KMART Corp. (Kmart) will pay $1.4 million to resolve allegations that it violated the False Claims Act by using drug manufacturer coupons and gasoline discounts as improper Medicare beneficiary inducements. Joshua Leighr, a former Kmart pharmacist, filed the initial complaint alleging that the discount store permitted Medicare beneficiaries to use drug manufacturer coupons to reduce or eliminate prescription co-pays that they otherwise would be obligated to pay. For his efforts, Mr. Leighr will receive approximately $248,500 of the settlement. >> Read More.
Parsons Government Services Inc. has agreed to pay the United States $3.8 million to settle allegations that the company knowingly mischarged the U.S. Department of Energy (DOE) for ineligible or inflated short-term and long-term employee relocation costs in connection with its contract on the DOE Salt Waste Processing Facility Project (SWPF) at the DOE Savannah River Site in Aiken, South Carolina. Parsons sought and obtained reimbursement for these relocation expenses under the SWPF contract even for employees it knew did not qualify for these payments under the terms of the contract. >> Read More.
St. Joseph Hospice Entities, which consists of 13 hospice facilities, will pay $5,867,518 to resolve allegations that they submitted false claims for delivery of continuous home care hospice services to ineligible patients. According to the complaint, a significant number of patients received continuous care hospice services when there was no crisis, and thus, they were not eligible for such services. The allegations in this case arose from a lawsuit filed by 3 whistleblowers, who were former employees of the company. They will receive $1 million for their efforts. >> Read More.
Walter Investment Management Corp. (WIMC) will pay nearly $30 million to settle allegations that WIMC, and a number of its subsidiaries, violated the False Claims Act in connection with their participation in the Department of Housing and Urban Development’s (HUD’s) Home Equity Conversion Mortgages program, which insures “reverse” mortgage loans. According to the complaint, WIMC submitted false claims for debenture interest from HUD when failing to disclose that it had not met certain deadlines and, therefore, was not entitled to such interest payments. WIMC also submitted false claims for the reimbursement of unlawful referral fees by falsely representing them to be lawful sales commissions. Matthew McDonald, a former executive of Reverse Mortgage Solution Inc., a WIMC subsidiary, filed the initial whistleblower suit. Mr. McDonald will receive a $5.5 million relator’s share from the settlement. >> Read More.
Robert Wingfield, of Texas, and Bill Ma, of New Jersey, will pay $385,000 and $50,000, respectively, to resolve allegations that they engaged in a scheme to evade customs duties on imports of aluminum extrusions from the People’s Republic of China (PRC). According to the complaint, Wingfield conspired with domestic importers to submit false information to the government to evade duties, and that Ma later formed a company, Northeastern Aluminum Corp. (Northeastern), to act as the importer of record for the goods in an attempt to shield the real importers from liability. James F. Valenti Jr. brought the initial whistleblower suit. He will receive approximately $79,000 as his share of the settlements. >> Read More.
Columbus Regional Healthcare System (Columbus Regional) and Dr. Andrew Pippas will pay more than $25 million to resolve allegations that they violated the False Claims Act by submitting claims in violation of the Stark Law. According to the complaint, from May 2006 through May 2013, Columbus Regional submitted claims to federal health care programs for services at higher levels than supported by the documentation, and between 2010 and 2012, they submitted claims to federal health care programs for radiation therapy at higher levels than the therapy that was provided. Richard Barker, a former Columbus Regional executive filed the whistleblower suit. Mr. Barker’s share of the settlement has not yet been determined. >> Read More.
Alive Hospice, Inc. paid over $1.5 million to reimburse the government for alleged overbilling of Medicare and TennCare for hospice services. The settlement resolves the government’s allegations that Alive submitted claims to Medicare and TennCare for general inpatient hospice care for patients who did not qualify for that care during the period from June 1, 2010 through December 31, 2012 and for seven patients who did not qualify for general inpatient services on specific dates in 2007 and 2008. Former Alive triage nurse Linda Anderson filed the qui tam suit. Anderson will receive $263,197 as her share of the settlement. >> Read More.
St. Francis Hospital will pay $4 million to settle allegations the hospital improperly billed Medicare and Medicaid for patients admitted into its inpatient rehabilitation unit in Wilmington, Delaware between 2007 and 2010. The settlement agreement also resolves separate allegations that St. Francis employed an individual who was excluded from participating in any Federal health care programs. >> Read More.
PAE Government Services Inc. (PAE) and RM Asia (HK) Limited (RM Asia) will pay $1.45 million to resolve allegations that they engaged in a bid-rigging scheme that resulted in false claims for payment under a U.S. Army contract for services in Afghanistan. According to the complaint, former managers of PAE and RM Asia funneled subcontracts paid for by the government to companies owned by the former managers and their relatives by using confidential bid information to ensure that their companies would beat out other, honest competitors. Steven D. Walker, a former employee of PAE, filed the whistleblower suit. Mr. Walker will receive $261,000. >> Read More.
North Broward Hospital District in Florida will pay $69.5 million to settle allegations that the district violated the False Claims Act and the Stark Law when it engaged in improper financial relationships with doctors who referred patients to the North Broward district. Dr. Michael Reilly, a Florida orthopedic surgeon, filed the initial whistleblower complaint in 2010. Dr. Reilly alleged that North Broward provided nine doctors improper financial compensation that exceeded the fair market value of their services. Based on an analysis of practices and compensation in the region, Dr. Reilly argued that the referring physicians were overpaid by at least $150,000 per year. Dr. Reilly will receive $12 million as his share of the recovery. >> Read More.
Adventist Health System will pay $118 million to settle allegations that Adventist violated the False Claims Act and the Stark Law when it paid doctors excessive compensation for patient referrals. According to the complaint, Adventist submitted false claims to Medicare and Medicaid for services rendered to patients referred by physicians who received bonuses based on a formula that improperly took into account the value of the physicians’ referrals. This is the largest healthcare fraud settlement ever made involving physician referrals to hospitals. The settlement resolves allegations from two lawsuits filed respectively by whistleblowers Michael Payne, Melissa Church and Gloria Pryor, who worked at Adventist’s hospital in Hendersonville, North Carolina, and Sherry Dorsey, who worked at Adventist’s corporate office. >> Read More.
Elizabeth Kressin, D.C., from Spencer, Iowa will pay $62,349 to resolve allegations she violated the False Claims Act by improperly billing the Medicaid system for medically unnecessary chiropractic procedures and for the treatment of conditions for which payment is not allowed, including bed wetting, colic and ear infections. The allegations resolved by the settlement arose from an investigation led by the Department of Health and Human Resources and initiated by the State of Iowa’s Medicaid Program Integrity Unit. >> Read More.
L-3 Communications Corporation, Vertex Aerospace LLC and L-3 Communications Integrated Systems LP (collectively L-3) will pay $4.63 million to resolve allegations that from 2006 through November 2011, L-3 knowingly overcharged the government for time their independent contractors spent at the CRCs by billing for each individual not based on the actual time that individual spent at the CRC, but based instead on the earliest arrival or latest departure time of any other individual who also processed through the center that same day. Martin will receive $798,675 from the recovery. Read More.
American Access Care Holdings, LLC will pay $3,594,791 to resolve allegations that between January 2007 and September 2011, AAC improperly billed Medicare and Medicaid for multiple percutaneous transluminal angioplasties performed during the same patient encounter. The government also alleges that, between October 2005 and September 2011, AAC improperly submitted claims to Medicare and Medicaid for procedures performed during follow-up visits that were not medically necessary. >> Read More.
Pediatric Services of America will pay $6.88 million to resolve allegations it failed to disclose and return overpayments to Medicare and Medicaid for home nursing care visits that the company did not properly document the requisite monthly supervisory visits by a registered nurse and overstated the length of time staff provided services to federal healthcare recipients. The settlement resolves allegations filed by whistle blowers Yvette Odumosu and Sheila McCray. Odumosu and McCray will receive a $1.1 million share of the settlement. >> Read More.
Allied Dental Practices of New Jersey will pay $420,000 to settle allegations that the company deleted patient accounts in which it owed money to insurers and patients. Former Allied Dental financial manager Jennifer D’Agostino filed the whistleblower complaint. She will receive $87,500 as her share of the recovery. >> Read More.
PC Specialists Inc., doing business as Technology Integration Group (TIG), agreed to pay $5.9 million to settle allegations that from 2003 to 2013, TIG sold Dell computers to National Nuclear Security Administration (NNSA) at inflated prices for use at Sandia National Laboratories. TIG failed to include credits for rebates and discounts it received from Dell, thus causing false claims to the government for the inflated prices. Maverick Granger, a former TIG executive, filed the qui tam suit. His share of the settlement has not yet been determined. >> Read More.
HD Supply Waterworks will pay $4,945,000 to resolve allegations that it participated in a scheme designed to take advantage of the Disadvantaged Business Enterprise (DBE) program in order to obtain subcontracts on federally-funded projects. The government alleges that Waterworks enabled several prime contractors to represent falsely that American Indian Builders & Suppliers, Inc. (AIB), a Native American owned company certified as a DBE in New York and in other states, had performed a commercially useful function on federally-funded contracts by negotiating price and other terms of sale when, in reality, the prime contractors had negotiated such terms with Waterworks and used AIB as a pass through. >> Read More.
