FCA State

December 11, 2018

Aurora Health Care, Inc. has agreed to pay $12 million to settle allegations of defrauding Medicare and Wisconsin's Medicaid program in certain reimbursement claims filed between 2008 to 2012. According to the United States and State of Wisconsin, the healthcare provider and two physicians entered into improper financial relationships in violation of the federal and state False Claims Acts as well as the Stark Law. As a result, some of the claims that Aurora submitted to the government health programs were improper. Despite alerting the government to the illegal arrangement, a qui tam complaint filed by unnamed whistleblowers alleged different claims. Although the whistleblowers will still receive a share of the recovery, the government did not intervene in their lawsuit, which will be dismissed as part of the settlement. USAO EDWI

December 4, 2018

Dermatology Associates of Central New York, PLLC has agreed to pay $811,196.88 to settle claims that it overcharged Medicaid, Medicare, and TRICARE by falsely submitting claims under physicians' names, in violation of both the federal and New York False Claims Acts. A whistleblower complaint revealed that many of the physicians named on invoices were not in the office the day care was provided and could not have supervised in the rendering of services, and that some of the non-physician practitioners who provided care were not licensed to do so in the state of New York. As a result of bringing the fraud to light, the unnamed whistleblower will receive $138,000. USAO NDNY

December 4, 2018

Medical device-maker LivaNova USA, Inc. has agreed to pay $1.87 million to resolve claims that it paid improper kickbacks to physicians who were among the largest referrers of patients for LivaNova's implanted epilepsy device.  The payments took the form of "speaking fees" for the doctors, although the doctors who received them were primarily speaking to their own staffs.  Ashley Case, a former employee of LivaNova, initiated the investigation by filing a case under the False Claims Act; she will receive an unspecified share of the settlement.  USAO NDGA

November 27, 2018

In New York, Bottini Fuel pleaded guilty to unlawfully retaining overpayments made by fuel oil customers, including public entity customers.  Rather than inform customers that they had made overpayments, or refund those payments, Bottini admitted that it diverted the customers' credit balances to the personal accounts of company owners, employees, and other friends and family.  Bottini agreed to pay over $3.2 million in restitution and civil damages.  The investigation was initiated by the filing of a whistleblower complaint under the New York False Claims Act; the unnamed whistleblower will receive $491,358 of the settlement.  NY AG

November 13, 2018

Offshore art purchaser, Porsal Equities Ltd., will pay $10.75 million to settle claims for tax fraud and for violation of the New York False Claims Act. Between 2010 and 2015 Porsal Equities Ltd., a company based in the British Virgin Islands, finagled their way out of paying sales tax on over $50 million in artwork and other goods purchased in New York. They fraudulently claimed that they were exempt from paying sales tax because the art was purchased for resale. The truth is that the art was purchased for personal use and for display in the New York City apartments of the company’s sole director.  Furthermore, despite the notice which the director received from a tax authority, Porsal Equities failed to pay use tax on art they purchased outside of New York which was shipped into New York for personal use in the apartments belonging to the director. Porsal Equities did admit their violations in the settlement agreement. The company also agreed to report and file use tax returns for any artwork used in the state. NY AG

November 6, 2018

An Indiana-based dental care practice and admin support company have agreed to pay a total of $5.139 million to settle allegations they violated the federal and Indiana state False Claims Acts. According to whistleblower and qui tam plaintiff Dr. Jihaad Abdul-Majid, between 2009 and 2013, ImmediaDent of Indiana, LLC and Samson Dental Partners, LLC allegedly billed Indiana's Medicaid program for procedures that were either upcoded (i.e. represented to be more serious and more expensive than they actually were), were not actually performed, or were not medically necessary. Samson Dental Partners is additionally accused of violating Indiana’s law prohibiting the corporate practice of dentistry. Because the companies refused oversight proposed during settlement, they have now been classified as "high risk" to federal healthcare programs. IN AG; USAO WDKY

October 1, 2018

Pharmaceutical distributor AmerisourceBergen Corporation will pay $625 million to the federal government and 43 states to settle claims that between 2001 and 2014 a pre-filled syringe program at one of its subsidiaries, Medical Initiatives, Inc., violated federal law.  Despite lacking the proper licensing and registration, MII opened FDA-approved sterile vials of oncology drugs, and in a non-sterile environment, pooled the medicine and transfered it into non-FDA approved pre-filled syringes which were then sold to oncology practices and physicians.  This practice allowed Amerisource to capture the "overfill" in the original FDA-approved sterile vials and produce a larger number of pre-filled syringes.  AmerisourceBergen also resolved claims that it provided unlawful kickbacks to physicians to induce them to purchase pre-filled syringes rather than vials.  The settlement resolved three qui tam actions initiated by whistleblowers Michael Mullen, Daniel Sypula, Kelly Hodge, and Omni Healthcare, Inc.; a payment of over $93 million will be made to relators. Previously, in September, 2017, AmerisourceBergen Specialty Group pleaded guilty to illegally distributing misbranded drugs and agreed to pay $260 million in criminal fines and forfeitures. USAO E.D.N.Y.;  NY