FCA State

July 10, 2019

Overstock.com has been ordered by a Delaware court to pay $7.3 million following a jury verdict against it on claims that the online retailer misrepresented its disposition of abandoned gift card balances to Delaware's revenue agency in order to avoid obligations under the Delaware escheat law, which requires that Delaware-chartered companies turn over unclaimed assets to the state.  The case was brought by whistleblower William Sean French, a former employee of a gift card company, under the Delaware False Claims and Reporting Act. DEL (note: the trial court judgment was reversed by the Delaware Supreme Court in an opinion issued June 24, 2020)

July 2, 2019

For allegedly violating the False Claims Act, mental health nonprofit Wisconsin Community Services, Inc. (WCS) has agreed to pay $537,904 to the United States and the State of Wisconsin.  WCS voluntarily disclosed that one of its pharmacists had billed Medicare and Medicaid for brand name medications over several years, even though generic medications had been dispensed.  USAO EDWI

July 2, 2019

To settle a qui tam suit by a former employee, LexisNexis Risk Solutions and its affiliates have agreed to pay $5.8 million to resolve their liability under the Illinois, Massachusetts, New Jersey, New York, and Tennessee False Claims Acts.  LexisNexis had signed a contract with law enforcement agencies to access automobile crash reports that they then sold to individuals, insurance companies, and law firms for claims adjustment purposes.  According to the contract, LexisNexis would pay the agencies each time a report was sold; however, it allegedly paid the agencies for the first report only but not for each subsequent report.  AG IL; AG NJ; AG NY; Later Florida settlement

June 14, 2019

IBM and its subsidiary, Cúram Software, will pay $14.8 million for allegedly making material misrepresentations to the State of Maryland during a contract award process for the state’s health insurance exchange website.  Cúram, which was acquired by IBM at the end of 2011, had applied for the award in 2012 and subsequently became a subcontractor on the project, which was partially funded by federal grants.  However, during the application process, and with IBM’s knowledge, Cúram allegedly misrepresented the development status and existing functionality of its software, as well as its software’s ability to integrate with other software.  The resulting issues caused the State of Maryland to terminate the contract and replace Cúram’s software.  DOJ; USAO MD

June 12, 2019

Lake Country Pharmacy and Compounding Center in Georgia, along with two of its principals, Chris and Carey Vaughan, have settled allegations filed by a whistleblower under the federal False Claims Act and Georgia False Medicaid Claims Act.  According to former pharmacist Chris Coleman, Lake Country submitted bills to Medicare, Medicaid, and TRICARE for compounded medications that were made from non-reimbursable bulk powders but billed as if they were made from reimbursable tablets.  Without admitting or denying these charges, Lake Country agreed to pay $365,000 and enter into an Integrity Agreement with the Department of Health and Human Services.  USAO MDGA

May 31, 2019

Oklahoma Heart Hospital, LLC and Oklahoma Heart Hospital South, LLC (collectively “OHH”), have agreed to pay $2.8 million to resolve a qui tam suit by a former employee, which alleged that OHH violated the federal and state False Claims Acts and defrauded Medicaid by submitting claims for outpatient procedures as if they were inpatient procedures.  Though multiple allegations were raised in the lawsuit, only the allegation involving the upcoded claims was intervened by the government; the other allegations will be dismissed as part of the settlement.  USAO WDOK