Whistleblower Case

June 29, 2017

A whistleblower will receive an award of $488,700 from the $2.7 million to be paid by Innovative Therapies, Inc. and its parent company Cardinal Health, Inc. to settle charges they violated the False Claims Act by submitting false claims to Medicare through their marketing of certain negative pressure wound treatment devices as durable medical equipment when they knew these devices did not have the expected life of a durable device.  DOJ (MDTN)

June 28, 2017

Paul Chan will receive a whistleblower award of more than $9.2 million from the $42 million to be paid by PAMC Ltd. and Pacific Alliance Medical Center Inc. (which together own and operate Los Angeles acute care hospital Pacific Alliance Medical Center) to settle charges they violated the False Claims Act and the Stark Law by engaging in improper financial relationships with referring physicians.  DOJ

June 16, 2017

Pennsylvania-based skilled nursing facility operator Genesis Healthcare Inc. agreed to pay roughly $53.6 million to settle charges that companies and facilities acquired by Genesis violated the False Claims Act by causing the submission of false claims to government health care programs for medically unnecessary therapy and hospice services, and grossly substandard nursing care. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Joanne Cretney-Tsosie, Jennifer Deaton, Kimberley Green, Camaren Hampton, Teresa McAree, Terri West, and Brian Wilson, former employees of companies acquired by Genesis. They collectively will receive a whistleblower award of $9.67 million from the proceeds of the government's recovery. DOJ

June 13, 2017

New Jersey doctor Robert Claude McGrath and his chiropractor son Robert Christopher McGrath admitted to conspiring to defraud Medicare by using unqualified people to give physical therapy to Medicare recipients. Together with their practice, the Atlantic Spine & Joint Institute, they also agreed to pay $1.78 million to resolve allegations they violated the False Claims Act through the illegal billings. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Linda Stevens, a former billing manager at Atlantic Spine. She will receive a whistleblower award of roughly $338,200 from the proceeds of the government's recovery. DOJ (DNJ)

June 7, 2017

Texas-based medical and physical therapy provider Union Treatment Center agreed to pay $3 million to settle charges it violated the False Claims Act by defrauding the federal workers’ compensation (FECA) program.  The company will also waive claims for payment exceeding $1.6 million and be permanently excluded from participating in federal health care programs.  According to the government, UTC fraudulently billed the FECA program for services it did not render, routinely overcharged for medical examinations, falsely inflated the time patients spent in therapy, billed for unnecessary services and supplies, and paid kickbacks in exchange for patient referrals.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. DOJ (WDTX)

May 31, 2017

Massachusetts-based eClinicalWorks, one of the country's largest vendors of electronic health records software, along with certain of its employees, agreed to pay $155 million to resolve charges the company violated the False Claims Act by misrepresenting the capabilities of its software.  The company also allegedly paid kickbacks to certain customers in exchange for promoting its product.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Brendan Delaney, a software technician formerly employed by the New York City Division of Health Care Access and Improvement.  He will receive a whistleblower award of roughly $30 million from the proceeds of the government's recovery. DOJ

May 30, 2017

Florida-based managed care service provider Freedom Health Inc. agreed to pay roughly $32 million to settle charges it violated the False Claims Act by engaging in illegal schemes to maximize its Medicare Advantage plan payments from the government.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Freedom Health employee and Constantine Cannon client Darren D. Sewell.  He will receive a yet-to-be-determine whistleblower award from the proceeds of the government's recovery.  Whistleblower Insider

May 26, 2017

Kuwaiti-based Agility Public Warehousing Co. KSC agreed to globally resolve criminal, civil, and administrative cases arising from allegations that it overcharged the United States when performing contracts with the Department of Defense to supply food for U.S. troops from 2003 through 2010.  As part of the settlement, Agility agreed to pay $95 million to resolve civil fraud claims, to forgo administrative claims against the United States seeking $249 million in additional payments under its military food contracts, and to plead guilty to a criminal misdemeanor offense for theft of government funds.  According to the government, Agility overcharged the DOD for locally available fresh fruits and vegetables that Agility purchased through the Sultan Center Food Products Company, K.S.C. (TSC).  Agility charged the full amount of TSC’s invoices despite agreeing with TSC it would pay 10 percent less than the amount billed.  The government further alleged Agility failed to disclose and pass through rebates and discounts it obtained from U.S.-based suppliers. The allegations originated in a whistleblower lawsuit filed against Agility and TSC under the qui tam provisions of the False Claims Act by Kamal Mustafa Al-Sultan, a former vendor of Agility.  Mr. Al-Sultan will receive a whistleblower award of $38.85 million from the proceeds of the government's recovery. DOJ