Mercy Health Springfield Communities and Mercy Clinic Springfield Communities will pay $5.5 million to resolve allegations that the hospitals knowingly submitted false claims for services rendered to patients referred by physicians who received kickback bonuses where the value of the physicians’ referrals of patients to the clinic were used to quantify the bonus amount. Dr. Jean Moore, a physician currently employed by one of the defendants, filed the whistleblower suit. Dr. Moore will receive $825,000 from the recovery announced today. >> Read More.
Oswego Hospital, a 164-bed acute care community hospital located in Oswego, New York will pay $1.4 million to resolve liability stemming from healthcare billing improprieties that the hospital self-disclosed to the federal government. Under the settlements, the United States will receive $1,026,790.89, and the State of New York, which also participated in the investigation, will receive $429,666.44. >> Read More.
East Central Family Health Center of Oklahoma will pay $825,000 to settle allegations that from January 1, 2010, through April 30, 2012 East Central submitted or caused to be submitted false claims for payment to the Oklahoma Medicaid program for behavioral health services furnished to Medicaid beneficiaries. East Central also entered a 5-year Corporate Integrity Agreement with HHS-OIG as part of the settlement. >> Read More.
Three New York hospitals, together with SpecialCare Hospital Management Corporation (SpecialCare), and SpecialCare’s chief executive officer, Robert McNutt, will pay over $8 million to resolve allegations they defrauded Medicare and Medicaid in connection with detoxification treatment provided to patients. The settlements resolved claims brought jointly by the United States and the New York State Attorney General’s Medicaid Fraud Control Unit. According to the complaint, the defendants operated inpatient drug and alcohol detoxification programs under the name "New Vision" without certification from the New York State Office of Alcoholism and Substance Abuse Services. Because the programs were unlicensed, the hospitals were not entitled to bill Medicare and Medicaid for treatment provided to patients. The government also alleged that two of the hospitals, Columbia Memorial and St. Joseph’s, paid SpecialCare for patient referrals in violation of federal and state anti-kickback statutes. Additionally, the government claimed that services provided to New Vision patients were not medically necessary. >> Read More.
Dr. Bashir Azher, M.D., an Arizona-licensed physician paid $207,988 to resolve civil allegations that from February 2006 through July 2014, Dr. Azher knowingly submitted materially false claims for reimbursement for prostate laser ablation procedures that were too short to generate a therapeutic benefit, failed to meet professionally recognized standards of care, were medically unnecessary, and/or violated applicable Medicare regulations. The settlement resolves a lawsuit filed in June 2014 by Dr. Arnaldo Trabucco, M.D. >> Read More.
U.S. Investigations Services Inc. (USIS) and its parent company, Altegrity, will forgo their right to collect payments valued at $30 million in exchange for a release of liability under the False Claims Act in connection with USIS’ deliberate circumvention of contractually required quality reviews of completed background investigations in order to increase the company’s revenues and profits. Blake Percival, a former executive at USIS, originally filed the whistleblower suit. His share of the recovery has yet to be determined. >> Read More.
Sandia Corporation, a wholly-owned subsidiary of Lockheed Martin, will pay $4.7 million to resolve allegations that between 2008 and 2012, the company violated the False Claims Act and the Byrd Amendment by using federal funds to lobby Congress and federal agencies to secure contract renewals. >> Read More.
Quest Diagnostics, Inc. will pay nearly $1.8 million to settle allegations that the company fraudulently performed duplicative lab tests and double billed Medicare for the procedures. Former Quest Diagnostics employee Eliza Martinez filed the whistleblower suit and will receive $358,000 for her efforts. According to the complaint, Quest Diagnostics submitted duplicative claims to Medicare for certain venipuncture services and diagnostic tests and certain panel tests and select components of those panels. >> Read More.
Jeffrey Sponseller, O.D. of Augusta, Sponseller Eye Care One, P.C., and S&H Eye Care, LLC, currently doing business as “Eye Care One,” will pay $275,000 to settle allegations the company submitted bogus claims for the most expensive type of eye examination conducted on nursing home patients when, in reality, either a very short eye examination was conducted, or no examination at all. >> Read More.
EDF Resource Capital Inc. and its CEO, Frank Dinsmore, will pay $6 million to settle allegations the company failed to remit payments owed to the Small Business Administration (SBA) under the 504 loan program. The settlement also resolves a lawsuit filed by the United States against EDF and a related entity, Redemption Reliance LLC, alleging that EDF failed to remit required payments to the SBA to satisfy its loss-sharing obligations. The lawsuit also alleges that the SBA agreed to advance funds to EDF in connection with certain defaulted 504 loans but that, after EDF assigned the loan documents for these loans to Redemption Reliance, neither EDF nor Redemption Reliance remitted the monies owed on these loans to the SBA. >> Read More.
PoleZero Corporation has agreed to pay $2.8 million to resolve allegations from 2004-2013 the company knowingly provided RF filters and ICE equipment to the Air Force that failed to meet contractual specifications. The suit was filed under the qui tam provision of the FCA. The relator will receive $504,000 from the settlement. >> Read More.
John Muir Health will pay $550,000 to resolve allegations that between January 1, 2009, and December 31, 2013, physicians who were contracted with John Muir Health to deliver radiation therapy failed to adequately supervise that treatment. A former employee of John Muir Health filed the qui tam suit and will receive $110,000 as her share of the recovery. >> Read More.
LB&B Associates Inc. and its principals, Lily A. Brandon and F. Edward Brandon will pay $7.8 million to resolve allegations that they made false statements to obtain contracts through the Small Business Administration’s (SBA’s) 8(a) Business Development Program for Small Disadvantaged Businesses. LB&B falsely represented that Lily Brandon – who satisfied the criteria for a socially and economically disadvantaged person under the program – controlled the operations of LB&B, when she did not. The civil settlement resolves a lawsuit filed by Steven O. Sansbury and James T. Buechler, former employees of LB&B. Mr. Sansbury and Mr. Buechler will recover a total of $1.5 million of the settlement. >> Read More.
AstraZeneca LP will pay the United States and participating states a total of $54 million to resolve allegations that it knowingly underpaid rebates owed under the Medicaid Drug Rebate Program. The settlements partially resolve a whistleblower lawsuit filed by pharmacist Ronald J. Streck. His share of the recovery has yet to be determined. >> Read More.
Blanding Health Mart Pharmacy will pay $8 million to resolve allegations that from Feb. 9, 2015, to April 13, 2015 the Jacksonville-based compounding pharmacy knowingly billed the government for improper and medically unnecessary compounding pain prescriptions. >> Read More.
Covan World Wide Moving, Inc., Coleman American Moving Services, Inc., and other related entities will pay $5 million to settle allegations the companies increased the weights of shipments and storage of military service member’s and federal employee’s household goods and then submitted claims for payment to the government for the inflated weights. Two whistleblowers filed the lawsuit, they will receive $1.2 million. >> Read More.
Dr. Neelesh Bangalore, a Stockton oncologist, will pay $736,000 to settle allegations that Bangalore purchased chemotherapy drugs from Warwick Healthcare Solutions Inc., a former United Kingdom-based drug distributer that did not have a license to distribute drugs in the United States. Bangalore administered these drugs to patients, and billing federal healthcare programs. Further, one medication purchased from Warwick was Altuzan, a drug not approved by the FDA. >> Read More.
Commerzbank will pay $866,000 to settle allegations the bank borrowed $350 million from the Federal Reserve while, among other things, helping Iran evade economic sanctions by secretly bringing Iranian gold trading to the United States. Terms of the whistleblower’s share has yet to be released. >> Read More.
California-based medical device manufacturer NuVasive Inc will pay the $13.5 million to resolve allegations that between 2008 and 2013, NuVasive promoted the use of the CoRoent System for surgical uses that were not approved or cleared by the FDA. As a result of this conduct, NuVasive caused physicians and hospitals to submit false claims to federal health care programs for certain spine surgeries that were not eligible for reimbursement. Kevin Ryan, a former NuVasive sales representative, filed the whistleblower suit. Mr. Ryan will receive approximately $2.2 million. >> Read More.
First Tennessee Bank N.A. will pay $212.5 million to resolve allegations that it violated the False Claims Act by knowingly originating and underwriting mortgage loans insured by the U.S. Department of Housing and Urban Development’s (HUD) Federal Housing Administration (FHA) that did not meet applicable requirements. According to the investigation, from January 2006 through October 2008, First Tennessee repeatedly certified FHA insurance mortgage loans that did not meet HUD underwriting requirements. In 2007, First Tennessee significantly increased its FHA originations, while at the same time, the quality of its FHA underwriting significantly decreased. >> Read More.
