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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:

Page 10 of 111

July 22, 2022

Medical device manufacturer Biotronik Inc. has agreed to pay nearly $13 million to resolve allegations of paying kickbacks to physicians in order to induce use of their implantable cardiac devices, and causing false claims to be submitted to Medicare and Medicaid.  The alleged violations of the Anti-Kickback Statute and False Claims Act were brought to light in a qui tam suit by Jeffrey Bell and Andrew Schmid, both former sales representatives for Biotronik, who as part of the settlement will receive a $2.1 million relator’s share.  USAO CDCA

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medicaid, Medical Devices and DME, Medicare, Whistleblower Case, Whistleblower Rewards,

July 14, 2022

BioReference Health, LLC, formerly known as BioReference Laboratories, Inc. and OPKO Health, Inc., have agreed to pay nearly $10 million and enter into a five-year Corporate Integrity Agreement to settle a whistleblower-brought case alleging it violated the Anti-Kickback Statute, Stark Law, and False Claims Act.  The alleged misconduct involved making lease payments to healthcare providers that exceeded fair market value, and later failing to report or return any overpayments to federal healthcare programs.  USAO MA

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Healthcare Fraud, Laboratory and IDTF, Whistleblower Case, Whistleblower Rewards,

July 13, 2022

Solera Specialty Pharmacy and its CEO, Nicholas Saraniti, has agreed to pay $1.31 million and enter into a three-year integrity agreement to resolve allegations of defrauding Medicare.  Solera allegedly submitted fraudulent claims for Evzio—a high-priced version of naloxone, which reverses opioid overdoses—based on prior authorization requests that contained false clinical information, that were not actually approved by physicians, and that improperly listed Solera’s contact information as if it were the physician’s.  In connection with a criminal information, Solera has also entered into a deferred prosecution agreement.  The whistleblower in this case, a former employee of Evzio manufacturer kaléo Inc. named Rebecca Socol, will receive a $262,000 share of the settlement.  DOJ

Tagged in: FCA Federal, Healthcare Fraud, Medicare, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

July 8, 2022

Aerojet Rocketdyne Inc., which provides propulsion and power systems for vehicles belonging to the Department of Defense and NASA, has agreed to pay $9 million to resolve a whistleblower lawsuit.  According to Brian Markus, a former employee, the company misrepresented its compliance with the cybersecurity requirements of contracts with those agencies, in violation of the False Claims Act.  For bringing a successful qui tam case, Markus will receive a relator’s share of $2.61 million.  USAO EDCA

Tagged in: Certifications, Cybersecurity and Data Breaches, Defense Contract Fraud, FCA Federal, Whistleblower Case, Whistleblower Rewards,

June 14, 2022

Defense contractor Kellogg Brown & Root Services, Inc. and related entities will pay $13.7 million to resolve allegations that the companies submitted false claims under KBR’s Logistics Civil Augmentation Program (LOGCAP) III contract for the delivery of logistics support to U.S. Army forces in Iraq.  In an action originally brought by a whistleblower, the government alleged that KBR employees rigged bids on certain subcontracts in exchange for kickbacks from the subcontractors, and unlawfully passed on the inflated cost of those subcontracts to the government. DOJ

Tagged in: Bribery and Bid-Rigging, Defense Contract Fraud, FCA Federal, Government Procurement Fraud, Whistleblower Case,

June 10, 2022

A doctor who allegedly submitted claims to Medicare and Medi-Cal for unperformed procedures, services, and tests, in violation of the California and federal False Claims Acts, has agreed to pay $9.5 million to resolve a civil suit.  The qui tam case by Minas Kochumian’s former medical assistant Elize Oganesyan, and former IT consultant Damon Davies, alleged that claims for treatment of osteopathic issues that were submitted over a six year period were false.  The settlement includes $5.5 million that Kochumian already paid as criminal restitution in a separate case in the Central District.  As part of the civil settlement, Oganesyan and Davies will share a $1.75 million award.  CA AG; USAO EDCA

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Medicaid, Medicare, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

June 10, 2022

Steward Health Care System LLC and related entities will pay $4.7 million to resolve allegations of False Claims Act violations involving improper financial and referral arrangements between SHC and physician practices. Steward Good Samaritan Medical Center, Inc., contracted with Brockton Urology Clinic to administer a Prostate Cancer Center of Excellence at SGSMC. SGSMC paid BUC throughout the agreement as compensation for sending referrals to SGSMC. The investigation revealed other such arrangements between Steward and physician practices. The conduct was exposed by whistleblowers, who filed under the FCA’s qui tam provisions. The relators will receive 17% of the recovery. USAO MA

Tagged in: FCA Federal, Government Investigation, Healthcare Fraud, Hospital Fraud, Provider Fraud, Whistleblower Case,

June 1, 2022

Behavioral health provider Healthkeeperz, Inc. has agreed to pay $2.1 million to resolve allegations that it falsely billed North Carolina’s Medicaid program for services that were not covered.  The allegations arose from a lawsuit filed by Ginger Hill under the qui tam provisions of the federal False Claims Act and the North Carolina False Claims Act.  USAO WD NC; NC

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Medicaid, Provider Fraud, Whistleblower Case,

June 1, 2022

Caris Life Sciences, Inc. will pay $2.9 million to resolve claims that it falsely billed Medicare for laboratory tests to detect the activity of certain genes within a tumor that predicted the risk of recurrence by fraudulently circumventing Medicare’s 14-day rule, which, during the relevant time period, prohibited laboratories from separately billing Medicare for tests performed on specimens if a physician ordered the test within 14 days of the patient’s discharge from a hospital stay.  By submitting separate claims for the laboratory tests, Medicare paid twice for the same service, first to the hospital as part of the hospital’s lump-sum DRG payment, and in a direct payment to Caris.  Caris allegedly discouraged providers from ordering testing within 14 days of discharge, or canceled and re-submitted orders to avoid the 14 day window.  The settlement covers two separate whistleblower actions.  USAO EDNY

Tagged in: Anonymity, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Medical Billing Fraud, Whistleblower Case,

May 25, 2022

Textile manufacturer HEYtex USA will pay $3 million to resolve an action brought by a whistleblower under the False Claims Act alleging that the company knowingly supplied fabrics to the U.S. military that failed to meet contract specifications, and falsely certified that its military-grade fabrics met specifications when, in fact, they had failed to pass required testing.  The whistleblower first reported the falsified test results to company management, but was initially ignored.  USAO WD Va

Tagged in: Certifications, Contract Non-Compliance, Defense Contract Fraud, FCA Federal, Government Procurement Fraud, Whistleblower Case,

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