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Whistleblower Case

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Page 100 of 111

February 5, 2015

Minnesota-based medical device manufacturer ev3 Inc. (formerly known as Fox Hollow Technologies Inc.) agreed to pay $1.25M to resolve allegations it violated the False Claims Act by causing certain hospitals to submit false claims to Medicare for unnecessary inpatient admissions related to minimally-invasive atherectomy procedures for removing hardening of the arteries. According to the government, Fox Hollow sold the Silver Hawk Plaque Excision System for these procedures and advised hospitals to bill them as more expensive inpatient procedures, as opposed to less costly outpatient procedures, to artificially increase their Medicare reimbursement claims. The charges originated with a whistleblower lawsuit was filed under the qui tam provisions of the False Claims Act by former Fox Hollow sales representative Amanda Cashi. She will receive a whistleblower award of $250,000. DOJ

February 2, 2015

Tennessee-based Community Health Systems Professional Services Corporation and three affiliated New Mexico hospitals agreed to pay $75M to settle allegations they violated the False Claims Act by making illegal donations to county governments which were used to fund the state share of Medicaid payments to the hospitals. The allegations were first raised in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Community Health revenue manager Robert Baker. He will receive a whistleblower reward of $18,671,561 as his share of the government’s recovery. DOJ

January 26, 2015

Kentucky-based ambulance services company Lafferty Enterprises, LLC(d/b/a Trans-Star Ambulance Services) agreed to pay $948,000 to settle charges it violated the False Claims Act by billing federal health care programs for medically unnecessary services over the course of several years. According to the government, from February 2006 until December 2012, the company transported Medicare patients to and from dialysis clinics by ambulance when an ambulance transport was not medically necessary. The charges originated from a whistleblower lawsuit filed by Kevin Fairlie under the qui tam provisions of the False Claims Act. He will receive a whistleblower award of $189,600. DOJ

January 9, 2015

Global pharmaceutical company Daiichi Sankyo Inc. agreed to pay $39 million to resolve allegations it violated the False Claims Act by paying kickbacks to induce physicians to prescribe Daiichi drugs, including Azor, Benicar, Tribenzor and Welchol. According to the government, Daiichi paid physicians improper kickbacks in the form of speaker fees as part of Daiichi’s Physician Organization and Discussion programs which were often just lavish dinners with the speaking physicians’ own medical group or staff. The charges originated with a whistleblower lawsuit filed by former Daiichi sales representative Kathy Fragoules under the whistleblower provisions of the False Claims Act. She will receive a whistleblower award of $6.1 million. DOJ

DOJ Catch of the Week -- CenterLight Healthcare

Posted  01/22/16
By the C|C Whistleblower Lawyer Team This week's Department of Justice "Catch of the Week" goes to New York-based CenterLight Healthcare, Inc. and CenterLight Health System, Inc.  Yesterday, the companies agreed to pay $46.7 million to resolve allegations that they violated the federal and New York State False Claims Acts by enrolling ineligible members in their Medicaid managed long-term care plan. ...

December 19, 2014

Boston-based records storage company Iron Mountain agreed to pay $44.5M to resolve allegations it violated the False Claims Act by overcharging federal agencies for record storage services under General Services Administration (GSA) contracts. The charges originated with a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Brent Stanley, a former Iron Mountain employee, and Patrick McKillop, who worked in the records management industry. Collectively, they will receive a whistleblower reward of $8M. DOJ

December 3, 2014

Rite Aid Corporation agreed to pay $3M to resolve allegations it violated the False Claims Act by offering illegal inducements to Medicare and Medicaid beneficiaries to transfer their prescriptions to Rite Aid pharmacies. The government alleged that from 2008 to 2010, Rite Aid had improperly influenced the decisions of Medicare and Medicaid beneficiaries to transfer their prescriptions to Rite Aid pharmacies by offering them gift cards in exchange for their business. The charges originated in a whistleblower complaint filed by Jack Chin under the qui tam provisions of the False Claims Act. Chin will receive a whistleblower award of approximately $500,000. DOJ

December 1, 2014

Maricopa County Community College District (MCCCD) agreed to pay $4M to resolve allegations under the False Claims Act that it submitted false claims to the Corporation for National and Community Service concerning AmeriCorps state and national grants. The allegations first arose from a whistleblower lawsuit filed by MCCCD employee Christine Hunt under the qui tam provisions of the False Claims Act. She will receive a whistleblower award of $775,827. DOJ

December 1, 2014

North Atlantic Medical Services Inc., doing business as Regional Home Care Inc., agreed to pay $852,378 to resolve allegations it violated the False Claims Act by submitting claims to Medicare and Medicaid for respiratory therapy services provided by unlicensed personnel. NAMS is a medical device company based in Massachusetts that provides equipment and services for the treatment of respiratory ailments, such as oxygen deficiency and sleep apnea. According to the government, from September 2010 to January 2013, NAMS used unlicensed employees to set up sleep apnea masks and oxygen therapy equipment for patients in Massachusetts. The charges were initiated by former NAMS employees Konstantinos Gakis and Demetri Papageorgiou who filed a whistleblower action under the qui tamprovisions of the False Claims Act. They will receive a whistleblower award of $153,428. DOJ

November 12, 2014

Home healthcare agency CareAll Management LLC agreed to pay $25M to settle charges it violated the False Claims Act by submitting false and upcoded home healthcare billings to Medicare and Medicaid. According to the government, between 2006 and 2013, CareAll overstated the severity of patients’ conditions to increase billings and billed for services that were not medically necessary and rendered to patients who were not homebound. The current allegations first arose in a whistleblower lawsuit filed by Toney Gonzales under the qui tam provisions of the False Claims Act.  Gonzales will receive a whistleblower award in an undisclosed amount.  Whistleblower Insider
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