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Whistleblower Rewards

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January 13, 2023

The SEC has awarded more than $5 million to a whistleblower who first reported internally, and whose subsequent tip to the agency helped shape its investigation.  Based on the whistleblower’s information, agency staff were able to identify witnesses and effectively draft document and information requests.  SEC

December 20, 2022

Cochlear implant manufacturer Advanced Bionics LLC paid $11.4 million to resolve claims brought in a whistleblower action that the company falsely stated that the radio-frequency (RF) emissions generated by some of its cochlear implant processors met international standards when it submitted pre-market approval applications to the FDA.  The company allegedly knew that the devices did not meet standards, and manipulated testing conditions to obtain passing test results.  Whistleblower David Nyberg, a former engineer at Advanced Bionics, will receive a qui tam award of $1.9 million from the federal amount of the settlement.  DOJ; USAO ED PA

December 20, 2022

BioTelemetry Inc. and its subsidiary CardioNet LLC, which provide cardiac monitoring services (including Holter and mobile cardiovascular telemetry (MCT) tests), will pay $44.875 million to resolve claims that they submitted false claims to federal healthcare programs for cardiac monitoring services that were improperly performed overseas and by unqualified technicians.  CardioNet used an India-based contractor to perform diagnostic and analysis services of heart monitoring data, and while it had a formal policy of sending such data for federal healthcare beneficiaries to a U.S.-based independent diagnostic testing facility for review and analysis, in fact, substantial amounts of such data was sent to its Indian contractor.  The government further alleged that most of the offshore technicians tasked with reviewing ECG Data for federal healthcare program beneficiaries did not have the basic qualifications to perform the tests in question. The government’s investigation was initiated by a qui tam action filed by former CardioNet employees Christopher Strasinski and Philip Leone, who will share a whistleblower award of approximately $8.3 millionDOJ; USAO ED PA

December 19, 2022

A company outsider who submitted multiple anonymous tips to the SEC and the target company, which initiated an internal investigation based on the information, received a whistleblower award of $37 million.  The company reported the whistleblower’s information to the Commission, which then opened its own investigation.  Claimant submitted an additional tip to the Commission within 120 days that included the email that Claimant had sent to the company.  Claimant’s award was based on amounts recovered by the Commission and amounts recovered in a related action.  SEC

December 15, 2022

Florida-based Ocenture LLC and its subsidiary, Carelumina LLC, have agreed to pay $3 million to settle allegations of submitting claims to Medicare that were tainted by illegal kickbacks.  Two marketers approached by Ocenture to participate in the kickback scheme, Christopher Improta and Peter Brandt, filed a qui tam suit against Ocenture which alleged the company provided kickbacks to physicians to have them falsely attest that genetic tests Ocenture solicited directly from Medicare beneficiaries was medically necessary.  The whistleblowers also alleged that Ocenture arranged for laboratories to process those tests and pay it a portion of the laboratories’ Medicare reimbursements.  For instigating a successful enforcement action, Improta and Brandt will share a $570,000 award.  DOJ

December 14, 2022

In a False Claims Act case pursued on a non-intervened basis, Academy Mortgage Corporation agreed to pay $38.5 million to resolve allegations that it improperly originated and underwrote mortgages insured by the Federal Housing Administration.  The whistleblower, Gwen Thrower, who was an underwriter at Academy, alleged that the Academy had an inadequate underwriting process that led to false certifications of compliance with underwriting requirements and, ultimately, to the government having to pay insurance claims on loans improperly underwritten by Academy.  Thrower will receive a whistleblower award of $11.5 millionDOJ

December 12, 2022

The SEC approved a whistleblower award of $20 million to an anonymous individual who voluntarily provided original information to the Commission that significantly contributed to an investigation that had been previously opened based on a referral from the Division of Examinations.  While noting that much of the information provided by the whistleblower was already known to Enforcement staff, the individual provided some helpful new information, met with Enforcement Division staff multiple times, and remained cooperative throughout the investigation.  SEC

December 7, 2022

Dignity Health and the Tenet Healthcare hospitals Twin Cities Community Hospital and Sierra Vista Regional Medical Center will pay a total of $22.5 million to resolve allegations that they submitted false claims to Medi-Cal in connection with the ACA’s Medicaid Adult Expansion program.  The defendants, who contracted with Medi-Cal, agreed to provide healthcare services to this newly-insured population and return surplus funds if they did not spend at least 85% of the specified funds on eligible services.  The government alleged that the hospitals falsely billed for “Enhanced Services,” which allowed them to overstate AE spending, including by billing for services that were duplicative of services already required. The settlements resolve claims brought in a whistleblower action by Julio Bordas, who previously served as a Medical Director for CenCal Health, the County Organized Health System through which Medi-Cal contracted with the hospitals. Bordas will receive $3.9 million as his share of the federal recovery.  DOJ; USAO CD Cal; CA

December 5, 2022

Optical lens manufacturer Essilor Laboratories of America, Inc. will pay $23.8 million to California to resolve allegations that the company violated the state’s Insurance Frauds Prevention Act when it allegedly provided kickbacks and other unlawful incentives to eye care providers in exchange for these providers’ promises to send business to Essilor. The state’s action was initiated by a whistleblower complaint filed by Christie Rudolph, who will receive a whistleblower reward of approximately $11.1 million. (see earlier settlement) CA
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