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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 96 of 111

September 21, 2015

Non-profit healthcare organization Adventist Health System agreed to pay $115 million to settle allegations it violated the False Claims Act by maintaining improper compensation arrangements with referring physicians and by miscoding claims.  The allegations originated in two whistleblower lawsuits filed by former Adventist hospital employees Michael Payne, Melissa Church and Gloria Pryor under the qui tam provisions of the False Claims Act.  The will receive a yet-to-be-determined whistleblower award from the government’s recovery. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Hospital Fraud, Medical Billing Fraud, Multiple Whistleblowers and First-to-File, Whistleblower Case, Whistleblower Rewards,

September 15, 2015

North Broward Hospital District, operator of hospitals and other health care facilities in the Broward County, Florida area, agreed to pay $69.5 million to settle allegations it violated the False Claims Act by engaging in improper financial relationships with referring physicians.  According to the government, the hospital district provided compensation to nine employed physicians that exceeded the fair market value of their services violating both the Stark Statute and False Claims Act.  The allegations first arose from a whistleblower lawsuit filed by Dr. Michael Reilly under the qui tam provisions of the False Claims Act.  Dr. Reilly will receive a whistleblower award of roughly $12 million.  DOJ

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

September 10, 2015

Tennessee-based non-profit hospice care provider Alive Hospice, Inc.paid roughly $1.5 million to reimburse the government for alleged violations of the False Claims Act through overbilling of Medicare and TennCare for hospice services.  According to the government, Alive submitted claims to Medicare and TennCare for general inpatient hospice care for patients who did not qualify for that care.  The allegations originated in a whistleblower lawsuit filed by Linda Anderson, a triage nurse who previously worked for Alive, under the qui tam provisions of the False Claims Act. She will receive a whistleblower award of $263,197. Whistleblower Insider

Tagged in: Home Health and Hospice, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

September 4, 2015

Columbus Regional Healthcare System and Dr. Andrew Pippas agreed to pay more than $25 million to resolve allegations they violated the False Claims Act by submitting claims in violation of the Stark Law.  The settlement also resolves allegations that Columbus Regional and Pippas submitted claims for payment to federal health care programs that misrepresented the level of services they provided.  According to the government, between 2003 and 2013, Columbus Regional provided excessive salary and directorship payments to Pippas that violated the Stark Law.  The government further alleged Columbus Regional submitted claims to federal health care programs for services at higher levels than supported by the documentation.  The allegations first arose in two whistleblower lawsuits filed former Columbus Regional executive Richard Barker under the qui tam provisions of the False Claims Act and the Georgia False Medicaid Claims Act.  Barker will receive a yet-to-be-determined whistleblower award.  DOJ

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

September 4, 2015

Robert Wingfield and Bill Ma agreed to pay $385,000 and $50,000, respectively, to resolve allegations they violated the False Claims Act by engaging in a scheme to evade customs duties on imports of aluminum extrusions from China.  Wingfield was the US sales representative for Tai Shan Golden Gain Aluminum Products Ltd., the Chinese company that exported the aluminum extrusions in this case.  According to the government, Wingfield conspired with domestic importers to submit false information to the government to evade duties, and Ma later formed a company, Northeastern Aluminum Corp., to act as the importer of record for the goods in an attempt to shield the real importers from liability.  The allegations originated in a whistleblower lawsuit filed by James F. Valenti Jr. under the qui tam provisions of the False Claims Act.  Valenti will receive a whistleblower award of approximately $79,000.  DOJ

Tagged in: Customs Fraud, FCA Federal, Whistleblower Case, Whistleblower Rewards,

September 4, 2015

Walter Investment Management Corp. agreed to pay $29.63 million to resolve allegations that, through its subsidiaries, Reverse Mortgage Solution Inc., REO Management Solutions LLC and RMS Asset Management Solutions LLC, it violated the False Claims Act in connection with the subsidiaries’ participation in the Department of Housing and Urban Development’s Home Equity Conversion Mortgages program, which insures “reverse” mortgage loans.  The allegations originated in a whistleblower lawsuit filed former RMS executive Matthew McDonald under the qui tam provisions of the False Claims Act.  McDonald will receive a whistleblower award of $5.15 million.  DOJ

Tagged in: FCA Federal, Financial and Investment Fraud, Financial Institution Fraud, Housing and Mortgage Fraud, Whistleblower Case, Whistleblower Rewards,

September 3, 2015

St. Joseph Hospice Entities, which consists of 13 hospice facilities in Mississippi, Louisiana, Texas and Alabama, and Patrick T. Mitchell, its majority owner and manager, agreed to pay $5,867,518 to resolve allegations they violated the False Claims Act by submitting false claims for delivery of continuous home care hospice services to patients who were not entitled to receive them.  The allegations originated in a whistleblower lawsuit filed by 3 former employees of the company under the qui tam provisions of the False Claims Act.  They will receive a whistleblower award of roughly $1 million.  DOJ

Tagged in: FCA Federal, Home Health and Hospice, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

September 1, 2015

Discount department store chain KMART Corp., which operates approximately 780 in-store pharmacies throughout the US, agreed to pay $1.4 million to resolve allegations it violated the False Claims Act by using drug manufacturer coupons and gasoline discounts as improper Medicare beneficiary inducements.  According to the government, Kmart improperly influenced the decisions of Medicare beneficiaries to bring their prescriptions to Kmart pharmacies by permitting them to use drug manufacturer coupons to reduce or eliminate prescription co-pays that they otherwise would be obligated to pay, and by also offering them varying levels of discounts on the purchase of gasoline at participating gas stations.  The allegations originated in a whistleblower lawsuit filed by former Kmart pharmacist Joshua Leighr under the qui tam provisions of the False Claims Act.  Leighr will receive a whistleblower award of approximately $248,500.  DOJ

Tagged in: Drug and DME Pricing, FCA Federal, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

August 19, 2015

Background check company US Investigations Services Inc. and its parent company Altegrity agreed to settle charges that USIS violated the False Claims Act by failing to provide proper background checks as required under its contract with the  Office of Personnel Management.  They agreed to forgo $30 million in payments they claim OPM owed them.  The allegations leading to the settlement were first raised in a whistleblower lawsuit filed by former USIS executive Blake Percival under the qui tam provisions of the False Claims Act.  He will receive a yet-to-be-determined whistleblower award.  Whistleblower Insider

Tagged in: Contract Non-Compliance, FCA Federal, Government Procurement Fraud, Whistleblower Case, Whistleblower Rewards,

August 19, 2015

Arizona physician Dr. Bashir Azher agreed to pay $207,988 to resolve allegations he violated the False Claims Act by submitting false bills to Medicare for prostate laser ablation procedures, commonly known as Green Light prostatectomies.  Specifically, the government charged Dr. Azher with submitting false claims for reimbursement for prostate laser ablation procedures that were too short to generate a therapeutic benefit, failed to meet professionally recognized standards of care, were medically unnecessary, and/or violated applicable Medicare regulations.  The government’s allegations originated in a whistleblower lawsuit filed by Dr. Arnaldo Trabucco under the qui tam provisions of the False Claims Act.  He will receive a yet-to-be-determined whistleblower award.  DOJ

Tagged in: FCA Federal, Lack of Medical Necessity, Medical Billing Fraud, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

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