Whistleblower Rewards Archives - Page 84 of 102

April 18, 2016

California-based sportswear importer Winds Enterprises, Inc. agreed to pay $1.5 million to resolve allegations it violated the False Claims Act by underpaying on import duties on shipments from 2010 to 2014. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a former Winds Enterprises employee, who will receive whistleblower award of $300,000 from the proceeds of the government's recovery. DOJ (WDWA)

Tagged in: Customs Fraud, FCA Federal, Whistleblower Case, Whistleblower Rewards,

April 14, 2016

Boston Medical Center (BMC) and two of its physician practice organizations agreed to pay $1.1 million to resolve allegations they violated the False Claims Act by improperly billing Medicare and Medicaid. Specifically, the government charged that (1) BMC billed Medicare for more units of Rituxan, an expensive cancer drug, than BMC actually infused in its patients; (2) BMC billed Medicare and Medicaid for services at its pre-surgical treatment center even though the global fee for the subsequent surgeries covered those same treatments; and (3) BMC submitted claims to Medicare for outpatient podiatry services where the clinical documentation did not support the reasonableness and necessity of the services. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by BMC’s former Chief Compliance Officer, Kathleen Heffernan. She will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery. DOJ (DMA)

Tagged in: FCA Federal, Hospital Fraud, Medicaid, Medical Billing Fraud, Medicare, Whistleblower Case, Whistleblower Eligibility, Whistleblower Rewards,

April 13, 2016

Florida Pain Medicine Associates, Inc. and its owners, Drs. Bart Gatz, Alexis Renta, and Albert Rodriguez, agreed to pay $1.1 million to resolve allegations they violated the False Claims Act by billing Medicare for medically unnecessary nerve conduction studies. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Rosa Gomez, who had worked in Florida Pain Medicine’s billing department. She will receive a whistleblower award of $242,000 from the proceeds of the government's recovery. DOJ (SDFL)

Tagged in: FCA Federal, Laboratory and IDTF, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

April 11, 2016

Tennessee-based drug urine screening company PremierTox 2.0, Inc. (previously called Nexus) agreed to pay $2.5 million to resolve allegations it violated the False Claims Act by submitting false claims when billing Medicare, TennCare and Kentucky Medicaid for drug urine screening services. According to the government, PremierTox had a swapping arrangement under which Nexus gave below cost discounts on its urine drug screen tests to patients in Tennessee without insurance, in exchange for physicians’ referring their patients with Medicare or TennCare coverage to Nexus. The government also contended that in Tennessee Nexus submitted excessive claims to Medicare and TennCare for laboratory testing that was beyond what was medically reasonable and necessary. The allegations originated in two whistleblower lawsuits filed under the qui tam provisions of the False Claims Act by a former office manager of a pain clinic and the former CEO of PremierTox. The office manager will receive a whistleblower award of $361,250, and the former CEO will receive a whistleblower award of $56,250. DOJ (MDTN)

Tagged in: Anti-Kickback and Stark, FCA Federal, Laboratory and IDTF, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

April 27, 2016

Michigan and 34 other states reached an agreement in principle to settle allegations against Wyeth, a subsidiary of Pfizer, Inc. The settlement will resolve allegations that Wyeth knowingly underpaid rebates owed under the Medicaid Drug Rebate Program for the sales, Protonix Oral and Protonix IV between 2001 and 2006. Both are drugs that are used to treat conditions such as acid reflux. Under the settlement Wyeth agreed to pay $784.6 million to the United States and the States. Over $371 million of this amount will go to the Medicaid Program. The settlement stems from two whistleblower lawsuits which were filed in the United States District Court for the District of Massachusetts. The United States, 35 states (including Michigan) and the District of Columbia intervened in the lawsuits. NY, NJ, MI, WA

Tagged in: Drug and DME Pricing, FCA State, Medicaid, Multiple Whistleblowers and First-to-File, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

