Whistleblower Case Archives - Page 102 of 111

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,

May 6, 2014

Baptist Health System, the parent company for a network of affiliated hospitals and medical providers in the Jacksonville, Florida area, agreed to pay $2.5M to settle allegations that its subsidiaries violated the False Claims Act by submitting claims to Medicare and Medicaid for medically unnecessary services and drugs. Specifically, the government charged that two neurologists in the Baptist Health network intentionally misdiagnosed patients with various neurological disorders so they could bill the government health care programs for services and drugs they did not actually need. The allegations were first raised in a qui tam lawsuit filed by former Baptist Health employee, Verchetta Wells, under the whistleblower provisions of the False Claims Act. DOJ

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

March 18, 2014

American Family Care Inc., a network of walk-in medical clinics with offices in Alabama, Tennessee and Georgia, agreed to pay $1.2M to resolve allegations under the False Claims Act that it knowingly submitted claims to Medicare for outpatient office visits that were billed at a higher rate than was appropriate. The settlement resolves a qui tam lawsuit filed by a former employee of American Family Care under the whistleblower provision of the False Claims Act. DOJ

Tagged in: FCA Federal, Provider Fraud, Upcoding, Whistleblower Case,

March 7, 2014

Ocean shipping companies Sea Star Line and Horizon Lines agreed to pay $1.9M and $1.5M, respectively, to resolve allegations that they violated the False Claims Act by fixing the price of government cargo transportation contracts between the continental US and Puerto Rico, the Department of Justice announced today. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

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

February 27, 2014

Omnicare Inc., an Ohio-based long-term care pharmacy, agreed to pay $4.2M to settle allegations that it engaged in a kickback scheme in violation of the False Claims Act. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act.DOJ

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

February 25, 2014

Diagnostic Imaging Group agreed to pay $15.5M to resolve allegations that its diagnostic testing facility falsely billed federal and state health care programs for tests that were not performed or not medically necessary and by paying kickbacks to physicians. The allegations were first raised in three qui tam lawsuits filed under the whistleblower provisions of the False Claims Act. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Laboratory and IDTF, Lack of Medical Necessity, Medical Billing Fraud, Whistleblower Case,

February 21, 2014

Endo Pharmaceuticals and its parent Endo Health Solutions agreed to pay $192.7M to resolve criminal and civil liability arising from Endo’s marketing of the prescription drug Lidoderm for uses not approved as safe and effective by the FDA. The allegations were first raised in three qui tam lawsuits filed under the whistleblower provisions of the False Claims Act. DOJ

Tagged in: FCA Federal, Off-Label and Unapproved Use, Pharma Fraud, Whistleblower Case,

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