Nashville-Based Friendship Home Healthcare and related companies pay $6.5 million to resolve allegations that from 2007 through 2013 Friendship billed TennCare for private duty nursing services that were supervised by a woman who was excluded from billing federal and state health care programs and that Friendship submitted forms to TennCare that contained the forged signature of Friendship’s Director of Nursing. Kay Flippo, a practical nurse previously employed by Friendship Home Healthcare file the suit. Her share has not been determined. >> Read More.
Health Management Associates (HMA) and Clearview Regional Medical Center agreed to pay $595,155 to settle allegations that from 2008 through 2009 the hospitals paid kickbacks to an obstetric clinic that served primarily undocumented Hispanic women. The complaint alleges that HMA paid kickbacks to Hispanic Medical Management in return for their agreement to send pregnant women to HMA for deliveries paid for by Medicaid. Former chief financial officer of Walton Regional (a HMA Hospital) Ralph Williams filed the qui tam suit and received $119,031. >> Read More.
Chartwells, the largest food vendor for the Washington DC public school system, will pay $19 million to settle allegations the company overcharged the city and mismanaged its school meal programs, with food often arriving to schools late, spoiled or in short supply. Jeffrey Mills, executive director of the Office of Food and Nutritional Services for D.C. Public Schools starting in 2010 filed the suit. Mills recently settled a separate employment termination suit with the school system claiming he was fired for raising concerns about the Chartwells contract. >> Read More.
Vanguard Health Systems paid $2.9 million to settle allegations the company billed federal healthcare programs for services that were not properly supervised by a physician and were performed by medical “fellows” but billed as performed by physicians. Jacque Lee, a healthcare management professional at MedSynergies, Inc. (a joint venture with Vanguard prior to Tenet’s acquisition of Vanguard) filed the whistleblower suit. Lee will receive 18% of the recovery. >> Read More.
Atlanta dentist Dennis Jaffe will pay $324,327.05 to settle allegations specifically that Jaffe violated the False Claims Act by fraudulently billing Medicaid for tooth extraction procedures and for fraudulently billing for services rendered by a dental assistant when Jaffe was not present in the office. Michelle Smith filed suit under the qui tam, or whistleblower, provisions of the False Claims Act. Her share was not disclosed. >> Read More.
Scott Watry, president and owner of Watry Homes, LLC, will pay $1.6 million to settle allegations the company underpaid wages on federally funded housing projects. Watry Homes, LLC, does roofing, siding, and carpentry work on private residences, commercial projects, and public housing projects in Wisconsin. From 2011 to 2012, Watry Homes performed contracts worth approximately $4.7 million on the Westlawn public housing project in Milwaukee. , Mr. Watry also agreed to pay $659,822 in restitution to workers who were underpaid on the Westlawn project. >> Read More.
Children’s Hospital, Children’s National Medical Center Inc. (CNMC) will pay $12.9 million to resolve allegations that they submitted false cost reports and other applications to state and federal health programs. CNMC misstated information in order to increase reimbursement rates from HHS and Medicaid programs. James A. Roark Sr., a former employee of CNMC filed the suit. Mr. Roark will receive $1,890,649.98. >> Read More.
Hebrew Homes Health Network Inc. and William Zubkoff, the former president and executive director of Hebrew Homes Health Network Inc. have will pay $17 million to resolve allegations that Hebrew Homes operated a sophisticated kickback scheme in which they hired numerous physicians ostensibly as medical directors pursuant to contracts that specified numerous job duties and hourly requirements. The various facilities had several such medical directors under contract at any given time, paying each several thousand dollars monthly. The United States alleged that in reality these were ghost positions, and that most of the medical directors were required to perform few, if any, of their contracted job duties. Instead, they were allegedly paid for their patient referrals to the Hebrew Homes facilities, which increased exponentially once the medical directors were put on the payroll. Stephen Beaujon, a former CFO of Hebrew Homes, filed the whistleblower suit. Mr. Beaujon will receive $4.25 million. >> Read More.
Advanced Homecare, Inc. will pay $1,293,169 to resolve allegation that the company treated patients who were not actually homebound and did not have a valid physician certification of home health need, as required by Medicare. Marsha Yandell, a former employee at Advanced Homecare filed the case. She will receive more than $200,000 as part of today’s settlement. >> Read More.
Inspire Pharmaceuticals (“Inspire”), an Illinois based company, will pay $6 million to settle allegations the company illegally marketed the drug Azasite for off-label uses not approved by the U.S. Food and Drug Administration. The settlement stems from a complaint filed by a whistleblower, Jill DeGuzman, a former Inspire sales manager, her share of the recovery has yet to be determined. >> Read More.
Covenant Hospice Inc. agreed to pay $10,149,374 to settle allegations that between Jan. 1, 2009, and Dec. 31, 2010, Covenant Hospice Inc. improperly submitted hospice claims for general inpatient care that should have been billed at the routine home care level for Medicare, Tricare and Medicaid patients. No whistleblower information was released. >> Read More.
Donald C. Proctor, Jr., M.D., a Mohs surgeon and facial plastic surgeon practicing in Vero Beach, Florida, and Grove Place Surgery Center, LLC, an ambulatory surgical center managed by Dr. Proctor, have agreed to pay $4 million to resolve allegations the center billed Medicare for Mohs surgeries and other surgical procedures that Dr. Proctor either did not perform or were medically unnecessary. Ferdinand F. Becker, M.D., a facial plastic surgeon and former Mohs surgeon who referred patients to Dr. Proctor, and Linda Wildes, who worked as Dr. Proctor’s histology technician for over eight years filed the whistleblower suit. Dr. Becker and Ms. Wildes will receive $920,000. >> Read More.
Edward Berman, MD, will pay $218,633 to resolve allegations he “up-coded” certain services, submitting claims to Medicare by using a higher-paying billing code when services with lower-paying billing codes were actually provided. >> Read More.
VMware Inc. and Carahsoft Technology Corporation have agreed to pay $75.5 million to resolve allegations that they misrepresented commercial pricing practices in connection with the sale of VMware products and services under Carahsoft’s MAS contract. These misrepresentations enabled the companies to overcharge the government for VMware’s products and services from 2007 through 2013. Dane Smith, who is a former vice president of the Americas at VMware Inc., filed the civil lawsuit in the Eastern District of Virginia. Mr. Smith’s share of the recovery has not been determined. >> Read More.
Community Health Network (CHN), a non-profit health system with more than 200 sites of care and affiliates throughout the State of Indiana, will pay $21 million to settle allegations that from late 1990s through October 2009, CHN had contracts with free-standing ambulatory surgery centers or “ASCs” not owned by CHN. Through these contracts, the ASCs would provide out-patient surgical services to CHN patients. CHN would then bill Medicare and Medicaid for the surgical services through the billing departments of its hospitals. When CHN presented the bill to the Medicare and Medicaid contractors, however, the billing information represented that the surgery was performed in the out-patient department of one of CHN’s hospitals, rather than in an ASC. In addition to the settlement, CHN has also agreed to enter into a Corporate Integrity Agreement with HHS-OIG. >> Read More.
Education Affiliates (EA), a for-profit education company based in White Marsh, Maryland will pay $13 million to settle allegations the company altered admissions test results so as to admit unqualified students, created false or fraudulent high school diplomas and falsified students’ federal aid applications, and that multiple EA schools referred prospective students to “diploma mills” to obtain invalid online high school diplomas. Five whistleblowers filed qui tam suits in this case. As part of this resolution, the five whistleblowers will receive payments totaling approximately $1.8 million. >> Read More.
Express Scripts will pay $60 million to resolve allegations that the company participated in a kickback scheme with Novartis wherein the drug maker used different plans – including rebates – to induce specialty pharmacies to boost prescriptions for various drugs. The settlement stems from litigation that originated with David Kester, a former Novartis sales manager who in 2011 filed the qui tam. >> Read More.
San Diego-based companies, Balboa Ambulance Service and E.R. Ambulance, and three Orange County companies, Care Ambulance Service, Pacific Ambulance and Bowers Companies will collectively pay $11.5 million to settle allegations the companies engaged in kickback schemes to secure patient referrals. The companies provided deeply discounted -- and often below-cost --ambulance services to hospitals or skilled-nursing facilities in exchange for exclusive rights to the facilities' more lucrative Medicare patient referrals. Kelvin Carlisle, a competitor in the San Diego, Orange and Los Angeles County ambulance marketplaces, filed the whistleblower suit. He will receive $1.7 million of the recovery. >> Read More.
16 hospitals and their respective corporate parents will pay $15.69 million to resolve False Claims Act allegations that the providers sought and received reimbursement from Medicare for services that were not medically reasonable or necessary. According to the complaint, the respective hospitals submitted fraudulent claims to Medicare for Intensive Outpatient Psychotherapy (IOP) services. The allegation claims the fraudulent billing practices began as early as 2005 and continued through 2013. The whistleblower will receive approximately $2.6 million of the recovery. >> Read More.
