False Claims Act

SunTrust Mortgage Inc. has agreed to pay $968 million to resolve False Claims Act violations in connection with mortgage origination, servicing, and foreclosure abuses, the U.S. Department of Justice announced earlier this week.  About half, $418 million, resolve SunTrust’s liability; the rest will provide consumer relief for homeowners.

SunTrust admitted that between January 2006 and March 2012, it originated and underwrote Federal Housing Administration (FHA)-insured mortgages that did not meet FHA requirements, that it failed to carry out an effective quality control program to identify non-compliant loans, and that it failed to self-report to HUD even the defective loans it did identify.  SunTrust also admitted that numerous audits and other documents disseminated to its management described significant flaws and inadequacies in SunTrust’s origination, underwriting, and quality control processes, and notified SunTrust management that as many as 50 percent or more of SunTrust’s FHA-insured mortgages did not comply with FHA requirements.

SunTrust has agreed to provide $500 million in relief in the next three years directly to borrowers and homeowners in the form of reducing the principal on mortgages for borrowers who are at risk of default, reducing mortgage interest rates for homeowners who are current but underwater on their mortgages, and other relief.  The settlement will likely provide direct benefits to borrowers far in excess of $500 million because SunTrust will not be permitted to claim credit for every dollar spent on the required consumer relief.  SunTrust has also agreed to pay $50 million in cash to redress its servicing practices, $40 million of which will be distributed to borrowers and homeowners through the Borrower Payment Fund established by the NMS and administered by the states. 

The joint federal-state agreement also requires SunTrust to implement significant changes in how they service mortgage loans, handle foreclosures, and ensure the accuracy of information provided in federal bankruptcy court.  The agreement requires new servicing standards which will prevent foreclosure abuses of the past, such as robo-signing, improper documentation and lost paperwork, and create dozens of new consumer protections.  The new standards provide for strict oversight of foreclosure processing, including third-party vendors, and new requirements to undertake pre-filing reviews of certain documents filed in bankruptcy court. 

The new servicing standards ensure that foreclosure is a last resort by requiring SunTrust to evaluate homeowners for other loss mitigation options first.  In addition, SunTrust is restricted from foreclosing while the homeowner is being considered for a loan modification.  The new standards also include procedures and timelines for reviewing loan modification applications and give homeowners the right to appeal denials.  SunTrust will also be required to simplify the process for homeowners needing help by creating a single point of contact for borrowers seeking information about their loans and—importantly—maintaining adequate staff to handle calls.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

A lawsuit accusing OneWest Bank FSB, formerly known as IndyMac Bancorp Inc., of knowingly submitting or causing the submission of false claims to a federal mortgage program has been unsealed, Reuters reported.  The U.S. government paid out over $200 million as a result of the alleged fraud.

The complaint was filed by Michael Fisher, who worked on modifications for OneWest from 2008 to 2012, and alleges that OneWest violated the Home Affordable Modification Program (HAMP).  OneWest allegedly loaned new principle without itemizing as required, thereby not providing required disclosure of terms such as payment amounts, interest rates, finance charges, and late payment policies.  The lawsuit says that as a result of these false statements, the government paid $206 million under HAMP to help homeowners avoid foreclosure.

The lawsuit was filed under the whistleblower provisions of the False Claims Act, which allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.  The Act also allows the government to intervene in such cases, which it has elected not to do in this case.  Should Fisher prevail, he will be entitled to up to 30 percent of the recovery.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

The Medical Center of Southeastern Oklahoma (MCSO) and its parent, Health Management Associates, Inc., have agreed to pay $1,065,000 to the U.S. and $435,000 to the State of Oklahoma to resolve allegations that the hospital knowingly submitted or caused the submission of false claims to the Oklahoma Medicaid Program, the U.S. Attorney’s Office for the Eastern District of Oklahoma announced last month.  MCSO is an acute care hospital located in Durant, Okla.  HMA was acquired by Community Health Systems last year.

