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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:

Page 92 of 111

August 29, 2014

The SEC announced a whistleblower award of more than $300,000 to a company employee who performed audit and compliance functions and reported wrongdoing to the SEC after the company failed to take action when the employee reported it internally.  It is the first award for a whistleblower with an audit or compliance function at a company.  This particular whistleblower award recipient reported concerns of wrongdoing to appropriate personnel within the company, including a supervisor.  But when the company took no action on the information within 120 days, the whistleblower reported the same information to the SEC.  SEC

Tagged in: Reporting to Government, SEC Whistleblower Reward Program, Securities Fraud, Whistleblower Case, Whistleblower Eligibility, Whistleblower Rewards,

June 16, 2014

Albany, N.Y.-based hedge fund advisory firm Paradigm Capital Management and owner Candace King Weir agreed to pay $2.2M to settle charges of engaging in prohibited principal transactions and then retaliating against the employee who reported the trading activity to the SEC.  This is the first time the SEC has filed a whistleblower retaliation case under its new authority to bring such enforcement actions under the Dodd-Frank Act.  SEC

Tagged in: Regulatory Violations, Retaliation, SEC Whistleblower Reward Program, Securities Fraud, Whistleblower Case, Whistleblower Rewards,

January 12, 2016

Kentucky-based healthcare provider Kindred Healthcare, Inc. and its two RehabCare Group subsidiaries agreed to pay $125 million to resolve allegations of violating the False Claims Act by knowingly causing skilled nursing facilities to submit false claims to Medicare for rehabilitation therapy services that were not reasonable, necessary and skilled, or that never occurred at all.  According to the government, RehabCare’s policy has been to achieve the highest Medicare reimbursement level regardless of the clinical needs of its patients, resulting in the provision of unreasonable and unnecessary services to Medicare patients, and its skilled nursing facility customers submitting inflated bills to Medicare covering those services.  The allegations originated in a whistleblower lawsuit filed by Janet Halpin, a RehabCare physical therapist and former rehabilitation manager, and Shawn Fahey, a RehabCare occupational therapist, under the qui tamprovisions of the False Claims Act.  They will receive a whistleblower award of nearly $24 million from the government proceeds of the settlement.  Whistleblower Insider

Tagged in: FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Medicare, SNF, Whistleblower Case, Whistleblower Rewards,

January 12, 2016

Connecticut-based J&L Medical Services agreed to pay $600,000 to resolve allegations it violated the federal and state False Claims Acts.  J&L Medical is a durable medical equipment company that provides Continuous Positive Airway Pressure (CPAP) and Bilevel Positive Airway Pressure (BiPAP) devices and accessories to Medicare and Medicaid beneficiaries who have been diagnosed with obstructive sleep apnea.  According to the government, the company regularly used the services of unlicensed technicians to provide respiratory therapy services to Medicare and Medicaid beneficiaries, including setting up CPAP and BiPAP machines, fitting the patients with the masks used with those machines, and educating the patients about the use of the machines.  The allegations originated in a whistleblower lawsuit filed by John Hart, a former employee of J&L Medical and a licensed respiratory therapist, under the qui tam provisions of the False Claims Act.  He will receive a whistleblower award of $102,000 from the proceeds of the government’s recovery.  DOJ (CT)

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Improper Medical Personnel, Laboratory and IDTF, Medicaid, Medical Devices and DME, Medicare, Whistleblower Case, Whistleblower Rewards,