PharMerica Corporation will pay $31.5 million to resolve allegations the company violated the Controlled Substances Act by dispensing Schedule II controlled drugs without a valid prescription and violated the False Claims Act by submitting false claims to Medicare for these improperly dispensed drugs. Specifically, PharMerica knowingly caused the submission of false claims to Medicare Part D for improperly dispensed Schedule II drugs. Jennifer Denk, a pharmacist formerly employed by PharMerica, filed the whistleblower suit. Ms. Denk will receive $4.3 million as her share. >> Read More.
United Parcel Service Inc. (UPS) will pay $25 million to resolve allegations that it submitted false claims to the federal government in connection with its delivery of Next Day Air overnight packages. According to the complaint, UPS concealed its failure to comply with its delivery guarantees, thereby depriving federal customers of the ability to request refunds for the late delivery of packages. UPS knowingly recorded inaccurate delivery times on packages, applied inapplicable “exception codes” to excuse late delivery, and provided inaccurate “on-time” performance data under the federal contracts. Robert K. Fulk, a former employee of UPS, filed the suit. Fulk will receive $3.75 million of the settlement. >> Read More.
DaVita HealthCare Partners will pay $495 million to settle allegations the company systematically dumped renal care supplements (Zemplar and Venofer) down the drain in order to increase billing to Medicare and Medicaid. According to the complaint, DaVita administered iron and vitamin supplements such as Zemplar, Vitamin D, and Venofer, vials containing more than what the patients needed and the rest was thrown away. This case was not joined by the Department of Justice; it is the largest settlement for a non-intervened case. Former DaVita employees Alon Vainer and Daniel Barbir filed the whistleblower suit, their share has yet to be finalized. >> Read More.
A federal jury found Dr. Phillip Robinson liable under the False Claims Act for seeking payment from Medicare for more than 11,000 unnecessary eye examinations he provided to nursing home residents. As a result, Dr. Robinson will pay more than $1.2 million. This settlement comes on the heels of January 2015 settlement where Dr. Robinson’s practice group, Associates in Eye Care, paid $800,000 to settle similar allegations. >> Read More.
Jackson-Madison County General Hospital will pay $1.3 million to resolve allegations that from January 2004 through December 2011 it billed Medicare and Medicaid in connection with the placement of unnecessary cardiac stents and other unnecessary cardiac procedures. Dr. Wood D. Deming initially raised the allegations in a whistleblower lawsuit. Dr. Deming’s share has yet to be determined. >> Read More.
Orbit Medical Inc. and Rehab Medical Inc. will pay $7.5 million to resolve allegations that Orbit submitted false claims to federal health care programs for power wheelchairs and accessories. In particular, the government alleged that Orbit sales representatives changed or added dates to physician prescriptions and chart notes to falsely documents that the prescription was sent to the supplier within 45 days of the face-to-face beneficiary exam. The face-to-face exam is required to qualify for reimbursement. Former Orbit employees Dustin Clyde and Tyler Jackson filed the qui tam suit. They will receive approximately $1.5 million of the recovery. >> Read More.
Dr. Sean Orr of Jacksonville, Florida, has agreed to pay $150,000 to settle allegations that from September 2009 to April 2012, Dr. Orr knowingly misdiagnosed certain patients with various neurological disorders, such as multiple sclerosis (MS), which caused federal health care programs to be billed for medically unnecessary services and drugs. Verchetta Wells, a former Baptist Neurology Inc. employee, filed the whistleblower suit. Wells will receive $26,250 from the settlement with Orr. >> Read More.
Medco Health Solutions Inc. will pay $7.9 million to settle allegations that it engaged in a kickback scheme where Medco provided pharmacy benefit management services to clients who receive subsidies under the Medicare Retiree Drug Subsidy program. According to the complaint, Medco solicited remuneration from AstraZeneca, a pharmaceutical manufacturer, in exchange for identifying Nexium as the “sole and exclusive” proton pump inhibitor on certain of Medco’s prescription drug lists known as formularies. Former AstraZeneca employees Paul DiMattia and F. Folger Tuggle, whose share of the settlement has not been determined, filed the lawsuit. >> Read More.
Garden State Cardiovascular Specialists P.C. (Garden State) will pay $3.6 million to resolve allegations that Garden State and its principals, Jasjit Walia M.D. and Preet Randhawa M.D., submitted claims to Medicare for various cardiology diagnostic tests and procedures, including stress tests, cardiac catheterizations and external counterpulsation, which were not medically necessary. Cheryl Mazurek filed the whistleblower lawsuit and will receive more than $648,000 of the recovery. >> Read More.
Medtronic and affiliated Medtronic companies, Medtronic Inc., Medtronic USA Inc., and Medtronic Sofamor Danek USA Inc., paid $4.41 million to resolve allegations that between 2007 and 2014, Medtronic sold the Department of Veterans Affairs (VA) and the U.S. Department of Defense (DoD) products manufactured in China and Malaysia, which are prohibited countries under the Trade Agreements Act of 1979 (TAA). The products at issue include anchoring sleeves sold with cardiac leads used to secure the leads to patients, certain instruments and devices used in spine surgeries, and a handheld patient assistant used with a wireless cardiac device. The suit was filed by three whistleblowers, they will receive a 750,000 share of the recovery. >> Read More.
Air Ideal Inc. and its majority owner, Kim Amkraut, will pay $250,000 to resolve allegations that they made false statements to the Small Business Administration (SBA) to obtain certification as a Historically Underutilized Business Zone (HUBZone) company. The settlement resolves allegations brought by Patricia Hopson, who is employed in the construction industry. As part of the resolution, Ms. Hopson will receive $42,500. >> Read More.
Health Diagnostics Laboratory Inc. (HDL), will pay $47 million to resolve allegations that it paid kickbacks to physicians in exchange for patient referrals and billing federal health care programs for medically unnecessary testing. HDL induced physicians to refer patients for blood tests by paying them processing and handling fees of between $10 and $17 per referral and by routinely waiving patient co-pays and deductibles. As a result, physicians allegedly referred patients to HDL for medically unnecessary tests, which were then billed to federal health care programs. Dr. Michael Mayes, Scarlett Lutz, Kayla Webster and Chris Reidel filed the qui tam suit. The whistleblowers’ share of the settlements has yet to be determined. >> Read More.
The Jacksonville Center for Reproductive Medicine and its owner, Dr. Michael Fox, will pay $98,838.98 to resolve these allegations that from Jan. 1, 2009, until February 2013, Fox operated a fertility practice that billed for services at a higher rate of reimbursement than appropriate. U.S. attorneys said this case was developed by proactively mining health care reimbursement data. >> Read More.
Sprint has agreed to pay $15.5 million to settle allegations that the telecommunications company overbilled the government while conducting “court-ordered intercepts” of its customers. The suit asserted that Sprint violated the False Claims Act, an anti-fraud law, and broke federal regulations that forbid companies from using government reimbursements to update unrelated equipment or services. >> Read More.
C.W. Matthews Contracting, a Marietta, GA based construction firm will pay $1 million dollars to settle allegations that it submitted false and misleading certifications to the Government regarding work performed on several federally funded highway construction projects as well as the company`s compliance with the U.S. Department of Transportation`s Disadvantaged Business Enterprise . According to the complaint, between 2006 and 2007, C.W. Matthews was awarded several highway construction contracts that contained DBE clauses. The investigation found that C.W. Matthews accepted DBE contracts and then contracted with non-DBE companies, a direct violation of the contract. >> Read More.
Dr. Zheng Ziang Wang of the Wang Eye Clinic PC paid $790,000 to settle allegations he submitted claims for payment of certain eye procedures that were not medically necessary. In addition to the fine, Dr. Wang is barred for 5 years from participating in all government health-care programs. >> Read More.
Asbury Health Center, a continuing-care retirement community located in Pittsburgh, will pay the United States $1,331,837.96 concerning billings submitted to Medicare for skilled nursing facility services. The settlement results from a self-disclosure by Asbury. >> Read More.
Family Dermatology P.C. will pay $3,247,835 plus interest to settle allegations that it engaged in improper financial relationships with a number of its employed physicians. The allegations arose from three separate lawsuits filed by three whistleblowers, Scott M. Ross MD, Mark F. Baucom and Harold Milstein MD. The whistleblowers will collectively receive more than $584,000 of the settlement. >> Read More.
Citizens Medical Center will pay $21.8 million to settle allegations that it illegally paid doctors for referrals. According to the complaint, the hospital paid several cardiologists more than the fair market value of their services and paid bonuses to emergency room doctors based partly on the value of their cardiology referrals. The allegations stem from a whistle-blower complaint filed by three physicians who had privileges to practice at the hospital at the time: Dr. Dakshesh “Kumar” Parikh, Dr. Harish Chandna and Dr. Ajay Gaalla. They will collectively receive nearly $6 million of the recovery. >> Read More.
R.J. Zavoral & Sons, Inc., John Zavoral, Peter Zavoral and Craig Pietruszewski will pay $1.85 million to resolve allegations that they violated the False Claims Act and the Financial Institutions Reform, Recovery, and Enforcement Act by making false statements to the Small Business Administration (SBA) and the U.S. Army Corps of Engineers. According to the complaint, the Defendants made numerous false statements to both the SBA and the Corps of Engineers in order to be awarded a Heartsville Coulee Diversion Section 8(a) contract. >> Read More.
