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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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United States Reaches a “Tipping Point” in Managed Care Enforcement: DOJ Intervenes in Constantine Cannon’s Lawsuit Against Kaiser Permanente

Posted  07/30/21
Kaiser Permanente Building with Logo
In a sign that the government’s enforcement efforts against fraud in the Medicare managed care system have reached a tipping point, the U.S. Department of Justice announced today that it is joining a portion of a whistleblower lawsuit brought by a Constantine Cannon client under the False Claims Act against Kaiser Permanente and affiliated entities, one of the nation’s largest managed-care organizations. ...

July 28, 2021

Clothing companies Stargate Apparel, Inc. (now known as Excel Apparel Corp.), Rivstar Apparel, Inc. (now defunct), and former CEO and owner Joseph Bailey have agreed to pay a total of $6 million to settle a whistleblower’s allegations that they submitted false claims to U.S. Customs and Border Protection (CBP).  Between 2004 and 2015, Stargate, Rivstar, and Bailey allegedly engaged in two different fraud schemes to avoid paying millions of dollars in customs duties.  Both of the schemes involved submitting separate invoices to the CBP, which underreported the true value of goods being imported into the United States.  USAO SDNY

July 23, 2021

Alabama non-profit SpectraCare Health Systems, Inc., which provides services including developmental disability services, intermediate care medical services, and behavioral health services, agreed to pay $1 million to resolve claims first brought in a whistleblower action alleging that the provider improperly billed Alabama Medicaid and failed to return overpayments to the Alabama Medicaid Agency.  The defendant was alleged to have submitted false claims including claims without correct and complete documentation, and duplicate claims, and to have knowingly retained payments it received to which it was not entitled.  The settlement will be split between the federal government and the Alabama Medicaid Agency, with the whistleblower receiving 19% of the federal recovery.  USAO MD AL

Compliance Week to Feature Two Constantine Cannon Whistleblower Clients in New Series

Posted  07/23/21
silver whistle
Compliance Week announced this week a new series of articles on whistleblowers, highlighting the important role they play while simultaneously being stigmatized for doing the right thing.  The six-part series titled “Witness to Wrongdoing” was announced on July 21st and will feature the stories of various whistleblowers, including two Constantine Cannon clients.  The series will run from July 26th to July 30th...

Catch of the Week: EEG Testing Company and Private-Investment Company to Pay $15.3M for Kickback and False-Billing Allegations

Posted  07/23/21
man holding money in hand and another hand with one finger over mouth
Whistleblowers came forward with six False Claims Act actions against a national EEG testing company and an investment company for allegedly paying kickbacks and falsely billing government healthcare programs.  Texas-based provider Alliance Family of Companies (now Stratus) and private investor Ancor Holdings together will pay $15.3 million to resolve the cases. For their actions in coming forward, two...

July 23, 2021

California-based Interface Rehab has agreed to pay $2 million to settle claims arising from a qui tam suit by its former director of rehab, Keith Pennetti.  According to Pennetti, Interface violated the False Claims Act when it pressured its therapists to increase the amount of therapy provided to Medicare Part A residents at eleven facilities, with no regard to medical necessity, and caused false claims to be submitted to Medicare.  For instigating the action, Pennetti will receive $360,000 of the settlement proceeds.  USAO CDCA

DOJ Fights a Catch-22

Posted  07/23/21
DOJ website magnified logo
FCA cases live or die on their evidence, and it’s no surprise that defendants wage long wars to resist efforts by the plaintiff (whether a whistleblower or the government) to prove their case.  Heeding the old saw about the best defense, defendants also generally go on the offensive.  They happily foot staggering legal bills to try to wear out a typically less-well-funded plaintiff with onerous discovery...

July 21, 2021

Alliance Family of Companies LLC, a national electroencephalography testing company, and Ancor Holdings LP, a private insurance company, have agreed to pay a combined $15.3 million to resolve alleged violations of the False Claims Act and Anti-Kickback Statute.  According to a number of whistleblowers, Alliance provided free electroencephalography (EEG) interpretation reports to induce physician orders, caused physicians to submit false claims to the government, used inaccurate billing codes to generate higher reimbursements, and billed for a specialized digital analysis that it didn’t actually perform.  The whistleblowers also alleged that while performing due diligence prior to investing in Alliance, Ancor learned of the kickbacks but allowed them to continue after the change in management.  Two of the whistlebl­owers involved will share a reward of nearly $3 million.  DOJ

July 19, 2021

Prime Healthcare Services, one of the largest hospital systems in the nation, its founder and CEO Dr. Prem Reddy, and interventional cardiologist Dr. Siva Arunasalam have agreed to pay $37.5 million to resolve two suits filed by former executive Martin Mansukhani, and former employees Marsha Arnold and Joseph Hill.  In violation of the federal and California False Claims Acts, certain Prime hospitals had allegedly submitted inflated invoices to Medi-Cal and other government health programs, or submitted claims to Medi-Cal and Medicare under Arunasalam’s provider number for services provided by an excluded physician.  Additionally, in acquiring Arunasalam’s physician practice and surgery center, Prime allegedly paid above fair market value for referrals from Arunasalam to one of their hospitals.  For being the first to file, one of the whistleblowers, Mansukhani, will receive a relator’s share of nearly $10 million.  CA AG; USAO CDCA

Fifth Circuit Affirms Government Dismissal Of Cases Brought By Corporate Whistleblower

Posted  07/16/21
By Leah Judge
gavel on bench
Last week, a three-judge panel of the Court of the Appeals for the Fifth Circuit sided with the government in its bid to dismiss a whistleblower case brought by a limited liability company against pharmaceutical giants Eli Lilly and Bayer.  The case offers another example of the government flexing its dismissal power in the wake of the Granston Memo, a 2018 Department of Justice directive to winnow False Claims Act...
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