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Whistleblower Case

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Page 101 of 111

November 6, 2014

Medical device maker Biotronik Inc. agreed to pay $4.9M to resolve allegations it violated the False Claims Act by paying kickbacks to induce physicians to use its products. Specifically, the government charged that Biotronik induced electrophysiologists and cardiologists practicing in Nevada and Arizona to use Biotronik pacemakers, defibrillators and cardiac resynchronization therapy devices by paying them in the form of repeated meals at expensive restaurants and inflated payments for membership on a physician advisory board. The allegations first arose in a whistleblower lawsuit filed by a former Biotronik employee, Brian Sant, under the qui tam provisions of the False Claims Act. Sant will receive a whistleblower award of $840,000. DOJ

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

October 30, 2014

San Francisco based hospital system Dignity Health (formerly known as Catholic Healthcare West) agreed to pay $37M to settle False Claim Act charges that 13 of its hospitals in California, Nevada and Arizona submitted false claims to Medicare and TRICARE by admitting patients for inpatient services who could have been treated on a less costly, outpatient basis. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Kathleen Hawkins, a former employee of Dignity. She will receive a whistleblower award of $6.25M. DOJ

Tagged in: FCA Federal, Hospital Fraud, Other Government Health Programs, Upcoding, Whistleblower Case, Whistleblower Rewards,

October 29, 2014

North Florida Shipyards and its president, Matt Self, agreed to pay $1M to resolve allegations they violated the False Claims Act by creating a front company, Ind-Mar Services Inc., to improperly secure Coast Guard contracts that were designated for Service Disabled Veteran Owned Small Businesses (SDVOSBs). The allegations originated in a whistleblower lawsuit filed by Robert Hallstein and Earle Yerger under the qui tam provisions of the False Claims Act. They will receive a whistleblower award of $180,000.DOJ

Tagged in: Defense Contract Fraud, FCA Federal, Set-Asides and Preferences, Whistleblower Case, Whistleblower Rewards,

October 29, 2014

Medical device maker EBI LLC, doing business as Biomet Spine and Bone Healing Technologies and Biomet Inc., agreed to pay $6M to resolve allegations it violated the False Claims Act by paying kickbacks to induce use of its bone growth stimulators, which are used to repair fractures that are slow to heal. Specifically, the government alleged that from 2001 to 2008 EBI paid staff at doctors’ offices (through personal service agreements) to influence doctors to order its bone growth stimulators. The allegations originated in a whistleblower lawsuit filed by former EBI product manager Yu Yue under the qui tam provisions of the False Claims Act, who will receive an undisclosed whistleblower award. DOJ

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

October 21, 2014

Kentucky-based cardiologists Satyabrata Chatterjee and Ashwini Anand, who jointly owned cardiologist physician group Cumberland Clinic, agreed to pay $380,000 to resolve allegations they violated the False Claims Act by entering into sham management agreements with Saint Joseph Hospital in exchange for the referral of cardiology procedures and other healthcare services to Saint Joseph. The government alleged that St. Joseph Hospital entered into sham agreements with Chatterjee and Anand, under which the physicians were paid to provide management services but did not in fact do so and that in exchange Chatterjee and Anand agreed to enter into an exclusive agreement with Saint Joseph to refer Cumberland Clinic patients to the hospital for cardiology and other services in violation of the Stark Law and the Anti-Kickback Statute. The government previously entered into a $16.5M settlement with Saint Joseph for the allegedly sham management contracts for unnecessary and excessive cardiology procedures. The allegations originated from a whistleblower lawsuit filed by three Lexington, Kentucky cardiologists under the qui tam provisions of the False Claims Act. The three whistleblowers, Drs. Michael Jones, Paula Hollingsworth and Michael Rukavina, will collectively receive a whistleblower award of $68,400. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Hospital Fraud, Whistleblower Case, Whistleblower Rewards,

October 17, 2014

Two groups of Houston-based diagnostic centers agreed to pay more than $2.6M to settle allegations they violated the False Claims Act by engaging in improper financial relationships with referring physicians in violation of the Stark Statute. One group of centers, which operates under the name One Step Diagnostic, agreed to pay $1.2M. The other group of centers, consisting of Complete Imaging Solutions LLC doing business asHouston Diagnostics, Deerbrook Diagnostics & Imaging Center LLC,Elite Diagnostic Inc., Galleria MRI & Diagnostic LLC, Spring Imaging Center Inc. and West Houston MRI & Diagnostics LLC agreed to pay about $1.5M. The allegations originated from a whistleblower lawsuit filed by three whistleblowers under the qui tam provisions of the False Claims Act, who will receive an undisclosed award. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

October 10, 2014

Extendicare Health Services Inc., an operator of a chain of skilled nursing facilities, and its subsidiary Progressive Step Corporation (ProStep), agreed to pay $38 million that Extendicare billed Medicare and Medicaid for materially substandard nursing services that were so deficient they were effectively worthless and billed Medicare for medically unreasonable and unnecessary rehabilitation therapy services. It is the largest failure of care settlement with a chain-wide skilled nursing facility in the Justice Department’s history. The government’s charges originated from two whistleblower lawsuits filed by Tracy Lovvron and Donald Gallick under the qui tam provisions of the False Claim Act. They will receive whistleblower awards of more than $1.8 million and $250,000, respectively. DOJ

Tagged in: FCA Federal, Healthcare Fraud, Lack of Medical Necessity, SNF, Whistleblower Case, Whistleblower Rewards,

August 4, 2014

Community Health Systems (CHS), the nation’s largest operator of acute care hospitals, agreed to pay $98 million to resolve multiple whistleblower lawsuits alleging the company billed government health care programs for inpatient services that should have been billed as outpatient or observation services. According to the government, CHS engaged in a corporate-driven scheme to increase inpatient admissions of Medicare, Medicaid and TRICARE (military) beneficiaries over the age of 65 who originally presented to the emergency departments at 119 CHS hospitals.Whistleblower Insider

Tagged in: FCA Federal, Hospital Fraud, Other Government Health Programs, Upcoding, Whistleblower Case,

July 8, 2014

Virginia-based move management company RE/MAX Allegiance Relocation Services agreed to pay roughly half a million dollars to resolve allegations it violated the False Claims Act by overbilling the government for transportation services. The government alleged RE/MAX charged the government for federal employee relocation services it never provided and charged inflated rates for relocation services it did provide by charging inapplicable tariff rates. Former RE/MAX employee Michael Angel will receive a whistleblower reward in an undisclosed amount under the qui tam provisions of the False Claims Act. DOJ

Tagged in: Falsifying Invoices, FCA Federal, Government Procurement Fraud, Whistleblower Case, Whistleblower Rewards,

June 25, 2014

Omnicare Inc., the nation’s largest provider of pharmaceuticals and pharmacy services to nursing homes, agreed to pay $124M to resolve charges it violated the Anti-Kickback Statute and the False Claims Act by providing improper financial incentives to skilled nursing facilities in return for their continued selection of Omnicare to supply drugs to elderly Medicare and Medicaid patients. The government’s action against Omnicare originated with two lawsuits filed by whistleblowers under the qui tam provisions of the False Claims Act. The first whistleblower, former Omnicare employee Donald Gale, will receive roughly $17M out of the government’s recovery. Whistleblower Insider

Tagged in: Anti-Kickback and Stark, FCA Federal, Multiple Whistleblowers and First-to-File, Pharma Fraud, SNF, Whistleblower Case, Whistleblower Rewards,

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