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Whistleblower Rewards

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Sharp HealthCare — Medicare Fraud/Kickbacks (undisclosed settlement amount)

Three of our whistleblower attorneys represented a whistleblower in a qui tam action under the False Claims Act against Sharp HealthCare, a regional hospital system in San Diego.  Our client alleged that the Sharp Healthcare Center for Research, Sharp’s clinical-trial research arm, fraudulently billed government payers in violation of “secondary payer” rules that prohibit billing the government when other payers will pay for a patient’s care. Our whistleblower client also alleged that Sharp cultivated an illegal kickback scheme to entice prospective trial sponsors to host clinical trials at Sharp by regularly undervaluing Sharp’s costs involved in managing clinical trials.  By offering below-market value incentives and billing government and commercial insurers for injuries, the lawsuit alleged that Sharp sought to increase its attractiveness to trial sponsors. Sharp’s alleged purpose was to burnish the organization’s reputation and offer a lucrative stream of income for Sharp-affiliated physicians involved in clinical trials. Sharp settled the whistleblower’s case for an undisclosed amount.  Read more here.

Unitrans International Inc., Anham FZCO, et al. — Government Contract Fraud ($45 million)

Our attorneys represented Rory Maxwell, John Bush, and Supreme Foodservice GmbH in a qui tam action under the False Claims Act against Unitrans International Inc., a privately held Virginia defense contracting company, and Anham FZCO, an associated Dubai Free Zone company, for making false certifications of compliance with the U.S. sanctions regime against Iran to induce the U.S. Defense Logistics Agency and the U.S. Army to award Anham wartime contracts to provide food and transportation to U.S. troops.  Our whistleblower clients also alleged Anham knowingly and falsely represented construction progress on its Bagram warehouse in related bid proposals to the government.  In December 2019, Unitrans agreed to pay $45 million to resolve criminal and civil allegations related to this alleged misconduct, which includes $27 million to resolve our whistleblower clients’ False Claims Act allegations.  Read more about the case at the Department of Justice website here and in The Washington Post here.

December 3, 2019

Weapons manufacturer Capco, LLC has agreed to pay over $1 million to resolve fraud allegations raised by its former quality engineer, James Cole.  According to Cole, from 2016 to 2018, the company knowingly certified that M320 grenade launchers sold to the U.S. Army were manufactured in compliance with contract specifications, when in fact a critical component had been manufactured using the wrong type of steel.  Capco also failed to disclose the issue despite conducting an internal investigation.  For bringing the issue to light, Cole will receive approximately $235,000 of the recovery. USAO CO

November 26, 2019

Boston Heart Diagnostics Corporation will pay $26.7 million to resolve claims that it paid illegal kickbacks to physicians who referred laboratory tests to the company.  Boston Health provided laboratory testing to hospitals in Texas in exchange for per-test payments from the hospitals.  In order to secure more referrals from the hospitals' doctors for its testing services, Boston Health set up "management service organizations" which made payments to referring physicians.  Although these physician payments were disguised as investment returns, they were actually based on, and were provided in exchange for, the physicans' referrals.  In addition, Boston Heart was alleged to have provided other remuneration to referring physicians, including the provision of in-office dieticians, and to have waived patient co-payments and deductibles.  The settlement resolves two different cases brought by  whistleblowers, who will receive $4.36 million from the settlement.  DOJ

November 20, 2019

Louisville, Kentucky hospital Jewish Hospital & St. Mary’s Healthcare Inc. has agreed to pay $10.1 million to resolve allegations that the hospital, doing business as Pharmacy Plus and Pharmacy Plus Specialty, submitted false claims to Medicare for prescription drugs that did not have the required physician order or proof of delivery, for prescription refills that were not reasonable and necessary, or for prescriptions that otherwise did not meet Medicare coverage requirements.  In addition, defendant was alleged to have violated the Anti-Kickback Statute by providing unlawful remuneration to patients in the form of free blood glucose testing supplies and waiver of co-payments and deductibles for insulin.  The case was initiated by a qui tam complaint filed by pharmacist Robert Stone, who will receive $1.85 million from the settlement.  DOJ

November 18, 2019

Computer hardware supplier Eagle Alliance will pay $110,000 to resolve a case brought by a whistleblower alleging that the company improperly double-billed the government for computer equipment, and billed for used equipment as if it were new.  Jeffrey Brenner, a former employee of Eagle Alliance, will receive $18,700 as a whistleblower reward.  USAO MD

November 15, 2019

California healthcare system Sutter Health, its hospital the Sutter Memorial Center Sacramento, and the Sacramento Cardiovascular Surgeons Medical Group, Inc., will pay a total of $43.12 million to resolve allegations that the entities violated the Stark Law and improperly double-billed Medicare.  Specifically, Sutter Memorial will pay $30.5 million to resolve charges of wrongfully billing Medicare for services referred to the hospital by Sac Cardio, with whom the hospital maintained improper financial arrangements that overcompensated the Sac Cardio physicians.  In addition, Sutter will pay $15.12 million to resolve allegations that it paid physicians compensation at rates that exceeded fair market value, leased office space to them at below-market rates, and reimbursed them for expenses at inflated rates.  In addition to the Stark Law violations, the settlement also resolved allegations that Sac Cardio submitted duplicative bills for physician assistant services (Sac Cardio will pay $500,000 to resolve these claims), and allegations that several Sutter ambulatory surgical centers had double-billed Medicare for radiological services that had actually been provided, and billed for, by a separate entity.  DOJ reported that allegations against Sutter Memorial and Sac Cardio were first made in a qui tam lawsuit brought by Laurie Hanvey, who will receive $5.9 million from the settlement, and that Sutter Health self-disclosed other conduct at issue in the settlement. DOJ; USAO ED Cal; USAO ND Cal

CFTC Whistleblower Program Annual Report Shows Program Open for Business, yet Challenges Persist

Posted  11/15/19
Screenshot of CFTC Whistleblower Program web page
Fifteen million dollars is how much the United States Commodity Futures Trading Commission’s (CFTC) Whistleblower Program paid whistleblowers in FY 2019 according to the agency’s annual report to Congress.  This amount includes:
  • $7 million to one individual whistleblower;
  • Over $2 million to a non-insider whistleblower who provided independent analysis of market data; and,
  • Close to $1.5 million to a...

November 7, 2019

Compound drug ingredient supplier Fagron Holding USA LLC has agreed to pay over $22 million to resolve two qui tam suits involving three of Fagron’s wholly-owned subsidiaries.  According to whistleblowers, Freedom Pharmaceuticals Inc. grossly inflated the price of active pharmaceutical ingredients used in compound prescriptions, causing pharmacy customers to submit false claims to TRICARE.  Other allegations involved subsidiaries Pharmacy Services Inc. and B&B Pharmaceuticals Inc., which were accused of submitting false claims to federal healthcare programs, manipulating prescription drug pricing, paying kickbacks to physicians, and illegally waiving patient copays.  DOJ

CATCH OF THE WEEK — Tenet Healthcare to Pay $66M Over Kickback Allegations

Posted  11/7/19
Tenet Healthcare Logo
Tenet Healthcare, a healthcare giant that operates 65 hospitals and conducts over 10 million patient encounters annually, has agreed in principle to pay the United States roughly $66M to settle allegations that it violated the Stark Law and the Anti-Kickback Statute. These laws generally prohibit medical providers from paying or receiving kickbacks, remuneration, or anything of value in exchange for referrals of...
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