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$2.6 Million Whistleblower Settlement With Bay Sleep Clinic

The clinic will settle whistleblower allegations of using unlicensed technicians and unapproved locations and of doctor kickback referrals. Constantine Cannon LLP is pleased to announce a $2.6 million settlement on behalf of its client for whistleblower allegations against Bay Sleep Clinic. The settlement was announced by the United States government on December 28, 2016, against Bay Sleep Clinic, which currently operates 20 locations throughout northern California; its related Qualium Corporation and Amerimed Corporation businesses; and owners and operators Anooshiravan Mostowfipour and Tara Nader. The “qui tam,” or whistleblower, lawsuit alleged that the defendants fraudulently billed Medicare for sleep studies conducted by unlicensed individuals in unapproved locations; improperly dispensed durable medical equipment from unapproved locations using unlicensed technicians; and paid doctors for referrals in violation of the federal Anti-Kickback Statute. The defendants neither admitted nor denied liability. The whistleblower, Elma F. Dresser, is a former Bay Sleep Clinic employee who worked as a sleep technician and marketer for eight years. Through her various roles at the company, Ms. Dresser became familiar with the defendants’ alleged scheme to bilk money from Medicare. She filed her suit in 2012, leading the government to investigate the claims and join the case. Ms. Dresser was represented by Eric R. Havian, partner and attorney, Jessica T. Moore, partner and attorney, Anne Hayes Hartman, partner and attorney, Hallie Noecker, attorney, and Sarah Poppy Alexander, attorney of Constantine Cannon’s whistleblower practice in San Francisco, along with co-counsel from the Law Office of William C. Dresser. “It’s rewarding to see the alleged fraudsters held responsible. Because of the close cooperation and work between the whistleblower and the government, we were able to recover significant funds for the government,” said Anne Hayes Hartman, co-lead counsel on the case. “It is gratifying to represent people like Elma Dresser, who bravely stepped forward with knowledge of her employer’s wrongdoing. Many do not appreciate the risks whistleblowers face to hold alleged wrongdoers accountable.” “Sleep studies are a quickly expanding medical field,” said Jessica T. Moore, who served as co- lead counsel on the case. “Ensuring the safety of these procedures should be a top priority of the government for all patients, Medicare and otherwise.” The federal False Claims Act allows whistleblowers to sue companies that are defrauding the government and receive a reward if the government recovers any funds as a result. The government may choose to intervene in the lawsuit, as it has done in this case. The False Claims Act is one of the government’s most effective weapons in combatting fraud, waste, and abuse by those who contract with the government. Healthcare fraud alone is estimated to cost the U.S. billions of dollars. Such fraud can be difficult to discern without access to inside information; well-placed whistleblowers are necessary to provide the information the government might otherwise lack to help stop these practices.

Top-10 Whistleblower Successes for 2016

Posted  01/3/17
By the C|C Whistleblower Lawyer Team Here is our look-back at the top-10 whistleblower award recoveries for 2016. 10. Harry Markopolos -- Famed Bernie Madoff whistleblower Harry Markopolos made a filing under the whistleblower provisions of the Financial Institutions Reform, Recovery and Enforcement Act (FIRREA) which led to the agreement by Massachusetts-based State Street Bank and Trust Company to pay a total...

December 28, 2016

Bay Sleep Clinic, its related businesses -- Qualium Corporation and Amerimed Corporation -- and their owners and operators, Anooshiravan Mostowfipour and Tara Nader, agreed to pay $2.6 million to settle allegations they fraudulently charged Medicare for diagnostic sleep tests and medical devices in violation of Medicare payment rules. The allegations originated in a whistleblower lawsuit filed by Elma F. Dresser under the qui tam provisions of the False Claims Act. She will receive a whistleblower award of approximately $545,000 from the proceeds of the government's recovery. DOJ (NDCA)

