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Whistleblower News From The Inside -- September 21, 2015

Posted  September 21, 2015

By the C|C Whistleblower Lawyer Team

United States Intervenes in False Claims Act Lawsuit against Mississippi Hospital –  The United States has intervened in a lawsuit and filed a complaint against Stone County Hospital, its management company  Corporate Management Inc., and individuals who own and control both companies, for submitting false claims to the Medicare program by knowingly charging excessive and ineligible expenses from 2002 to the present.  Because Stone County Hospital is a “critical access hospital,” a status recognizing the role of such facilities in offering hospital coverage in rural, underserved areas, it is entitled to receive 101 percent of the actual and allowable costs of providing Medicare beneficiaries with outpatient, inpatient, laboratory, ambulance and post-acute care services, so long as those costs are reasonable and necessary.  The government’s complaint alleges that the individual defendants claimed excessive compensation, and wrongfully claimed a personal luxury automobile on the hospital’s cost report.  The government’s complaint was filed in a lawsuit initially brought by a whistleblower under the False Claims Act.  DOJ

Medical Biller Sentenced to 45 Months in Prison for Role in $4 Million Health Care Fraud Scheme – The medical biller of a Chicago-area visiting physician practice was sentenced on Friday to 45 months in prison for her role in a $4 million health care fraud scheme.  From 2007 to 2011, defendant Mary Talaga was the primary medical biller at Medicall Physicians Group Ltd., a physician practice that visited patients in their homes and prescribed home health care.  The evidence at trial showed that Talaga and her co-conspirators routinely billed Medicare for overseeing patient care plans when, in fact, the doctors at Medicall rarely provided the service.  The evidence at trial also showed that Talaga and her co-conspirators billed Medicare for other services that were never provided, including services rendered to patients who were deceased, services purportedly provided by medical professionals no longer employed by Medicall, and services purportedly provided by medical professionals who, based on billing records, worked over 24 hours per day.  DOJ

SEC Fielding Flood Of Whistleblower Tips, Boston Head Says – In an interview with Law360, Securities and Exchange Commission Boston regional director Paul Levenson said of whistleblower reports, “It’s been a steady fire hose of information for quite some time. . . .  We are approaching the task systematically, making sure that tips are promptly addressed, triaged and directed where they need to go. Within the financial industry, we are beginning to see a change in culture and a recognition that coming forward with critical information is an essential part of our enforcement program.”  Levenson said retaliation would continue to be a key focus for the SEC as the whistleblower program gains steam.  “The law is clear: You can’t try to muzzle employees to keep them from talking to the SEC about violations,” he said.  Law360 (subscription)

EPA:   Volkswagen used ‘defeat device’ to illegally skirt air-pollution controls – The EPA has alleged that for at least five years, Volkswagen officials illegally rigged their vehicles’ pollution-control systems so they would run cleanly only during emissions tests, while spewing higher levels of pollutants on the highway.  The EPA joined California state officials in accusing the German automaker of deliberately circumventing air-pollution laws with the use of a software “defeat device” installed on nearly 500,000 Volkswagen and Audi diesel models sold in the United States  since 2008. If substantiated, the violation could lead to billions of dollars in penalties and repair costs, agency officials said.  The issue was first detected by university researchers testing the cars, who reported their findings to EPA.  Volkswagen has halted sales of the affected cars and will undertake a recall.  WaPo

Judge: Anti-Planned Parenthood group must turn over evidence – A federal judge said Friday that the anti-abortion group targeting Planned Parenthood with hidden cameras cannot refuse to turn over potential pieces of evidence by pleading the Fifth Amendment.  Judge William Orrick said in a hearing that the Center for Medical Progress must comply with the court’s requests for documents, escalating the weeks-long legal battle over the secret videos. The organization’s founder, David Daleiden, had previously told the court that the group planned to invoke the Fifth Amendment right against self-incrimination.  The Hill