False Claims Act

Hope Cancer Institute to Settle False Healthcare Claims for $2.9M

Submitted by mma on April 15, 2014
April 15, 2014
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Kansas-based Hope Cancer Institute and its owner Dr. Raj Sadasvian have agreed to pay $2.9 million to resolve allegations that they knowingly submitted or caused the submission of false claims to Medicare, Medicaid, and the Federal Employee Health Benefits Program, the U.S. Department of Justice announced yesterday.

The settlement resolves allegations that Sadasivan and Hope Cancer Institute submitted claims to federal health benefit programs for chemotherapy drugs that were not provided to federal health care beneficiaries.  Sadasivan allegedly instructed the employees of Hope Cancer Institute to bill for a predetermined amount of cancer drugs at certain dosage levels, when lower dosages of these drugs were actually provided to beneficiaries.   As a result of these instructions, Hope Cancer Institute submitted inflated claims to federal health care programs for drugs that were not actually provided to patients.

The lawsuit was originally filed by three former employees of Hope Cancer Institute 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 whistleblowers’ portion of the settlement has not yet been determined.

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 andhow you can take action.

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DC Clinics Settle False Medicare Claims for $2.8M; Whistleblower to Get $400K

Submitted by mma on April 10, 2014
April 10, 2014
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Alliance Rehabilitation, LLC and Active Physical Therapy Services, LLC, along with three individuals associated with those businesses, have agreed to pay the federal government $2.78 million to settle allegations that the companies knowingly submitted or caused the submission of false claims to Medicare and the TRICARE health care program, the U.S. Attorney’s Office for the District of Columbia announced yesterday.

The settlement resolves allegations that the companies submitted claims which falsely represented that the physical therapy services being billed were either rendered or directly supervised by the physical therapist identified on the claims by his or her National Provider Identifier (NPI) number. In fact, the physical therapist identified on the claim had no involvement in the services rendered.  The settlement also resolves allegations that Alliance Rehabilitation, LLC, and Active Physical Therapy Services, LLC, sought payment from TRICARE for physical therapy services that were not provided by the physical therapist identified on the claim.

In addition to the False Claims Act settlement, the companies and the associated individuals have entered into a five-year Corporate Integrity Agreement with the U.S Department of Human Health and Services Office of Inspector General.  That agreement imposes integrity obligations on each of the entities and individuals and requires them, among other things, to retain an independent review organization to review their coding, billing, and claims submissions to Federal health care programs.

The lawsuit was originally filed by two former Alliance employees 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 whistleblowers in this case will receive $400,000 as their 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 andhow you can take action.

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CA Companies Settle False Claims For $1.9M; Whistleblower to Get $393K

Submitted by mma on April 9, 2014
April 9, 2014
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Five California-based masonry subcontractors and two individuals have agreed to pay the government $1.9 million to resolve allegations that the parties violated the False Claims Act in connection with military construction contracts, the U.S. Department of Justice announced today.  The defendants allegedly misrepresented their status as disadvantaged small businesses.  The defendants are Frazier Masonry Corp., F-Y Inc., CTI Concrete & Masonry Inc., Masonry Technology Inc., Masonry Works Inc., Russell Frazier and Robert Yowell. 

The case involved contracts to construct facilities at Marine Corps bases at Camp Lejeune, N.C., and Camp Pendleton, Calif.  Under the rules of the Small Business Administration, the contracts required that a certain percentage of the work be performed by disadvantaged small businesses.  This contract requirement was intended to benefit small firms owned by women, minorities and other disadvantaged groups. 

The government alleged that the defendant masonry subcontractors and their principals misrepresented to the prime contractors that they were small businesses, and that these misrepresentations caused the prime contractors to falsely certify that they had complied with the small business provisions of the contracts in claiming payment.  Russell Frazier previously pleaded guilty in related criminal proceedings to causing false statements.

The lawsuit was originally filed by Rickey Howard, a former employee of Frazier Masonry Corp., 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.  Howard will receive $393,383 as his 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 andhow you can take action.