The Medical Center of Central Georgia (MCCG) will pay $20 million to settle allegations that the hospital billed Medicare for more expensive inpatient services that should have been billed as less costly outpatient or observation services. As part of this agreement, MCCG entered into a corporate integrity agreement with (HHS-OIG). Under the agreement, MCCG is required to retain an independent review organization to review the accuracy of the company’s claims for services furnished to federal health care program beneficiaries. >> Read More.
nLight Photonics, Inc. (nLight), a privately-held, Vancouver, Washington-based manufacturer of high performance diode and fiber lasers will $420,000 to resolve allegations that between 2004 and 2013, the company violated the False Claims Act when it successfully pursued funding under the Small Business Innovation Research (SBIR) program from the Army, Navy, Air Force, NASA and Department of Energy. nLight initially flagged its ineligibility for the SBIR program in response to a request for information by an alert Department of Energy contracting officer overseeing both an nLight SBIR grant as well as an SBIR grant awarded to a company that nLight had acquired. >> Read More.
Hospital Authority of Irwin County (ICH) will pay $520,000 for alleged violations of the False Claims Act and the Stark Law in connection to the amount of compensation paid by ICH to Dr. Amin, with ICH's leases with physicians, and the supervision of certain diagnostic imaging services at ICH. Former ICH employees, Connie Brogdon and Summer Holland, filed the qui tam suit. >> Read More.
Life Focus Center of Charlestown, Inc. will pay $94,000 for allegedly violated the Massachusetts False Claims Act by billing more hours of service than were actually provided to a MassHealth member from 2008 through 2011, resulting in overpayments. According to the settlement, from December 2008 to February 2011, Life Focus Center allegedly engaged in a scheme where it billed MassHealth for day habilitation services not rendered to a developmentally disabled MassHealth member who either did not attend at all or rarely attended the day habilitation program. >> Read More.
Former Westfield State University president Evan S. Dobelle has agreed to pay $185,000 to settle a lawsuit brought by the attorney general, ending almost two years of litigation and controversy over his spending of school funds on international travel, limos, fancy hotels and expensive meals. According to the complaint, Dobelle misspent nearly $100,000 in university funds on personal expenses, violating the state’s False Claims Act. >> Read More.
Gilbane Building Company paid $1.1 million to resolve allegations that W.G. Mills Incorporated – a company with which Gilbane merged in November 2010 – violated the False Claims Act by creating a front company, Veterans Constructors Incorporated (VCI), in order to qualify for a Coast Guard contract designated for Service Disabled Veteran Owned Small Businesses (SDVOSBs). To qualify as a SDVOSB, a company must be operated and managed by service-disabled veterans and must not be affiliated with a large company. >> Read More.
Mental Health Association of Rockland County, Inc. paid $304,000 to resolve claims that its managers and employees altered records in advance of a Medicaid audit. “Audits are an important tool in protecting Medicaid funds that should be used to provide health care to millions of New Yorkers,” Attorney General Schneiderman said. This settlement comes on the heels of a $6 million settlement with a Bronx for-profit hospice provider. >> Read More.
BioTelemetry Inc., a heart monitoring company headquartered in Malvern, Pennsylvania, paid $6.4 million to resolve allegations that its subsidiary, CardioNet, overbilled Medicare and other federal health programs for Mobile Cardiac Outpatient Telemetry (MCOT) services when those services were not reasonable or medically necessary. >> Read More.
Dr. Charles Denham, of Laguna Beach, California, will pay $1 million to settle allegations that he received monthly payments from CareFusion Corporation while serving as the co-chair of the Safe Practices Committee, which reviews, endorses and recommends standardized healthcare performance measures and practices. Denham solicited and received payments in exchange for influencing the recommendations to the National Quality Forum and for recommending, promoting and/or arranging for the purchase of CareFusion’s products. >> Read More.
Recovery Home Care and National Home Care Holdings LLC paid $1.1 million to resolve allegations that the Recovery Home Care entities improperly paid doctors for referrals of home health care services provided to Medicare patients. According to the lawsuit, the physicians were over-compensated for work performed and, in reality, payments to the physicians were used to induce them to refer their patients to Recovery Home Care. Gregory Simony, a former employee of Recovery Home Care filed the suit. Simony will receive $198,000 of the recovered funds. >> Read More.
Tangible Software, Inc., owned and operated by Energy Management and Security Solutions, LLC since 2011, will pay between $500,000 and $1.05 million to resolve allegations that it submitted claims for reimbursement of costs associated with contracts with the GSA and Defense Information Systems Agency knowing that the requested reimbursements of costs exceeded what Tangible Software actually paid for the services. The whistleblower, Michael Bradle will receive a minimum of $80,000 from the settlement. >> Read More.
Hencorp Becstone Capital L.C. will pay $3.8 million to resolve allegations that it made false statements and claims to the Export-Import Bank of the United States in order to obtain loan guarantees. According to the complaint, Ricardo Maza, a Peruvian-based former Hencorp business agent, created false documentation to obtain Ex-Im Bank guarantees on fictitious transactions on which no products were sold or exported, and that Hencorp acted recklessly by outsourcing key credit review functions to Maza without adequate supervision or oversight. Genaro Benites Caballero, the former owner of one of the purported purchasers with no involvement in the fraud, and Patricia Doris Lee Dominguez, a former attorney for the purported purchaser filed the lawsuit. They will receive $608,000 of the settlement. >> Read More.
Lend Lease Construction, Inc. and Cindell Construction Company will pay $400,000 to settle allegations in connection with an agreement to perform construction work to renovate a property the government is currently leasing in Reston, Virginia known as “Patriots Park.” Lend Lease and Cindell submitted false claims to the government after lower-tier subcontractors hired by Cindell underpaid workers and failed to compensate the workers properly for overtime hours despite certifying compliance on weekly certified payrolls. >> Read More.
Fireman’s Fund Insurance Company will pay $44 million to settle allegations under the it knowingly issued insurance policies that were ineligible under the U.S. Department of Agriculture’s (USDA) federal crop insurance program and falsified documents. According to the complaint, between Jan. 1, 1999, and Dec. 31, 2002, Fireman’s Fund knowingly backdated policies, forged farmers’ signatures, accepted late and altered documents, whited-out dates and signatures, and signed documents after relevant deadlines. >> Read More.
Coastal Dermatology and its owner, Dr. Sanjiva Goyal, will pay $787,814 to resolve allegations that from Jan. 1, 2009, until April 2014 Goyal routinely billed for cosmetic dermatological procedures not covered under Medicare and TRICARE and billed at higher rate of reimbursement than appropriate. In mining through the data, Coastal Dermatology was identified as a top biller of procedures related to skin lesion removal procedures and removal of inflamed seborrheic keratoses, authorities said. >> Read More.
Portage Hospital, LLC, now UP Health System Portage, will pay $4.4 million to settle allegations that between January 1, 2006 and November 30, 2013, staff therapists provided medically unnecessary procedures to Medicare patients and failed to maintain adequate documentation of medical necessity. The settlement stems from a self-disclosure to the U.S. Department of Health & Human Services. >> Read More.
Miami-Dade County Transit will pay $10 million to settle allegations that the department misappropriated federal grants and failed to include mandatory clauses in its federal procurement contracts to create spending loopholes. Former Transit Authority employee Marjan Mazza filed the whistleblower suit. She will receive nearly $4 million as her part of the settlement which also includes a wrongful termination settlement. >> Read More.
Robinson Health System Inc. will pay $10 million to settle claims that it had improper business relationships with two physicians groups that violated ant-kickback provisions. According to the complaint, these physicians allegedly failed to provide sufficient bona fide management services to have justified the payments that they received. This was the result of Robinson’s self-disclosure of the violations. >> Read More.
MetLife Home Loans LLC will pay $123.5 million to resolve allegations that from September 2008 through March 2012, it violated the False Claims Act by repeatedly certifying FHA insurance mortgage loans that did not meet HUD underwriting requirements. MetLife’s conduct caused FHA to insure hundreds of loans that were not eligible for insurance and, as a result, FHA suffered substantial losses when it later paid insurance claims on those loans. >> Read More.
Acadiana Cardiology LLC, Acadiana Cardiovascular Center and convicted doctor, Mehmood Patel, M.D., will pay $650,000 for the submission of claims for unnecessary cardiovascular, endovascular and related procedures. Dr. Christopher Mallavarapu, a cardiologist who formerly practiced with Patel, filed the whistleblower suit. >> Read More.
Agility Health and Oceana County Medical Care Facility will pay $1 million to resolve allegations each knowingly submitted false claims to Medicare for in-patient skilled therapy services that were not provided and not medically necessary. Three whistleblowers filed the suit. They will share $200,000 of the settlement proceeds. >> Read More.
