Whistleblower Rewards

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

July 22, 2016

California-based medical device manufacturer Acclarent Inc., a subsidiary of Johnson & Johnson, agreed to pay $18 million to resolve allegations it violated the False Claims Act by causing health care providers to submit false claims to Medicare and other federal health care programs by marketing and distributing its sinus spacer product known as the Relieva Stratus MicroFlow Spacer (Stratus) for use as a drug delivery device without FDA approval of that use.  The government further alleged that Acclarent marketed the Stratus as a drug delivery device even after the FDA rejected the company’s 2007 request to expand the approved uses for the Stratus.  On July 20, Acclarent’s former CEO William Facteau and former VP of Sales Patrick Fabian were convicted of introducing adulterated and misbranded medical devices into interstate commerce.  The allegations originated in a whistleblower lawsuit filed by Melayna Lokosky under the qui tam provisions of the False Claims Act.  The whistleblower will receive an award of roughly $3.5 million from the proceeds of the government's recovery.  DOJ

July 22, 2016

Preferred Imaging, LLC, a provider of diagnostic imaging services, agreed to pay $3,510,000 to resolve allegations it violated the False Claims Act by improperly billing Medicare and Texas Medicaid for services performed without proper medical supervision.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Preferred Imaging employee Tracy Sifuentes.  She will receive a whistleblower award of $596,700 from the proceeds of the government's recovery.  DOJ (NDTX)

July 18, 2016

Bristol-Myers Squibb agreed to a $30 million settlement to resolve allegations of unlawful kickbacks to physicians in the marketing of Pravachol and other drugs.  The claims were made in a whistleblower suit filed under the California Insurance Frauds Prevention Act by three former Bristol-Myers sales representatives, who will receive a share of the settlement.  CA

July 14, 2016

Columbia University agreed to pay $9.5 million to resolve charges it violated the False Claims Act for improperly seeking and receiving excessive cost recoveries in connection with research grants funded by the National Institutes of Health (NIH).  According to the government, Columbia impermissibly applied its “on-campus” indirect cost rate, instead of the much lower “off-campus” indirect cost rate, when seeking federal reimbursement for 423 NIH grants where the research was primarily performed at off-campus facilities owned and operated by the State of New York and New York City.  The government further alleged Columbia failed to disclose to NIH that it did not own or operate these facilities and that Columbia did not pay for use of the space for most of the relevant period.  The allegations originated with 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 (SDNY)

July 13, 2016

Minnesota-based provider of hospice care Evercare Hospice and Palliative Care agreed to pay $18 million to resolve charges it violated the False Claims Act by claiming Medicare reimbursement for hospice care for patients not eligible for such care because they were not terminally ill.  Specifically, the government alleged that Evercare’s business practices were designed to maximize the number of patients for whom it could bill Medicare without regard to whether the patients were eligible for and needed hospice.  The allegations originated in whistleblower lawsuits filed by former employees of Evercare under the qui tam provisions of the False Claims Act.  They will receive a yet-to-be-determined whistleblower award from the proceeds of the government’s recovery.  Whistleblower Insider

July 13, 2016

Clothing importer Motives, Inc. and its affiliated foreign clothing manufacturers Motives Far East and Motives China Ltd. agreed to pay $13.375 million to settle charges of violating the False Claims Act by engaging in a double invoicing scheme to defraud the United States out of millions of dollars in customs duties.  As part of the settlement, the companies admitted to and accepted responsibility for under-reporting the value of its imported merchandise.  Under the scheme, the companies used two sets of invoices: one that undervalued the garments and was presented to the government for calculation of the appropriate customs duty, and the second that reflected the actual value of the garments.  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 (SDNY)