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Sikorsky Settles False Contract Claims for $3.5M

Submitted by mma on April 2, 2014
April 2, 2014
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Connecticut-based Sikorsky Aircraft Corporation has agreed to pay $3.5 million to settle allegations that the company knowingly submitted or caused the submission of false claims in connection with inflated prices for Black Hawk helicopter parts, the U.S. Attorney’s Office for the District of Connecticut announced earlier this week.

Sikorsky, which manufactures Black Hawk helicopters and spare parts for the U.S. military, allegedly failed to disclose accurate, complete and current cost and pricing data to the Army Aviation and Missile Life Cycle Management Command (“AMCOM”).  AMCOM is one of the purchasing commands of the Army that is charged with purchasing spare parts for the Black Hawk.

The Truth In Negotiations Act requires that contractors disclose accurate, complete and current cost and pricing data to the government during the negotiation process.  When determining the prices to be charged to the government, Sikorsky failed to disclose that it had lower prices for certain parts.  As a result, the government paid artificially excessive prices for those parts.

The False Claims Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.  Had there been a whistleblower in this case, the whistleblower could have received up to a million dollars as their 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.

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Lantheus Settles False Claims For $6.2M; Whistleblower to Get $1.1M

Submitted by mma on March 26, 2014
March 26, 2014
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Lantheus Medical Imaging and Bristol-Myers Squibb have agreed to pay $6.2 million to settle allegations that the company failed to pay New York State and City taxes, in violation of the False Claims Act, the New York Attorney General’s office announced.

Lantheus and its former parent company, Bristol-Myers Squibb, allegedly did not pay applicable New York State business franchise taxes, New York City corporation taxes or MTA surcharges from 2002 to 2006, when Lantheus was known as Bristol-Myers Squibb Medical Imaging. During that period, the company derived substantial revenues from its sales of medical imaging products to hospitals, clinics and other facilities in New York and from its training and servicing activities in connection with its sales.

The lawsuit was originally filed by a tax services provider who became aware of Lantheus’ failure to pay New York taxes, under the whistleblower provision of New York’s False Claims Act.  The Act is one of the state's most powerful civil fraud enforcement tools because it allows whistleblowers and prosecutors to take legal action against companies or individuals that defraud the government.  Under the False Claims Act, whistleblowers may be eligible to receive up to 30 percent of any money recovered by the government as a result of information they provide. The whistleblower in this action will receive $1.1 million from the settlement proceeds.

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.

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BizLink Settles False Claims For $1.2M; Whistleblower to Get $252K

Submitted by mma on March 25, 2014
March 25, 2014
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California-based Bizlink Technology, Inc. (BTI) has agreed to pay $1.2 million to settle allegations that the company violated the False Claims Act by underpaying customs duties owed on goods imported from China, the U.S. Attorney’s Office for the Northern District of California announced earlier this month.

BTI allegedly underpaid customs duties on goods that BTI imported into the United States from Bizlink International Electronics Co., Ltd., a factory in Shenzhen, China. BTI allegedly obtained two sets of invoices for each shipment from the Chinese factory: one true invoice that BTI paid, and a second invoice falsely stating a lower cost. The false invoices were allegedly used to calculate the customs duties that BTI paid on the imported goods, resulting in substantial underpayments.

The lawsuit was originally filed by a former employee of BTI under the whistleblower provision 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 unnamed whistleblower will receive $252,000 as his 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.

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American Family Care Settles False Medicare Claims for $1.2M

Submitted by mma on March 19, 2014
March 19, 2014
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American Family Care Inc. has agreed to pay $1.2 million to settle allegations that the company knowingly submitted or caused the submission of false claims to the federal health care program Medicare, the U.S. Department of Justice announced today.  American Family Care is a network of walk-in medical clinics headquartered in Birmingham, Ala., with offices in Alabama, Tennessee and Georgia.