Prabhjit S. Purewal, M.D., a Manteca based oncologist, agreed to pay the $550,000 to settle allegations that he defrauded Medicare, Tricare and Medicaid by billing for chemotherapy drugs the US Food and Drug Administration had not approved for use in the United States. >> Read More.
Dr. Alan Buhler will pay $1.047 million and Dr. Craig Prokos will pay $90,000 to settle allegations that they violated the False Claims Act when their wives accepted sham marketer salaries in exchange for their husbands’ referrals to a home health care company called A Plus Home Health Care Inc. William Guthrie, a former director of development at A Plus Home filed the qui tam suit. >> Read More.
Dickson Medical Associates (DMA) has agreed to pay $500,000 to settle allegations that it violated the False Claims Act when a DMA doctor imported and distributed foreign, non-FDA approved prescription drugs, which is prohibited under the Food, Drug and Cosmetic Act. >> Read More.
Compassionate Care Hospice of New York, LLC will pay $6 million to settle allegations the hospice submitted false and fraudulent claims to the state Medicaid program and Medicare for hospice services not rendered or inadequately provided. The $6 million settlement will provide $1.68 million back to Medicaid, of which $1.08 will go to New York State. The remainder of the settlement funds will go back to the Medicare program. >> Read More.
California-based C.R. Laurence Co. Inc., Florida-based Southeastern Aluminum Products Inc. and Texas-based Waterfall Group LLC have agreed to pay $2,300,000, $650,000 and $100,000, respectively, to resolve allegations that the companies engaged in schemes to evade customs duties on imports of aluminum extrusions from the People’s Republic of China (PRC). Whistleblower James F. Valenti Jr., filed the qui tam suit. He will receive $555,100 as his share of the settlements. >> Read More.
Baptist Health Medical Center-North Little Rock will pay $2.7 million to settle claims that it improperly billed the federal Medicare program for hospital stays lasting fewer than two nights. As part of the settlement, the hospital entered a five-year "corporate integrity agreement" requiring Baptist Health Medical Center-North Little Rock and Baptist Health Medical Center-Little Rock to be subject to independent annual claims reviews. >> Read More.
Dr. Mark Heinicke, a Louisville physician pleaded guilty this week to a criminal charge of treating patients with misbranded medications and was sentenced to a term of one year probation and ordered to pay restitution in the amount of $176,915.55. In a separate civil agreement, Dr. Heinicke agreed to pay $338,493.30. According to the civil settlement, Dr. Heinicke purchased foreign, non-FDA approved products and used these products on Medicare recipients and thereafter submitted or caused to be submitted false claims to Medicare. >> Read More.
AstraZeneca LP agreed to pay the government $7.9 million to settle allegations that it engaged in a kickback scheme to provide remuneration to Medco Health Solutions, a pharmacy benefit manager, in exchange for Medco maintaining Nexium’s “sole and exclusive” status on certain Medco formularies and through other marketing activities related to those Medco formularies. Former AstraZeneca employees Paul DiMattia and F. Folger Tuggle, who will collectively receive $1,422,000, filed the lawsuit. >> Read More.
ResCare Iowa Inc. will pay $5.63 million to resolve allegations that it submitted false home healthcare bills to the government for services provided to Medicare and Medicaid patients in Iowa without documenting that it followed specific compliance protocol. The state of Iowa, which paid part of the Medicaid funds at issue, will receive $2.32 million of the settlement amount. >> Read More.
Good Shepherd Hospice Inc. agreed to pay $4 million to resolve allegations that submitted false claims for hospice patients who were not terminally ill. The complaint alleges that Good Shepherd engaged in certain business practices , such as pressuring staff to meet admissions and census targets and paying bonuses to staff, including hospice marketers, admissions nurses and executive directors, based on the number of patients enrolled, that contributed to the false claims. Kathi Cordingley and Tracy Jones, former employees of Good Shepherd, filed the complaint. They will receive approximately $680,000 of the recovery. >> Read More.
Medtronic Inc. will pay $2.8 million to resolve allegations that Medtronic caused certain physicians to submit false claims for a medical procedure known as “SubQ stimulation.” The complaint alleges that even though the safety and efficacy of SubQ stimulation had not been established Medtronic promoted this procedure by, among other strategies, arranging to have physician-customers attend Medtronic-sponsored “on-site training programs” regarding the use of Medtronic spinal cord stimulation devices for SubQ stimulation. Jason Nickell, who formerly worked as a Medtronic sales representative, filed the lawsuit. Nickell will receive $602,000. >> Read More.
ev3 Inc., formerly known as Fox Hollow Technologies Inc., will pay $1.25 million to resolve allegations that Fox Hollow caused certain hospitals to submit false claims to Medicare for unnecessary inpatient admissions related to minimally-invasive atherectomy procedures. Amanda Cashi, who formerly worked as a Fox Hollow sales representative, filed the lawsuit. Cashi will receive $250,000. >> Read More.
Ageless Men's Health LLC will pay $1.6 million to settle allegations the clinic company billed for a medically unnecessary office visit each time a testosterone shot was administered. Ageless Men's Health agreed to enhanced accountability measures to be supervised by the Department of Health and Human Services' Office of Inspector General. These include monitoring by both internal and external auditors. >> Read More.
Eye Care P.S.C. (“AEC”), will pay $800,000 to settle allegations that it billed federal health care programs for medically unnecessary and worthless eye examinations provided to nursing home residents over the course of several years. The government alleges that because of the high number of patients seen by AEC optometrist Dr. Robinson on a daily basis, it was not possible for all of the patients to receive a legitimate eye exam. Therefore, the exams had no medical value. >> Read More.
Community Health Systems Professional Services Corporation (CHSPSC) and three affiliated New Mexico hospitals (CHS) will pay $75 million to settle allegations of donating to county governments, which were used to fund the state share of Medicaid payments to the hospitals. The settlement stems from a whistleblower complaint filed by a former CHSPSC revenue manager, Robert Baker. Baker will receive $18,671,561 as his share of the government’s recovery. >> Read More.
A central Florida based dermatology practice run by Dr. Michael Steppie will pay $3 million to settle allegations the practice knowingly billed the government for procedures that were not medically necessary and performed by unlicensed and unsupervised employees. Katherine Brown, Amber Bradshaw, and Vanessa Santos, former employees at the clinic filed the qui tam suit. They will receive more than $500,000 as their share of the settlement. >> Read More.
Composite Engineering Inc., a Northern California defense contractor, will pay $2 million to settle allegations the company artificially inflated the cost of materials and the amount of labor needed for spare parts for the Air Force Subscale Aerial Target program. >> Read More
Green Bag, Co. will pay $500,000 to settle a Customs Duties avoidance allegation. In this case, Green Bag kept two sets of books; one for the true cost of goods so manufacturers could be paid, and a fabricated book for underreporting costs to the United States Customs and Border Protection personnel. >> Read More.
Lafferty Enterprises of Kentucky will pay $948,000 to settle accusations that it violated the False Claims Act by unnecessarily transporting Medicare patients to and from dialysis clinics by ambulance from 2006 to 2012. Kevin Fairlie, the former owner of another Eastern Kentucky ambulance company, filed the complaint. Fairlie will receive $189,600 of the settlement. >> Read More.
Sea Mar Health Centers will pay $3.35 million to settle allegations of improperly billing Medicaid for routine “fee-for-service” payments as “encounters”, which effectively increased each bill by over $100 dollars per visit per patient. Further, Sea Mar exceeded the number of dental exams allowed per patient under Medicaid, without any documentation of the findings of such exams or that the exams were actually performed. >> Read More.
Nason Medical Centers and two of its owners, Dr. Baron S. Nason and Robert T. Hamilton will pay $1 million to settle allegations that Nason submitted claims for services that were not provided, for radiological services performed by unlicensed technicians, and for tests that were deemed medically unnecessary. Two former Nason Medical employees filed the qui tam suit and will receive $184,000 share of the recovery. >> Read More.
The Medical College of Wisconsin paid $840,000 to resolve allegations that the college knowingly billed federal health care programs for neurosurgeries involving residents who did not receive the required level of supervision from teaching physicians. Medicare will pay for a teaching physician's services only if the teacher is present for the surgery's key parts and either remains immediately available throughout the surgery or else arranges for a back-up surgeon to be available. The Medical College allegedly billed for teaching physicians' services even though they did not satisfy the supervision requirements. >> Read More.
Daiichi Sankyo Inc. will pay $39 million to resolve allegations that it violated the False Claims Act by paying kickbacks to induce physicians to prescribe Daiichi drugs, including Azor, Benicar, Tribenzor and Welchol. Daiichi will also enter a Corporate Integrity Agreement as part of the settlement. Kathy Fragoules, a former Daiichi sales representative, filed the qui tam suit and will receive $6.1 million of the recovery. >> Read More.
Kaplan Inc. will pay $1.3 million to settle allegations that it employed unqualified instructors at its medical assistant program in San Antonio. Leslie Coleman, a former Kaplan employee, filed the qui tam lawsuit in 2012. The majority of the settlement will be applied toward outstanding loan balances of 289 medical assistant students. Coleman will receive $212,158 as part of the settlement. >> Read More.
