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Whistleblower Case

This archive displays posts tagged as involving a whistleblower case or claim. You may also be interested in our pages:

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January 12, 2022

Six medical practices affiliated with Interventional Pain Management Center P.C. (IPMC), as well as physician-owner Dr. Amit Poonia, have agreed to pay nearly $7.5 million to resolve allegations of defrauding Medicare and the Federal Employees Health Benefit Program.  In a qui tam suit by Anu Doddapaneni and Christian Reyes, the whistleblowers alleged that Poonia and IPMC violated the False Claims Act by using a billing code that mischaracterized P-Stim and NeuroStim treatments—which transmit electrical pulses through needles placed just under the skin of a patient’s ear—as surgical implantation requiring anesthesia.  USAO EDNY

January 12, 2022

A diabetic shoe company, Foot Care Store, Inc., d/b/a Dia-Foot, and its President and CEO, Robert Gaynor, have agreed to pay $5.5 million to resolve allegations of billing Medicare and Medicaid for custom diabetic shoe inserts when in fact, their inserts were made using generic foot models.  The alleged misconduct occurred between 2013 and 2018 and was revealed in a whistleblower’s 2018 qui tam suit.  In addition to the monetary penalty, Dia-Foot has entered into a three-year Integrity Agreement that requires the company to implement updated policies and procedures and submit to quarterly independent review of its claims to Medicare and Medicaid.  USAO SDFL

Top Ten Non-Healthcare False Claims Act Recoveries of 2021

Posted  01/7/22
Abe Lincoln
Our roundup of 2021’s Top Ten Non-Healthcare False Claims Act (FCA) recoveries illustrates the statute’s continuing capacity to fight both conventional and emergent frauds straddling a variety of industries. In 2021 alone, the United States recovered hundreds of millions in taxpayer funds obtained through false claims tainted by textbook contracting fraud schemes (overbilling on government contracts, selling the...

Top Ten Whistleblower Awards of 2021

Posted  01/6/22
Red Whistle with People
2021 was another banner year for whistleblowers, who once again collectively recovered billions of dollars for the government and hundreds of millions of dollars in whistleblower rewards under the various government whistleblower programs.  This includes awards under the qui tam provisions of the federal False Claims Act and various state False Claims Act programs.  It includes awards under the Dodd-Frank SEC...

Vote Here Now for the 2021 Whistleblower of the Year

Posted  12/21/21
Whistleblower Insider wants to hear from you on who should be honored as our 2021 Whistleblower of the Year.  As in past years, we are especially interested in those individuals who best encapsulate the qualities of the typical whistleblower — courage, strength, integrity, selflessness, and a deep concern for public health and safety.  Check out last year’s candidates, including last year’s winner, Rebekah...

December 15, 2021

David Bellamah, and his business, Bellamah Vein & Surgery, PLLC, will pay $3.75 million to resolve allegations that they billed government healthcare programs for medically unnecessary venous procedures based on false medical records.  Defendants allegedly used improper techniques to conduct and analyze ultrasounds and used false ultrasound findings to diagnoses and treat venous reflux disease and varicose veins. The government’s claims were initiated by the filing a qui tam complaint by Lenore Lezanne, who previously worked as a sonographer at the Bellamah Vein Center; Lezane will receive a whistleblower award of 17% of the amounts recovered.  USAO MT

December 8, 2021

The owner and medical director of Georgia’s Milton Hall Surgical Associates, Jeffrey M. Gallups, will pay $3 million, and medical device manufacturer Entellus Medical will pay $1.2 million, to resolve claims that they entered into an unlawful kickback arrangement.  The government alleged that Gallups received cash payments and all-expense paid trips from Entellus in return for directing MHSA physicians to utilize sinuplasty related medical devices exclusively from Entellus and increase the number of sinuplasty procedures performed.  In addition, Gallups was alleged to have received “commissions” from medical testing laboratory NextHealth, in exchange for directing MHSA doctors to order medically unnecessary toxicology and genetic tests from NextHealth.  The settlement resolves a qui tam action initiated by former MHSA physician Myron Jones, M.D., who will receive approximately $614,000 from the settlement.  USAO ND GA

December 8, 2021

Pharmacist Riad “Ray” Zahr and two pharmacies he owned and operated, Plymouth Towne Care Pharmacy Inc. and Shaska Pharmacy LLC will pay $1 million to resolve a lawsuit initiated by a whistleblower alleging that the pharmacies submitted false claims for Evzio, a naloxone hydrochloride product used for the rapid reversal of an opioid overdose.  The government alleged that the claims included false and misleading prior authorization requests, including forged physician authorizations.  In addition, defendants dispensed Evzio without collecting or attempting to collect co-payments. DOJ; USAO MA

December 7, 2021

New Jersey-based Princeton Pathology Services P.A. will pay $2.4 million to resolve allegations that it overbilled Medicare by submitting claims using a Current Procedural Terminology (CPT) code that required written analysis by a pathologist, when no such analysis was required or had been prepared.  A whistleblower, Jayant Barai, M.D., initiated the matter by filing a qui tam complaint under the False Claims Act, and will receive an award of $456,000USAO NJ

December 2, 2021

Texas-based Flower Mound Hospital Partners LLC has agreed to pay $18 million and enter into a five-year Corporate Integrity Agreement to resolve fraud allegations.  According to Leslie Jennings, M.D., one of many physician-owners, when Flower Mound repurchased shares from physician-owners nearing retirement age and resold them to younger physicians, the company allegedly improperly took into account the value of each physician’s referrals in selecting to whom and how many shares would be resold.  Claims arising from these referrals were then knowingly submitted to Medicare, Medicaid, and TRICARE, in violation of the Anti-Kickback Statute, Physician Self-Referral Law, and False Claims Act.  For initiating a lawsuit that resulted in a successful enforcement action, Jennings will receive a $3 million share of the settlement.  DOJ
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