Following guidance adopted by the Centers for Medicare and Medicaid Services, health clinics such as American Family Care bill Medicare for their services by selecting a corresponding Evaluation and Management code.  The codes are divided into five different levels - from basic (level 1) to most complex (level 5).  Higher level codes result in higher reimbursement from Medicare than lower level codes.  The government alleged that American Family Care knowingly selected Evaluation and Management codes for a level of services that exceeded those actually provided in order to artificially increase the amount of reimbursement it received for those visits.

The lawsuit was originally filed by Anita C. Salters, a former American Family Care employee, under the whistleblower provision 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.  Salters’ portion of the settlement has not yet been determined.

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.

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Hospice Settles False Healthcare Claims for $3.9M; Whistleblowers to Get $712K

Submitted by mma on March 14, 2014
March 14, 2014
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CLP HealthcareServices, the parent company of Hospice Compassus, has agreed to pay $3.92 million to the U.S. government to settle allegations that the company knowingly submitted or caused the submission of false claims to federal health care programs, the U.S. Attorney’s Office for the Northern District of Alabama announced yesterday.

Hospices provide palliative care – any form of medical care or treatment that concentrates on reducing the severity of disease symptoms – to patients who decide to forego curative care of their illness. Medicare beneficiaries are entitled to hospice care if they have a prognosis of six months or less to live. The government alleged that Hospice Compassus was submitting false claims for hospice care for patients who were not eligible for such care.

The two lawsuits were originally filed by two former Hospice Compassus employees under the whistleblower provision 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 recover.  The unnamed whistleblowers received $712,000 between them as their 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.

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JPMorgan Whistleblower Gets $63.9M

Submitted by mma on March 13, 2014
March 13, 2014
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Keith Edwards, the whistleblower who provided tips that led to JPMorgan & Chase’s $614 million False Claims Act settlement, will receive $63.9 million as his portion of the settlement, the Chicago Tribune reported last week.  Edwards was formerly an employee of JPMorgan.

JPMC admitted that, for more than a decade, it approved thousands of Federal Housing Administration (FHA) loans and hundreds of Veterans Affairs (VA) loans that were not eligible for FHA or VA insurance because they did not meet applicable agency underwriting requirements. JPMC further admitted that it failed to inform the FHA and the VA when its own internal reviews discovered more than 500 defective loans that never should have been submitted for FHA and VA insurance. 

JPMC also falsely certified that loans it originated and underwrote were qualified for FHA and VA insurance and guarantees. As a consequence of JPMC’s misrepresentations, both the FHA and the VA incurred substantial losses when unqualified loans failed and caused the FHA and VA to cover the associated losses.

The lawsuit was originally filed by Edwards under the whistleblower provisions of the False Claims Act. The False Claims Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in 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.

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Halifax Settles False Medicare Claims for $85M; Whistleblower to Get $20.8M

Submitted by mma on March 11, 2014
March 11, 2014
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Florida-based Halifax Hospital Medical Center and Halifax Staffing Inc. (Halifax) have agreed to pay $85 million to settle allegations that the companies knowingly submitted or caused the submission of false claims to Medicare, in violation of the False Claims Act, the U.S. Department of Justice announced today.  Halifax allegedly also violated the Stark Law.

The Stark Law forbids a hospital from billing Medicare for certain services referred by physicians who have a financial relationship with the hospital.  In this case, the government alleged that Halifax knowingly violated the Stark Law by executing contracts with six medical oncologists that provided an incentive bonus that improperly included the value of prescription drugs and tests that the oncologists ordered and Halifax billed to Medicare.  The government also alleged that Halifax knowingly violated the Stark Law by paying three neurosurgeons more than the fair market value of their work.

As part of the settlement announced today, Halifax also has agreed to enter into a Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General (HHS-OIG), which obligates Halifax to undertake substantial internal compliance reforms and to submit its federal health care program claims to independent review for the next five years.

The allegations were originally made in a lawsuit filed by Elin Baklid-Kunz, a former employee of Halifax, under the whistleblower provision 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.  Baklid-Kunz will receive $20.8 million.

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.

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