Whistleblower Case

April 3, 2017

Kaiser Health News, NPR and Salon.com report that DOJ desires to consolidate a lawsuit with Constantine Cannon’s whistleblower case against UHG.

March 10, 2017

New York based information technology management software company CA Inc. agreed to pay $45 million to resolve allegations it violated the False Claims Act by making false claims in the negotiation and administration of a General Services Administration contract.  According to the government, CA provided false information about the discounts it gave commercial customers for its software licenses and maintenance services at the time the contract was negotiated and also violated the price reduction clause in the contract by not providing government customers with additional discounts when commercial discounts improved.  The allegations originated a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Dani Shemesh, a former employee of CA Software Israel LTD.  Shemesh will receive a whistleblower award of roughly $10.2 million from the proceeds of the government's recovery. DOJ

March 1, 2017

Florida-based information technology company People, Technology and Processes, LLC and the company's CEO and CFO, Victor Buonamia and Nicole Buonamia, agreed to pay $320,000 to resolve allegations they violated the False Claims Act by submitting improper invoices for work allegedly performed for the United States in support of the U.S. Army in Afghanistan.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former company employee Aidan Tamer Toprakci.  He will receive a whistleblower award of roughly $64,000 from the proceeds of the government's recovery. DOJ (MDFL)

March 16, 2017

Northern California Record discusses Constantine Cannon’s matter against Bay Sleep Clinic.  Click here to read its article: Government settles $2.6 M whistleblower suit against sleep clinics.

February 8, 2017

Florida-based Comprehensive Health Services, Inc., one of the country’s largest providers of workforce medical services, agreed to pay roughly $3.8 million to settle charges it violated the False Claims Act by double-billing and mischarging the government for medical services in connection with work it performed on an Internal Revenue Service contract.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by James J. Kerr, Jr.  He will receive a whistleblower reward of roughly $645,000 from the proceeds of the government’s recovery.  Whistleblower Insider

February 7, 2017

Florida physician Gary L. Marder, and the owner of the Allergy, Dermatology & Skin Cancer Centers in Port St. Lucie and Okeechobee, stipulated to a consent final judgment of over $18 million to settle False Claims Act allegations that Dr. Marder submitted claims to federal healthcare programs for medically unnecessary biopsies and radiation therapy services, radiation therapy services performed in contravention of standard practice regarding the amount of time between radiation treatments, and radiation therapy services performed without direct supervision and by unlicensed and/or unqualified physician assistants.  Dr. Kendall also allegedly submitted false claims to federal and state healthcare programs for laboratory services tainted by kickbacks to, and improper financial relationships with, Dr. Marder.  The allegations originated in a whistleblower lawsuit filed by Dr. Theodore A. Schiff under the qui tam provisions of the False Claims Act.  He will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (SDFL)

February 6, 2017

U.S. hospital service provider TeamHealth Holdings (as successor in interest to IPC Healthcare Inc., f/k/a IPC The Hospitalists Inc.), agreed to pay $60 million to resolve allegations it violated the False Claims Act by billing Medicare, Medicaid, the Defense Health Agency and the Federal Employees Health Benefits Program for higher and more expensive levels of medical service than were actually performed (a practice known as “up-coding”).  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Dr. Bijan Oughatiyan, a physician formerly employed by IPC as a hospitalist.  He will receive a whistleblower award of roughly $11.4 million.  DOJ

February 6, 2017

New Jersey-based Para-Plus Translations, Inc., together with its owners Robert Santiago, III and Sonia Santiago, agreed to pay $1.5 million to settle charges of violating the False Claims Act by submitting invoices to federal and state governmental clients that purposefully overstated the travel time and mileage incurred by its interpreters.  The allegations originated in a whistleblower lawsuit filed by Kimberly Martin under the qui tam provisions of the False Claims Act.  She will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (WDPA)

February 2, 2017

Pain management physician Dr. Robert Windsor, owner of National Pain Care, Inc. which owns pain management clinics in Georgia and Kentucky, agreed to the entry of a $20 million consent judgment to resolve allegations he violated the False Claims Act by billing federal health care programs for surgical monitoring services he did not perform and for medically unnecessary diagnostic tests.  The allegations originated in two whistleblower lawsuits filed under the qui tam provisions of the False Claims Act by Kris Frankenberg, Stephanie Herder and Bradley Davis.  They will receive a yet-to-be-determined whistleblower award from the proceeds of the government’s recovery.  Whistleblower Insider

February Roundup – February 17-20, 2017

Constantine Cannon attorneys quoted in articles about the DOJ joining its whistleblower lawsuit against UnitedHealth Group:

• UnitedHealth Filing Reflects DOJ’s Heightened Fraud Focus, Bloomberg BNA;
• Whistleblower suit alleges UnitedHealth defrauded Medicare, StarTribune;
• Justice Department joins Medicare Advantage fraud lawsuit against UnitedHealth, Modern Healthcare;
• Feds Join FCA Suit Targeting UnitedHealth Billing, Law360;
• United Healthcare Whistleblower Suit Provides ‘Interesting’ Investment Opportunity, The Street;
• Lawsuit says UnitedHealth tied to scheme to overbill Medicare, MINNPOST;
• DOJ joins whistle-blower suit accusing UnitedHealth of overbilling Medicare , Becker's Hospital Review;
• Justice Department joins lawsuit against UnitedHealth over Medicare billing, Minneapolis/St. Paul Business Journal;
• UnitedHealth Lower Off NYT Article Claiming Suit For Overbilling Medicare, Benzinga;
• UnitedHealth, Health Insurers Fall As DOJ Joins Whistleblower Suit, Investor's Business Daily;
• Feds join whistleblower suit that accuses UnitedHealth of inflating Medicare Advantage risk scores, Fierce Healthcare;
• United Health sinks after being sued by the US government (UNH), Business Insider;
• Feds join whistleblower lawsuit claiming UnitedHealth overcharged Medicare, TwinCities (Pioneer Press);
• UnitedHealth leads Dow losses after US joins whistleblower case, Financial Times;
• UnitedHealth shares fall after Justice Department joins Medicare whistleblower lawsuit, CNBC ;
•  UnitedHealth's Medicare business draws federal scrutiny, Minnesota Public Radio;
• DOJ joins whistleblower lawsuit against UnitedHealth Group, WellMed, Healthcare Finance News;
• Suit Says, Scheme Tied to UnitedHealth Overbilled Medicare for Years, Morning Outlook; and
• UnitedHealth Group Targeted by Whistleblower Lawsuit, Hamodia.