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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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June 21, 2023

Skilled nursing facility Alta Vista Healthcare & Wellness Centre and its management company Rockport Healthcare Services have agreed to pay $3.8 million to resolve allegations that it paid kickbacks to physicians to induce referrals of Medicare and Medicaid beneficiaries to its center.  The violations of the federal Anti-Kickback Statute, federal False Claims Act, and California False Claims Act were uncovered during a government investigation, and showed illegal kickbacks in the form of cash, gifts, and salaries paid from 2009 through 2019.  CA AG; DOJ

As States Look to Expand Health Coverage, State FCAs Become More Important than Ever

Posted  03/22/23
Continental US Map
The increasing burden of healthcare costs has state governments looking at new programs to expand government healthcare options for their residents.  Such an expansion of government spending will require a corresponding expansion of efforts to root out fraud, waste, and abuse that steals taxpayer dollars and reduces the benefits available.  Existing anti-fraud measures, including state False Claims Acts, will play a...

February 27, 2023

Several individuals and entities involved with the Saratoga Center for Rehabilitation and Skilled Nursing Care have agreed to pay over $7.1 million to resolve allegations of violating the False Claims Act by submitting claims for essentially worthless services.  From 2017 until the center closed in 2021, while receiving reimbursements from New York’s Medicaid program, the center’s owners and operators failed to provide adequate staffing, hot water, and clean linens, and failed to dispose of solid waste.  As a result of these failures, conditions fell below regulatory standards, and residents suffered from unnecessary errors and neglect.  NY AG; DOJ

February 8, 2023

Centene Corporation has agreed to pay $215 million to resolve allegations of violating the California False Claims Act.  A government investigation revealed that for almost two years, Centene failed to disclose or pass on discounted prescription drug costs to the state’s Medicaid program, as mandated by program rules, and instead falsely reported higher costs incurred by two of its managed care plans, which together serve beneficiaries in over 20 counties.  CA AG

February 7, 2023

A startup that operates as an online pharmacy for birth control and contraceptives has agreed to pay $15 million to settle whistleblower claims of defrauding California’s Medicaid program of millions of dollars.  In violation of the state False Claims Act, The Pill Club allegedly billed for ineligible services, services not rendered, and enormous quantities of expensive products not ordered by customers.  Investigators found that even in cases where customers asked to stop receiving those products, the company continued to dispense enormous quantities and bill the government for them.  CA AG

February 2, 2023

Central California medical provider Clinica Sierra Vista (CSV) has agreed to pay nearly $26 million to settle claims of violating the state False Claims Act.  Following an internal investigation, the company’s new management voluntarily disclosed to the government that former executives knowingly submitted false information on financial reports in order to receive higher payments from the state’s Medicaid program.  CA AG

Top Ten Non-Healthcare False Claims Act Recoveries of 2022

Posted  01/27/23
This year’s Top Ten Non-Healthcare False Claims Act Recoveries exhibit the False Claim Act’s (FCA) enduring ability to combat corporate misconduct across distinct industries.  In 2022, the United States recovered hundreds of millions in taxpayer funds falsely obtained by defendants through bribery and bid-rigging schemes, mortgage underwriting fraud, fraudulent loan applications, fraud in the energy sector, and...

Top Ten State Fraud Recoveries of 2022

Posted  01/19/23
State and local governments play a critical role in ensuring that businesses and individuals are held accountable if they commit healthcare fraud, financial fraud, government contract fraud, and more. For whistleblowers, state governments can offer additional opportunities to report wrongdoing. Where government funds are at stake – and state and local government spending reaching $3 trillion annually – more...

December 22, 2022

New York doctor David DiMarco and his companies, D. B. DiMarco, M.D., P.C. and DiMarco Vein Centers LLC, has agreed to pay $2 million to New York’s Medicaid program and withdraw from providing services to it after an investigation found DiMarco submitted false claims between 2015 and 2021.  According to the NY AG’s office, DiMarco submitted more than a thousand claims for procedures without sufficient documentation showing the procedures performed or their medical necessity.  AG NY

December 9, 2022

White Glove Community Care, Inc., a home health agency in Brooklyn, has agreed to pay $1.2 million to the New York Medicaid program and return $2 million in unpaid wages to current and former employees, following a whistleblower’s lawsuit under the state and federal False Claims Acts.  A joint investigation by the NY AG and EDNY found that between 2012 and 2018, White Glove failed to pay its home health and personal care aides wages and benefits owed to them under the state’s Wage Parity Act, yet sought and received funds from the state’s Medicaid program for the full wages and benefits owed.  AG NY; USAO EDNY
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