve False Claims allegations of billing Medicare and Medicaid for worthless and "grossly substandard nursing home services." According to press releases, five facilities in the Vanguard network allegedly submitted false claims for reimbursement, despite a litany of failures, including forging nurse and physician signatures, using unnecessary physical restraints on residents, failing to prevent pressure ulcers, failing to provide wound care as ordered, failing to provide standard infection control, failing to administer medications as prescribed, and failing to meet basic nutrition and hygiene requirements. The case is considered the largest case of fraud involving worthless services in state history. DOJ; USAO MDTN

Ohio Seeks to Recover Overcharges from OptumRx

Posted  02/21/19
Office building with logo for Optum
After a 2018 investigation by the Ohio Bureau of Workers Compensation (BWC) of its prescription drug spending, the BWC pharmacy program manager, John Hanna, concluded that "we were being hosed."  The BWC had contracted with OptumRx to act as a pharmacy benefits manager (PBM).  PBMs act as middlemen between drugmakers, pharmacies, and payors such as worker's compensation programs, Medicaid, Medicare, and other...
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