January 8, 2016

Dr. David G. Bostwick, owner of Virginia-based pathology lab Bostwick Laboratories Inc., agreed to pay up to $3.75 million to resolve charges of violating the False Claims Act for billing Medicare and Medicaid for medically unnecessary cancer detection tests and offering incentives to physicians to obtain Medicare and Medicaid business.  Specifically, Dr. Bostwick allegedly directed Bostwick Laboratories to bill Medicare and Medicaid for expensive cancer detection tests known as Fluorescent In Situ Hybridization (FISH) tests, as well as other tests, that were not medically necessary and were performed without the treating physicians’ consent or order.  FISH tests are used to detect bladder cancer.  Bostwick also allegedly offered various discounts and billing arrangements to treating physicians to induce them to refer business in violation of the Anti-Kickback Statute.  On Aug. 28, 2014, Bostwick Laboratories previously agreed to pay over $6.5 million to resolve the allegations in this lawsuit.  The allegations were originally raised in a whistleblower lawsuit brought by Michael Daugherty, who works in the industry, under the qui tam provisions of the False Claims Act.  Daugherty will receive a whistleblower award of over $2.5 million from the government’s settlements.  DOJ

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

January 5, 2016

Wisconsin-based Novum Structures LLC agreed to enter a guilty plea and pay $3 million to resolve its criminal and civil liability arising from its improper use of foreign materials in federally funded construction projects which had “Buy America” requirements.  Novum specializes in the design and construction of glass space frames often used in roofs and atrium enclosures.  The allegations originated in a whistleblower lawsuit filed by Brenda King under the qui tam provisions of the False Claims Act.  She will receive a whistleblower award of approximately $400,000 from the government’s recovery.  DOJ

Tagged in: FCA Federal, Government Procurement Fraud, Trade Agreements, Whistleblower Case, Whistleblower Rewards,

January 5, 2016

Nashville Pharmacy Services, LLC, and its majority owner Kevin Hartman, agreed to pay up to $7.8 million to settle charges they violated the False Claims Act by overbilling Medicare and TennCare for pharmacy services.  Specifically, the government claimed the Nashville-based pharmacy that specializes in dispensing HIV and AIDS-related medications automatically refilled medications without a request from the beneficiary or their physician; improperly waived TennCare and Medicare co-payments without an individualized assessment of ability to pay; improperly used pharmaceutical manufacturers’ co-payment cards to pay the co-payments of Medicare beneficiaries; billed for medications dispensed after the deaths of certain beneficiaries; and billed for medications that lacked a valid prescription.  The allegations originated in a whistleblower lawsuit filed by Marsha McCullough, a former Nashville Pharmacy order entry technician, under the qui tamprovisions of the False Claims Act.  She will receive a whistleblower award of 18 percent of the government’s recovery which could amount to $1.4 million.  Whistleblower Insider

Tagged in: Drug and DME Pricing, FCA Federal, FCA State, Healthcare Fraud, Medicaid, Medical Billing Fraud, Medicare, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

December 23, 2015

Memorial Health, Inc., Memorial Health University Medical Center, Inc., Provident Health Services, Inc., and MPPG, Inc. (d/b/a Memorial Health University Physicians) agreed to pay roughly $10 million to settle charges they violated the False Claims Act by submitting claims to the Government in violation of the Stark Law which prohibits hospitals from entering into improper financial relationships with referring physicians.  The settlement is the largest civil health care fraud recovery in the history of the United States Attorney’s Office for the Southern District of Georgia.  The allegations first arose in a whistleblower lawsuit filed by former Memorial Health CEO Phillip Schaengold under the qui tam provisions of the False Claims Act.  The whistleblower will receive a yet-to-be-disclosed whistleblower reward from the proceeds of the government’s recovery. DOJ (SDGA)

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

December 23, 2015

A $2.5 million settlement with long term care pharmacy Pharmerica, which services hundreds of nursing homes across the nation, completes the final leg of litigation involving the illegal promotion of Aranesp, an anemia drug manufactured by Amgen, Inc.  Including the 2013 settlement with Amgen ($24.9 million) and the 2014 settlement with Omnicare ($4.19 million), this settlement brings the government’s total recovery in this matter to just over $31.5 million.  The allegations were originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. DOJ (DSC)

Tagged in: Pharma Fraud, SNF, Whistleblower Case,

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