Whistleblower Rewards
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July 13, 2018
Orthopedic specialists in Oklahoma have agreed to pay $670,000 to settle allegations in a False Claims Act qui tam that they falsely billed Medicare, Medicaid, and Tricare for unnecessary ultrasonic guidance procedures and for services that were not performed. The settlement resolved two claims in the whistleblower action, brought by a former employee, in which the government had intervened prior to settlement; other claims continue to be litigated. USAO WDOKJuly 10, 2018
Liberty Ambulance agreed to pay $1.2 million to settle an FCA qui tam alleging that, from 2005 to 2016, Liberty had fraudulently upcoded life support services and unnecessarily transported patients. The case was filed by whistleblower Shawn Pelletier, who will receive $264,000 from the settlement, on top of $1.2 million he had received from prior settlements with other defendants. USAO MDFLJuly 9, 2018
NY-based Health Quest Systems, Inc. (Health Quest), and its subsidiary hospital Putnam Health Center (Putnam) entered a $14.7 million settlement with DOJ and a $895,427 settlement with New York based on their submission of inflated and otherwise impermissible claims for payment to Medicare and Medicaid. Specifically, the defendants billed Medicare for undocumented E&M services, billed for home-health services without supporting medical records, and billed for orthopedic surgeons who referred patients in violation of the Physician Self-Referral Law, also known as the Stark Law. Three former Health Quest employees, who filed suit under the qui tam provisions of the False Claims Act, will receive a share of the recovery, including a reward of nearly $2 million to one of the relators. DOJ; USAO NDNYJuly 3, 2018
A Virginia woman who owned several Medicaid support services companies has agreed to pay $1 million and to accept a lifetime ban on participation in the Virginia Medicaid Program as part of a settlement of allegations that she defrauded the program. Dawn Sykes allegedly paid illegal kickbacks and sought reimbursement for services that were not provided or were provided to ineligible recipients. The investigation was launched by a qui tam lawsuit under the FCA and Virginia Fraud Against Taxpayers Act, and the whistleblower will receive 18 percent of the settlement. USAO EDVACatch of the Week -- Health Quest Systems and Putnam Hospital Center
Posted 07/13/18
This week, DOJ announced a $14.7 million settlement with NY-based Health Quest Systems, Inc. (Health Quest), and its subsidiary hospital Putnam Health Center (Putnam) based on their submission of inflated and otherwise impermissible claims for payment to Medicare and Medicaid, making Health Quest and Putnam our Catch of the Week.
The settlement resolves allegations stemming from three separate lawsuits bought by...
CFTC Announces Record-Breaking $30 Million Whistleblower Award
Posted 07/12/18
Today, the Commodity Futures Trading Commission (CFTC) announced a $30 million whistleblower award-the largest ever under the CFTC’s Whistleblower Program. The award, which is nearly triple the size of the CFTC’s previous highest award, is the fifth made under the program since its inception in 2010 and the first under President Trump. In February, Bloomberg reported that a whistleblower would receive a $30...