Whistleblower Rewards

May 9, 2022

Prism Behavioral Solutions has agreed to pay $650,000 to resolve allegations of violating the federal and California False Claims Acts by billing California’s Medicaid program for services not provided to autistic children and young adults.  The whistleblower in this case, Diana Mason, is a behavioral analyst employed by Prism, and will receive a $170,000 share of the settlement.  USAO SDCA; CA AG

May 6, 2022

The SEC awarded $3.5 million to 4 whistleblowers in a single covered action. Three joint whistleblowers provided staff with information that caused a new investigation to be opened, and a fourth whistleblower provided analytical insights of publicly available information that focused the staff’s attention on new allegations that advanced the investigation. SEC

April 25, 2022

The SEC has awarded five whistleblowers a total of $6 million for their assistance in a single successful enforcement action.  According to the agency, one group of the whistleblowers provided key documents that prompted the agency to request additional documents from the respondent, while the second group provided firsthand accounts of the misconduct.  SEC

April 13, 2022

A number of anesthesia entities owned and operated by Care Plus Management, LLC (Care Plus), which itself is owned and operated by doctors Paul D. Weir and John R. Morgan, have agreed to pay $7.2 million to resolve allegations of violating the Anti-Kickback Statute and False Claims Act.  A qui tam suit by whistleblower Robert Douglas had alleged that between 2012 and 2016, Care Plus entered into illegal revenue-sharing arrangements with physicians in exchange for patient referrals.  For his contributions to a successful enforcement action, Douglas will receive a $1.3 million share of the settlement.  USAO NDGA

April 12, 2022

Providence Health & Services Washington has agreed to pay $22.7 million to settle allegations of submitting false claims to Medicare, Medicaid, and TRICARE.  According to an unnamed whistleblower, who will receive a $4.2 million relator’s share, the hospital allegedly gave their neurosurgeons volume-based financial incentives to perform complex surgeries, thereby incentivizing two neurosurgeons to perform an excessive number of complex surgeries on inappropriate candidates without regard to medical necessity or patient safety, and ultimately causing an excessive level of complications.  USAO EDWA

April 6, 2022

Florida hospital chain BayCare Health System Inc. will pay $20 million to resolve claims that the company knowingly caused false claims for federal Medicaid matching funds to be submitted to the United States by making improper, non-bona fide cash donations to the Juvenile Welfare Board of Pinellas County (JWB) knowing that the funds would be transferred by JWB to the State of Florida’s Agency for Health Care Administration for Florida’s Medicaid Program, which would trigger a corresponding federal matching payment.  The prohibition on non-bona fide donations ensures that states are paying a share of Medicaid payments; the non-bona fide donations increased Medicaid payments received by BayCare without any actual expenditure of state or local funds and enabled BayCare to recoup its original donations to JWB and also receive federal matching funds. The case was initiated with a qui tam complaint filed by Larry Bomar, who will receive $5 million as an award for initiating the whistleblower action. DOJ; MD FL

March 28, 2022

The CFTC has awarded four whistleblowers $625,000 for their contributions to the agency’s enforcement actions.  Three of the whistleblowers provided support jointly, while a fourth provided a high level of assistance.  CFTC

March 18, 2022

The CFTC has made a $10 million award to a whistleblower whose tip sparked an investigation, and whose supplemental information helped move it along.  CFTC