The settlement announced today resolves allegations that MCSO submitted claims to SoonerCare for surgical procedures performed by Dr. Daniel Castro, and related hospital services that were not medically necessary. The surgical procedures in question were functional endoscopic sinus surgeries (FESS) performed by Dr. Castro on children who were SoonerCare beneficiaries. According to the United States, Dr. Castro performed FESS’s on children that were not medically indicated, and Dr. Castro and the hospital billed SoonerCare for the unnecessary surgeries and related hospital services. The settlement also resolves claims that MCSO billed SoonerCare for hospital services related to FESS’s that Dr. Castro did not actually perform.

The allegations that the government has settled with MCSO and HMA were raised in a lawsuit filed under the qui tam, or whistleblower, provisions of the False Claims Act. The Act allows private citizens with knowledge of fraud to bring civil actions on behalf of the government and to share in any recovery. The whistleblower, Sandra Simmons, will receive $159,750 as part of today’s settlement.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

CRC Health Corp. has agreed to pay $9.25 million to settle allegations that the company knowingly submitted or caused the submission of false claims to Medicaid and Tennessee Medicaid, the U.S. Department of Justice announced last week.  CRC is a nationwide provider of substance abuse and mental health treatment services.

CRC owns and operates a residential substance abuse treatment facility in Burns, Tenn., called New Life Lodge.  The government alleged that New Life Lodge billed the Tennessee Medicaid program (TennCare) for substance abuse therapy services that were not provided or were provided by therapists who were not properly licensed by the state of Tennessee.  The government also alleged that New Life Lodge failed to make a licensed psychiatrist available to patients at the facility, as required by the state’s regulations; failed to maintain patient-staffing ratios required by Tennessee Department of Mental Health regulations and billed for Medicaid patients in excess of the state-licensed bed capacity at the facility.  In addition, the government alleged that New Life Lodge double-billed Medicaid for prescription substance abuse medications given to residents at the facility.  New Life Lodge currently is not treating Medicaid patients at its facility.

The allegations were originally raised in a lawsuit filed by Angie Cederoth, a former New Life Lodge employee, under the whistleblower provisions of the False Claims Act.  The Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.  Cederoth will receive $1.5 million as her portion of the settlement.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

The federal government has intervened in a False Claims Act lawsuit against Orbit Medical Inc. and its former Vice President Jake Kilgore, alleging that Orbit Medical’s sales representatives boosted power wheelchair and accessory sales by altering and forging physician prescriptions and supporting documentation, the Justice Department announced earlier this week.

Medicare pays for power wheelchairs for beneficiaries who cannot perform mobility- related activities of daily living in their home using other mobility assistance equipment, such as a cane, walker or power scooter. To qualify for reimbursement, a physician must conduct a face-to-face examination of the beneficiary and provide the supplier with a written prescription for a power wheelchair within 45 days of such an encounter, along with documentation that supports the medical necessity of the device. The prescription must be completed by the physician who performed the exam and must include the beneficiary’s name, the exam date, the diagnoses and conditions the wheelchair is expected to accommodate, the length of need, and the physician’s signature.  

The lawsuit alleges that Orbit Medical sales representatives, at Kilgore’s direction and encouragement, knowingly altered physician prescriptions and supporting documentation to get Orbit Medical’s power wheelchair and accessory claims paid by Medicare, the Federal Employees Health Benefits Plan, and the Defense Health Agency. In particular, the lawsuit alleges that Orbit Medical sales representatives created documents to falsely establish that physicians examined beneficiaries in person; changed physicians’ prescriptions to falsely establish medical necessity for the power wheelchair or accessory; created or altered chart notes and other documents to falsely establish the medical necessity of the power wheelchair or accessory; forged physicians’ signatures on prescriptions and chart notes; and added facsimile stamps to supporting documentation to make it appear as though physicians’ offices had sent the documents to Orbit Medical.  

On Oct. 23, 2013, a federal grand jury in Utah indicted Jake Kilgore on three counts of health care fraud, three counts of false statements related to health care and three counts of wire fraud, all arising from his tenure with Orbit Medical.

The lawsuit was originally filed by two former Orbit employees, Dustin Clyde and Tyler Jackson, under the whistleblower provisions of the False Claims Act.  The Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.  The Act also allows the government to intervene, which it has elected to do in this case.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.