North Atlantic Medical Services Inc. (NAMS), doing business as Regional Home Care Inc., will pay $852,378 to resolve allegations that from September 2010 to January 2013, NAMS used unlicensed employees to set up sleep apnea masks and oxygen therapy equipment for patients in Massachusetts. Former NAMS employees Konstantinos Gakis and Demetri Papageorgiou filed the qui tam suit. Gakis and Papageorgiou will receive $153,428. >> Read More.
Maricopa County Community College District (MCCCD) will pay $4.08 million to resolve allegations it submitted false claims to the Corporation for National and Community Service (CNCS) concerning AmeriCorps state and national grants. MCCCD allegedly improperly certified that students had completed the required number of service hours so that they would earn an education award. MCCCD also allegedly improperly received grant funds from CNCS to administer the project. The allegations resolved by this settlement arose from a whistleblower lawsuit filed by Christine Hunt, an MCCCD employee. Hunt’s share of the settlement is $775,827. >> Read More.
Rite Aid Corporation paid $2.99 million to resolve allegations that it offered illegal inducements to Medicare and Medicaid beneficiaries to transfer their prescriptions to Rite Aid pharmacies. From 2008 to 2010, Rite Aid knowingly and improperly influenced the decisions of Medicare and Medicaid beneficiaries by offering them gift cards in exchange for their business. Jack Chin filed the qui tam suit and will receive approximately $508,300 of the settlement. >> Read More.
DHS Technologies LLC and its subsidiary, DHS Systems LLC, have agreed to pay the federal government more than $1.9 million for failing to disclose to the General Services Administration that it offered greater discounts to a private company for the same items during the negotiation for a government contract. Sharon McKinney, the former contracting officer at DHS, initiated the lawsuit under the qui tam provision of the False Claims Act. >> Read More.
Supreme Foodservice, a “prime vendor” of food and related items to the Department of Defense and coalition troops in Afghanistan from 2005 until at least 2009, will pay $389.3 million, including $101 million in civil fines under the False Claims Act and a $288.3 million in criminal fines and restitution for overcharging and systematically bill-padding on food, water and fuel. >> Read More.
Stryker Corp. will pay $40 million under the False Claims Act and an additional $40 million in criminal penalties and its OtisMed subsidiary are excluded from doing business with Medicare, Medicaid and other government health programs for 20 years. The settlement resolves claims the company sold and intentionally distributed knee replacement surgery cutting guides after the FDA rejected them. Whistleblower Richard Adrian, a former Stryker sales executive, will get $7 million for initiating this part of the case, first filed in 2009. Between May 2006 and September 2009, OtisMed sold more than 18,000 OtisKnee devices, generating revenue of approximately $27.1 million. >> Read More.
Chabad of California (“Chabad”) will pay $844,985 for failing to comply with federal grant requirements. Chabad falsely assured the government of having written financial management procedures in place to regulate the use of grant funds. According to the complaint, no written financial management procedures existed, and Chabad allegedly used $127,745 for non-grant purposes, and misappropriated $272,495 in total under the grant. >> Read More.
The Regents of the University of California will pay $499,700 to resolve civil allegations under the False Claims Act that the University of California at Davis submitted false and misleading statements in connection with obtaining grants from the Department of Energy (DOE) and the National Science Foundation (NSF). The suit alleged that the false and misleading statements caused the DOE and NSF to approve duplicative grant funding. >> Read More.
The Research Foundation for the State University of New York will pay $3,750,000 to resolve allegations that its Center for Development of Human Services (CDHS) violated the False Claims Act by manipulating audits it performed of federally funded health care programs in New York State. In addition to the settlement, the Research Foundation has enhanced compliance measures, including appointing a Chief Compliance Officer to oversee the administration of the activities it sponsors. >> Read More.
Eyak Technology LLC (EyakTek) and Eyak Services LLC (ESL) will pay $2.5 million resolve allegations that between September 12, 2007, and October 4, 2011, EyakTek’s then-director of contracts, Harold Babb, accepted kickbacks from several subcontractors to direct subcontracts to them. EyakTek and ESL allegedly submitted invoices to the Army Corps that included charges for work that was never performed and lacked internal controls to detect the improper charges. In March 2012, Babb pleaded guilty to bribery and kickback charges. The U.S. District Court for the District of Columbia sentenced him to serve 87 months in prison, to be followed by 36 months of supervised release and more than $9 million in restitution for his role in the kickback scheme. >> Read More.
VMG Pulmonary, Sleep Institute and its physician/owner, Dr. Marivic Villa, will pay $250,000 to settle allegations that from January 1, 2009, until November 2012, they collectively billed the government for hundreds of thousands of dollars of services that were not medically necessary, and that were performed by unlicensed employees. This lawsuit was filed by Donald Nichols, a former employee at the clinic. Nichols will receive more than $50,000 as part of today’s settlement. >> Read More.
NP Precision Inc and its owner, Kenneth Narzikul, will pay $3.6 million to settle allegations the company violated provisions of the federal False Claims Act when it diverted government payments from NP subcontractors, and forged invoices and checks to hide their wrongdoing during an audit. Former NP employee Amy Farrow filed the whistleblower suit, she will receive a 20% share of the recovery. >> Read More.
St. Helena Hospital, an acute care hospital within the Adventist Health System will pay $2.2 million to settle allegations the hospital knowingly charged Medicare for medically unnecessary percutaneous coronary interventions and unnecessarily admitted angioplasty patients who should have been treated on a less costly, outpatient basis. Kacie Carroll, a former employee of St. Helena Hospital, filed the suit and will receive $450,000 from the recovery. >> Read More.
Iron Mountain Incorporated and Iron Mountain Information Management LLC (collectively Iron Mountain) paid $44.5 million to resolve allegations Iron Mountain violated the federal False Claims Act when overcharging federal agencies for record storage services under General Services Administration (GSA) contracts. The civil lawsuit was filed by Brent Stanley, a former Iron Mountain employee, and Patrick McKillop, who worked in the records management industry. Collectively, they will receive $8,010,000. >> Read More.
Lockheed Martin Integrated Systems (LMIS) will pay $27.5 million to resolve allegations that it knowingly overbilled the government for work performed by LMIS employees who lacked required job qualifications. The alleged labor mischarging occurred on the Rapid Response (CR2) contract and the Strategic Services Sourcing (S3) contract, both issued by the U.S. Army Communication and Electronics Command (CECOM). >> Read More.
Easton Hospital will pay $662,000 to settle allegations it billed Medicare for certain medical procedures performed by urologist Dr. Thomas Walden that were not performed, were only partially completed or were medically unnecessary. Two former hospital employees, David Kasprzak and David Heaton, filed the qui tam suit; their share of the recovery was not released. >> Read More.
Mark Goldman and Mark Goldman Associates (MGA) will pay $105,000 to settle allegations they violated provisions of the federal False Claims Act when failing to properly account for grant money given to Justice Planners International, a joint venture created to provide juvenile detention center consulting services to Native American tribes. >> Read More.
Arbon Equipment Corporation and Rite-Hite Holding Corporation paid $4 million to settle allegations the companies violated “prevailing wage laws,” which include the federal Davis-Bacon Act and Service Contract Act, and certain provision of the California Labor Code. Whistleblower and Arbon employee Mark Brooks filed the qui tam suit under provisions of the federal and California False Claims Act. Mr. Brooks will receive an award of $1,164,000. >> Read More.
Verizon New England Inc. (Verizon) paid $1.3 million to resolve allegations that the company overcharged the Commonweath of Massachusetts for telecommunications services under a statewide procurement contract. The company allegedly invoiced certain state contract customers for a variety of items and services at rates higher than those permitted by the state contract. >> Read More.
Northampton Hospital Company, LLC and Northampton Hospital Corporation, doing business as Easton Hospital (“Easton Hospital”) will pay $662,000 to settle allegations that the hospital billed Medicare for procedures performed by Dr. Thomas Walden, including extracorporeal shock wave lithotripsy, cystometrogram, green light laser, and transurethral resection of the prostate that were not performed by him and that were medically unnecessary. Easton Hospital employees David Kasprzak and David Heaton filed the whistleblower suit. >> Read More.
Ocean Dental PC, of Stillwater, Oklahoma, will pay more than $5 million to settle allegations that it violated the False Claims Act by submitting false Medicaid claims for dental work that was never performed or billed at a higher rate than allowed. Ocean Dental PC, which operates 28 clinics in seven states, did not admit any liability in the settlement, although one of its former dentists was sentenced to prison in 2012 after pleading guilty to health care fraud. >> Read More.
Office Depot will pay $68.5 million, plus legal fees, to settle a whistleblower-initiated California False Claims Act lawsuit alleging the company overcharging governmental jurisdictions across the state by failing to deliver guaranteed “most favored public entity” pricing on goods. The case was originally filed in 2009 by former Office Depot employee David Sherwin who died of cancer at age 59 in March of this year. 19 government agencies joined the California case, and some 1,200 local governments across California will benefit. >> Read More.