March 28, 2016

Tennessee-based defense contractor Kilgore Flares Company and one of its subcontractors, New York-based ESM Group Inc., agreed to pay $8 million to resolve charges they violated the False Claims Act by selling defective and illegally imported infrared countermeasure flares to the U.S. Army and, for ESM, knowingly evading U.S. customs duties. The allegations first arose in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Reade Manufacturing Company, a domestic manufacturer of magnesium powder which is used in the flares. The company will receive a whistleblower award of $400,000 from the proceeds of the government’s recovery from ESM. Whistleblower Insider

Tagged in: Customs Fraud, Defense Contract Fraud, FCA Federal, Whistleblower Case, Whistleblower Eligibility, Whistleblower Rewards,

March 23, 2016

Pennsylvania-based Respironics Inc. agreed to pay $34.8 million to resolve charges it violated the False Claims Act and Anti-Kickback Statute by paying kickbacks in the form of free call center services to durable medical equipment (DME) suppliers that bought its masks for patients with sleep apnea. Respironics allegedly provided DME companies with call center services to meet their patients’ resupply needs at no charge as long as the patients were using masks that Respironics manufactured; otherwise, the DME companies would have to pay a monthly fee based on the number of patients who used masks manufactured by a competitor of Respironics. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Dr. Gibran Ameer, who has worked for different DME companies. He will receive a whistleblower award of $5.38 million from the proceeds of the government's recovery. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Laboratory and IDTF, Medical Devices and DME, Other Government Health Programs, Whistleblower Case, Whistleblower Rewards,

March 14, 2016

Syracuse-based government contractor Hayner Hoyt Corporation agreed to pay $5 million to settle charges that its chairman and chief executive officer Gary Thurston, its president Jeremy Thurston, and its affiliate companies LeMoyne Interiors and Doyner Inc., violated the False Claims Act by exploiting contracting opportunities reserved for service-disabled veterans. According to the government, “by diverting contracts and benefits intended for our nation’s service-disabled veterans . . . , the defendants undercut Congress’s intent of encouraging contract awards to legitimate service-disabled veteran-owned small businesses.” The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Hayner Hoyt subsidiary employee John Rubar. He will receive a whistleblower award of $875,000 from the proceeds of the government’s recovery. Whistleblower Insider

Tagged in: Government Procurement Fraud, Set-Asides and Preferences, Whistleblower Case, Whistleblower Rewards,

March 9, 2016

New York-based Bard College agreed to pay $4 million to resolve allegations it violated the False Claims Act by receiving funds under the Department of Education’s Teacher Quality Partnership Grant Program despite failing to comply with the conditions of the grant. The settlement also resolves allegations that Bard awarded, disbursed, and received Title IV student loan funds at campus locations before such locations were accredited or before providing notice of such locations to the Department of Education in violation of applicable regulations and Bard’s Title IV Program Participation Agreements with the agency. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by two former students of Bard’s Master of Arts in Teaching Program at Paramount Bard Academy in Delano, California. They will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery. DOJ (EDCA)

Tagged in: Education Fraud, FCA Federal, Grant and Research Fraud, Whistleblower Case, Whistleblower Rewards,

March 8, 2016

21st Century Oncology Inc., the nation’s largest physician led integrated cancer care provider, and its wholly owned subsidiary South Florida Radiation Oncology agreed to pay $34.7 million to settle charges they violated the False Claims Act by performing and billing for cancer care procedures that were not medically necessary or properly provided. According to the government, the companies improperly billed for Gamma function procedures — which measure radiation doses — under circumstances where there was no medically appropriate purpose for the treatment. The allegations leading to the settlement originated in a whistleblower lawsuit filed by Joseph Ting, a former physicist at South Florida Radiation Oncology, under the qui tam provisions of the False Claims Act. He will receive a whistleblower award of more than $7 million from the proceeds of the government’s recovery. This settlement follows on the heels of the $19.75 million settlement 21st Century Oncology Inc. subsidiary 21st Century Oncology LLC agreed to pay in December to settle charges of billing for medically unnecessary laboratory urine tests and for paying kickbacks to encourage physicians to order the tests. Whistleblower Insider

Tagged in: FCA Federal, Lack of Medical Necessity, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

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