December 22, 2016

December 22, 2016 -- California-based Total Call Mobile, LLC agreed to pay $30 million for defrauding the Lifeline Program, a federal government subsidy program that offers discounted mobile phone services to eligible low-income consumers.  According to the government, Total Call and its co-defendant Locus Telecommunications, LLC, and their shared corporate parent KDDI America, Inc., knowingly submitted false claims for federal payments by seeking reimbursement for consumers who did not meet Lifeline eligibility requirements.  As part of the settlement, Total Call admitted and accepted responsibility for the alleged misconduct, including seeking reimbursement for tens of thousands of ineligible consumers.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act.  The whistleblower will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (SDNY)

December 15, 2016

New York City-based Forest Laboratories LLC and its subsidiary Forest Pharmaceuticals Inc. agreed to pay $38 million to resolve allegations they violated the False Claims Act and Anti-Kickback Statute by paying kickbacks to induce physicians to prescribe the drugs Bystolic, Savella and Namenda.  According to the government, Forest provided payments and meals to certain physicians in connection with speaker programs about the drugs as improper inducements to prescribe them.  The allegations originated in a whistleblower lawsuit filed by former Forest employee Kurt Kroening under the qui tam provisions of the False Claims Act.  He will receive a whistleblower award of approximately $7.8 million from the proceeds of the government’s recovery.  Whistleblower Insider

December 13, 2016

Elite Lab Services, LLC, along with its husband-and-wife owners Gerard and Suzanne Dengler, agreed to pay $3.75 million to settle charges of their violating the False Claims Act through their billing Medicare for tens of thousands of miles that were never driven by Elite Lab’s personnel.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Elite Lab employee Karen Malcolm.  She will receive a whistleblower award of $787,500 from the proceeds of the government's recovery.  DOJ (EDTX)

December 7, 2016

Not-for-profit regional hospital South Miami Hospital agreed to pay approximately $12 million to settle allegations that it violated the False Claims Act by submitting false claims to federal healthcare programs for medically unnecessary electrophysiology studies and other procedures allegedly performed by Dr. John R. Dylewski.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by South Miami Hospital doctors James A. Burks and James D. Davenport.  They will receive a whistleblower award of roughly $2,748,500 from the proceeds of the government's recovery.  DOJ (SDFL)

December 7, 2016

Lifepoint Dental Group, LLC, and its owners Aaron Blass, Angelina Blass, Mindy Richtsmeier, and Brad Richtsmeier, agreed to pay more than $300,000 to settle allegations that they violated the False Claims Act by submitting claims for dental procedures, including scalings and root planings, that were either medically unnecessary or did not happen.  The allegations originated in a whistleblower lawsuit filed by two former Lifepoint employees under the qui tam provisions of the False Claims Act.  The whistleblowers will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (NDIA)

December 2, 2016

Vitas Health Corporation Midwest and related entities agreed to pay $200,000 to resolve allegations that they violated the False Claims Act and the Anti-Kickback Statute by paying Dr. Farid Fata for patient referrals to its hospice care services.  In an earlier unrelated criminal matter, Fata pleaded guilty to health care fraud, conspiracy to pay and receive kickbacks and promotional money laundering, and was sentenced to a term of 45 years in prison.  The allegations originated in a whistleblower lawsuit under the qui tam provisions of the False Claims Act by Rita Dubois who worked at Vitas as the Director of Market Development in Southeastern Michigan.  Dubois will receive a whistleblower award of $36,000 from the proceeds of the government's recovery.  DOJ (EDMI)

November 30, 2016

A Houston jury found the entities formerly known as Allied Home Mortgage Capital Corp., Allied Home Mortgage Corp., and their president and chief executive officer Jim C. Hodge liable for violating the False Claims Act and the Financial Institutions Reform, Recovery, and Enforcement Act of 1989 (“FIRREA”) relating to mortgage fraud.  After a five-week trial, the jury awarded the United States roughly $93 million in damages, including more than $7 million against Hodge.  The allegations originated in a whistleblower lawsuit filed by former Allied manager Peter Belli 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.  Whistleblower Insider
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