Biotronik Inc. will pay $4.9 million to resolve allegations that the company provided kickbacks to induce physicians to use devices that it manufactured and sold, causing hospitals and ambulatory surgery centers to submit false claims to Medicare and Medicaid. Whistleblower, and Former Biotronik employee, Brian Sant, will receive approximately $840,000 of the federal settlement. >> Read More.
CareAll Management LLC will pay $25 million to resolve allegations that between 2006 and 2013, the company overstated the severity of patients’ conditions to increase billings to Medicare and Medicaid, and billed for services that were not medically necessary and rendered to patients who were not homebound. The qui tam suit was brought by Toney Gonzales, CareAll’s former Director Services. Mr. Gonzales will receive $3.9 million from the recovery. >> Read More.
Sevenson Environmental Services Inc., will pay $2.72 million to resolve allegations that it engaged in bid rigging and inflated charges to the U.S. Environmental Protection Agency (EPA) in connection with work performed at the Federal Creosote Superfund Site in Manville, New Jersey. Sevenson allegedly solicited and accepted more than $1.6 million in kickbacks from six companies in exchange for the award of subcontracts for work at the Federal Creosote Site. >> Read More.
Dr. Gilbert Lederman, the infamous New York oncologist who treated George Harrison and pressed him, on his deathbed, to sign a guitar, will pay over $2.3 million to settle allegations that he knowingly misrepresented charges to Medicare for thousands of radiosurgery treatments that were not eligible for reimbursement, causing millions of dollars in wrongful payments. >> Read More.
DRS Technical Services Inc. (DRS) will pay $13.7 million to settle allegations that it violated the False Claims Act by knowingly overbilling the government for work performed by unqualified personnel. From Jan. 1, 2003, to Dec. 31, 2012, DRS billed Army’s Communication and Electronics Command (CECOM) for work performed by individuals whose job qualifications did not meet all the qualifications prescribed by the contracts for the labor categories under which their efforts were billed, thereby falsely increasing the amount of money DRS claimed and CECOM paid. >> Read More.
Extendicare Health Services Inc. (Extendicare) and its subsidiary Progressive Step Corporation (ProStep) will pay $38 million to resolve allegations that Extendicare billed Medicare and Medicaid for materially substandard nursing services that were so deficient that they were effectively worthless and billed Medicare for medically unreasonable and unnecessary rehabilitation therapy services. Two whistleblowers brought separate cases against Extendicare. Tracy Lovvron will receive more than $1.8 million as her share Donald Gallick will receive more than $250,000 as his share. >> Read More.
The Boeing Company paid $23 million to resolve allegations that it submitted false claims for labor charges on maintenance contracts with the U.S. Air Force for the C-17 Globemaster aircraft. The government alleged that the company knowingly and improperly billed a variety of labor costs in violation of applicable contract requirements, including for time its mechanics spent at meetings not directly related to the contracts. The settlement resolves allegations originally brought in a lawsuit by present and former Boeing employees Clinton Craddock, Fred Van Shoubrouek, Anthony Rico and Fernando de la Garza. They will collectively receive $3,910,000 as their share of the settlement. >> Read More.
CareMed will pay $9.5 million for alleged false statements to insurance companies to secure prior authorization for the coverage of drugs by and for engaging in double-billing by re-stocking unused dosages of Procrit and Rituxan, and then re-selling the drugs and re-billing insurance companies that provide prescription drug coverage to Medicare beneficiaries or Medicaid. >> Read More.
Organon will pay $34 million to settle allegations that it underpaid rebates to state Medicaid programs, offered improper financial incentives to nursing home pharmacy companies, promoted its antidepressants for unapproved uses, and misrepresented its drug prices to New York’s Medicaid program. The settlement resulted from two whistleblower lawsuits, their share has not been disclosed. >> Read More.
Medical Business Service, Inc., will pay $1.95 million to settle claims that it fraudulently changed diagnosis codes on claims to Medicare and Medicaid, in order to get the rejected claims paid on behalf of radiologists. This settlement resolves a lawsuit filed by whistleblower Katlisa N. Vaughn. Her share of the settlement has not been disclosed. >> Read More.
One Step Diagnostic and a group of centers owned and controlled by Rahul Dhawan will pay $2.6 million to settle allegations they entered into sham consulting and medical director agreements with physicians who referred patients to One Step Diagnostic Centers. The suit alleged these centers engaged in improper financial relationships with referring physicians and improperly billed Medicare using the provider number of a physician who had not authorized them to do so. >> Read More.
Thermacore, a Lancaster, Pa. based thermal technology company will pay $965,000 to settle allegations that the company violated conditions of the Small Business Innovation Research program when submitting research-funding proposals to NASA and the Air Force. >> Read More.
Science Applications International Corporation (SAIC) will pay $1.5 million to resolve allegations that it knowingly engaged in prohibited conflicts of interest as a contractor for the U.S. Nuclear Regulatory Commission (NRC) between 1992 and 2000. Under these contracts, SAIC was required to avoid conflicting business relationships that could bias SAIC’s work for the NRC. SAIC repeatedly and falsely certified that it had no such conflicting business relationships, when SAIC actually engaged in multiple business relationships with entities that had a financial interest in the outcome of the NRC’s rulemaking effort. >> Read More.
Satyabrata Chatterjee and Ashwini Anand joint owners of Cumberland Clinic, will pay $380,000 to resolve allegations that they violated the False Claims Act by entering into sham management agreements with Saint Joseph Hospital in exchange for the referral of cardiology procedures and other healthcare services to Saint Joseph. The settlement stems from a complaint filed by three cardiologists; Drs. Michael Jones, Paula Hollingsworth and Michael Rukavina, will collectively receive $68,400. >> Read More.
Bostwick Laboratories, Inc., an anatomic and pathology lab based in Uniondale, New York, will pay $6,048,000 to resolve allegations that Bostwick improperly billed Medicare and Medicaid for tests and services referred in violation of the Anti-Kickback Statute and for tests performed without a doctor's order or consent. >> Read More.
DaVita will pay $400 million to settle civil charges involving kickbacks to doctors. Announced by the US Department of Justice tonight, this is the largest settlement that covers solely allegations of kickbacks in the healthcare industry. David Barbetta, a former DaVita employee in the mergers and acquisitions department, filed the qui tam suit in 2009. >> Read More.
First RF Corporation (First RF), an antenna and radio system company located in Boulder, Colorado, will pay $10 million to settle allegations that it submitted inflated claims for electronic warfare antennas sold to the U.S. Army to combat Improvised Explosive Devices. The qui tam suit alleged that First RF knowingly submitted false data to the Army that misrepresented First RF’s cost to manufacture the antennas, and thereby inflated the price for the antennas and the payments First RF received for them. >> Read More
Columbia University will pay more than $9 million to resolve allegations it of submitting false claims in connection with grants obtained to fund AIDS- and HIV-related work. Allegedly, Columbia wrongly charged many grants for work that was not dedicated to the funded projects, even though it had an obligation to track its employees' efforts from 2004 to 2012. The case stemmed from a whistleblower complaint filed in 2011 by Craig Love, who was ICAP's director of finance from 2008 to 2011, the lawsuit said. >> Read More.
EBI LLC, will pay $6.07 million to resolve allegations that it paid kickbacks to induce use of its bone growth stimulators and billed federal health care programs for refurbished stimulators. The settlement resolves in part an allegation filed by whistleblower. Yu Yue, a former product manager for EBI. Yu’s share has not yet been determined. >> Read More.
Dr. Charles L. Bennett, a former cancer research physician at Northwestern University’s Robert H. Lurie Comprehensive Center for Cancer, will pay the United States $475,000 to settle allegations he submitted improper claims for professional and consulting services, food, hotels, travel, conference registration fees, and other from Jan. 1, 2003, through Aug. 31, 2010. The allegations were initially brought in 2009 by Melissa Theis, who in 2007 and 2008 worked as a purchasing coordinator in hematology and oncology at Northwestern’s Feinberg School of Medicine. She will receive $80,750 >> Read More.
Dignity Health will pay $37 million to settle allegations that 13 of its hospitals in California, Nevada and Arizona knowingly submitted false claims to Medicare and TRICARE by admitting patients who could have been treated on a less costly, outpatient basis. The allegations involved cardiovascular and kyphoplasty procedures. Former Dignity employee Kathleen Hawkins filed the qui tam suit. Hawkins will receive approximately $6.25 million. >> Read More.
North Florida Shipyards and its president, Matt Self, will pay $1 million to resolve allegations that they created a front company, Ind-Mar Services Inc. in order to be awarded Coast Guard contracts that were designated for Service Disabled Veteran Owned Small Businesses (SDVOSBs). To qualify as a SDVOSB on Coast Guard ship repair contracts, a company must be operated and managed by service disabled veterans and must perform at least 51 percent of the labor. Robert Hallstein and Earle Yerger filed the whistleblower suit; they will receive $180,000. >> Read More.