Whistleblower Rewards

August 5, 2016

A series of anesthesia businesses collectively known as Sweet Dreams Nurse Anesthesia agreed to pay roughly $1 million to settle charges they violated the False Claims Act, Anti-Kickback Statute and Georgia False Medicaid Claims Act by paying unlawful kickbacks to health care providers for referrals.  According to the government, one alleged scheme involved Sweet Dreams’ provision of free anesthesia drugs to ambulatory surgery centers (ASCs) in exchange for granting Sweet Dreams an exclusive contract to provide anesthesia services at those ASCs.  A second alleged scheme allegedly involved the agreement of an affiliate of Sweet Dreams to fund the construction of an ASC in exchange for contracts for Sweet Dreams’ selection as the exclusive anesthesia provider.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Adam Nauss.  He will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (MDGA)

August 1, 2016

Houston-based cargo handling company Jacintoport International LLC and its Miami-based ocean transport affiliate Seaboard Marine Ltd. agreed to pay $1.075 million to settle charges they violated the False Claims Act in connection with a warehousing and logistics contract for the storage and redelivery of humanitarian food aid.  Specifically, the government alleged that Jacintoport, under the supervision and control of Seaboard, charged ocean carriers more for stevedoring than permitted to load over 50,000 tons of humanitarian food aid, and these inflated stevedoring charges were subsequently lumped into other costs for delivering humanitarian food aid and passed on to the government.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by John Raggio, a shipping contractor who allegedly received an invoice from Jacintoport that contained the excessive stevedoring charge.  He will receive a whistleblower award of $215,000 from the proceeds of the government's recovery.  DOJ

August 1, 2016

St. Joseph’s Hospital Health Center agreed to pay $3.2 million to resolve allegations it violated the federal False Claims Act and New York False Claims Act by billing the state Medicaid program for mental health services provided by unqualified staff.  Specifically, the government alleged that St. Joseph's billed Medicaid for mobile-crisis outreach services that failed to comply with Comprehensive Psychiatric Emergency Program (CPEP) staffing requirements.  The allegations originated in a whistleblower lawsuit filed by registered nurse Catherine Lembo under the qui tam provisions of the federal and New York False Claims Acts.  Ms. Lembo will receive a whistleblower award of $560,000 from the proceeds of the government’s recovery.  Whistleblower Insider

August 3, 2016

The U.S. Tax Court made a whistleblower award of $17.8 million to a pair of whistleblowers which for the first time includes a portion of criminal fines and civil forfeitures in addition to part of the taxes the government recouped because of information they provided.  The parties involved in the case weren’t disclosed but it appears to stem from the prosecution of Wegelin & Co, the Swiss bank that closed after it pleaded guilty in 2013 to conspiring with U.S. taxpayers to hide money from the IRS.  WSJ

July 29, 2016

A judgment for $4,752,101.50 was entered against LXE Counseling, LLC and its owner Lexie Darlene George (a/k/a Lexie Darlene Batchelor) for violations of the False Claims Act, the Oklahoma Medicaid False Claims Act and the Oklahoma Medicaid Program Integrity Act.  Specifically, LXE and Batchelor were found to have submitted claims to Oklahoma Medicaid for services that were, among other things: provided by unqualified persons; based on falsified time and service records; double billed; unauthorized or not provided.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act.  The whistleblower will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (WDOK)

July 28, 2016

South Carolina hospital Lexington County Health Services District Inc. (d/b/a Lexington Medical Center) agreed to pay $17 million to resolve allegations it violated the False Claims Act and the Physician Self-Referral Law (known as the Stark Law) by maintaining improper financial arrangements with 28 physicians.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Lexington Medical Center physician Dr. David Hammett.  He will receive a whistleblower award of roughly $4.5 million from the proceeds of the government’s recovery.  Whistleblower Insider

July 27, 2016

Deremedx Dermatology, P.C. (d/b/a Dermatique) and its owner Dr. Barry A. Solomon agreed to pay roughly $300,000 to resolve charges they violated the False Claims Act repeatedly billing Medicare and Medicaid for services performed as if Solomon were supervising the procedures even though he was not in the office and was in some cases out of the country.  Solomon also billed for so-called “impossible days” in which he submitted claims for more hours than he could have possibly worked.  The allegations originated in a whistleblower lawsuit filed by Diane Vitale under the qui tam provisions of the False Claims Act.  She will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (EDNY)

July 27, 2016

The University of Pittsburgh Medical Center, together with the University of Pittsburgh Physicians, UPMC Community Medicine, Inc., and Tri-State Neurosurgical Associates-UPMC, Inc., agreed to pay roughly $2.5 million to settle charges they violated the False Claims Act by submitting false claims to Medicare.  Specifically, the government alleged that certain neurosurgeons employed by UPMC submitted claims for assisting with or supervising surgical procedures performed by other surgeons, residents, fellows, or physician assistants, when those neurosurgeons did not participate in the relevant surgeries to the degree required.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act.  The whistleblowers will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (WDPA)

July 27, 2016

Connecticut psychiatrist Dr. Anton Fry and his company CPC Associates agreed to pay $36,704 to resolve allegations they violated the False Claims Act by submitting improper claims to Medicare for psychiatric services that were provided over the phone instead of by meeting with the beneficiaries in the office and treating them in person.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Jodi Cohen, a former patient of Dr. Fry, and Medical Bill Consultants, LLC, a billing company.  They will receive a whistleblower award of $6,239 from the proceeds of the government's recovery.  DOJ (DCT)

July 26, 2016

Massachusetts-based State Street Bank and Trust Company agreed to pay a total of at least $382.4 million -- including $155 million to the DOJ, $167.4 million in disgorgement and penalties to the SEC, and at least $60 million to ERISA plan clients in an agreement with the Department of Labor -- to settle allegations that it deceived its custody clients when providing them with indirect foreign currency exchange (FX) services.  According to the government, State Street admitted that contrary to its representations to certain custody clients, it did not price FX transactions at prevailing interbank market rates and instead executed FX transactions by applying a predetermined, uniform mark-up (if the custody client was a FX purchaser) or mark-down (if the custody client was an FX seller) to the prevailing interbank rate for FX.  State Street is also alleged to have falsely informed custody clients that it provided “best execution” on FX transactions, that it guaranteed the most competitive rates available on FX transactions and that it priced FX transactions based on a variety of factors when, in fact, prices were largely driven by hidden mark-ups designed to maximize State Street’s profits.  The allegations originated from famed Bernie Madoff whistleblower Harry Markopolos under the whistleblower provisions of the Financial Institutions Reform, Recovery and Enforcement Act (FIRREA).  State Street will pay an additional $147.6 to resolve private class action lawsuits filed by the bank’s customers alleging similar misconduct.  DOJ