False Claims Act

Michael R. Barr, former chief executive officer for HealthEssentials Solutions Inc., has agreed to pay $1 million to resolve allegations that he violated the False Claims Act by causing HealthEssentials to submit false claims to Medicare, the Justice Department announced today.

The government alleged that HealthEssentials billed for services that were inflated or not medically necessary and that Barr pressured HealthEssentials employees to inflate the company’s billings, despite having been advised by attorneys and others that doing so would be improper. The government further alleged that Barr pressured HealthEssentials employees to conduct special medical assessments on patients, without regard to whether the patients required the assessments, solely to increase the amount that HealthEssentials could bill for the visits. 

As part of the settlement, Barr has agreed to a three-year period of exclusion from participating in federally funded health care programs. Norman J. Pfaadt, HealthEssentials’ former chief financial officer, also agreed to pay $20,000 to resolve similar allegations.

The lawsuit was originally filed by Michael and Leigh RoBards, former HealthEssentials employees, 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.  Michael and Leigh RoBards will receive a total of $153,000 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 and how you can take action.

Dr. Ravi Sharma has agreed to pay $400,000 to resolve allegations that he and his clinics violated the False Claims Act by billing Medicare for vein injections and physician office visits performed by unqualified personnel, the Justice Department announced yesterday.

Sharma, who owned and operated the clinic Premier Vein Centers, allegedly messaged his office manager instructing her to perform varicose vein injections on patients when he was not in the office. The government further alleged that, when Sharma was in the office, he performed unnecessary vein injections and ultrasound imaging procedures associated with those vein injections.

Further allegations claim that Sharma also owned and operated a weight loss clinic called Life’s New Image, which billed patient visits with unqualified personnel as physician office visits using his own Medicare provider number.

As part of the settlement, Sharma entered into a three-year Integrity Agreement with the Office of Inspector General of the Department of Health and Human Services. The agreement requires Sharma to attend training courses provided by the Centers for Medicare and Medicaid Services and provides for an independent external review of his federal health care program coding and billing procedures.  

The lawsuit was originally filed by Patti Lovell, a former office manager for Sharma, 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.  Lovell will receive $72,000 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.

St. James Healthcare (St. James) and its parent company, Sisters of Charity of Leavenworth Health System (Sisters of Charity), have agreed to pay $3.85 million to resolve allegations that they violated the False Claims Act, the Anti-Kickback Statute and the Stark Law, the Department of Justice announced today.

Allegedly, St. James knowingly provided financial benefits to physicians and physician groups that made referrals to the hospital. The Anti-Kickback Statute prohibits the provision of remuneration with the intent to induce referrals of government health care program business.  The Stark Law restricts financial relationships that hospitals may enter into with physicians who refer patients to them.  Federal law prohibits payment by federal health care programs of medical claims that result from arrangements that violate the Anti-Kickback Statute or the Stark Law.

The settlement resolves allegations that St. James and Sisters of Charity provided various improper financial incentives to physicians and physician groups that were involved in a joint venture with St. James to own and operate a medical office building on the St. James campus.  These incentives included a payment to the joint venture that increased the share values for the physicians and physician groups resulting in below fair market value lease rates for the physicians renting space in the medical office building.  Additional incentives provided by St. James and Sisters of Charity included below fair market value lease rates for the land upon which the medical office building was constructed and other below fair market value arrangements related to shared facilities, use and maintenance. 

Under the False Claims Act, private parties with knowledge of fraud against the government may sue on behalf of the government and share in the recovery.  Had there been a whistleblower in this case, their portion of the settlement may have been anywhere from 15 to 30 percent.

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.

Illinois-based Abbott Laboratories has agreed to pay the United States $5.475 million to resolve allegations that the company violated the False Claims Act by paying kickbacks to induce doctors to implant the company’s vascular products, the Justice Department announced today.  Abbott is a global pharmaceuticals and health care products company.

The settlement resolves allegations that Abbott knowingly paid prominent physicians for teaching assignments, speaking engagements and conferences with the expectation that these physicians would arrange for the hospitals with which they were affiliated to purchase Abbott’s carotid, biliary and peripheral vascular products.  As a result, the United States alleged Abbott violated the Anti-Kickback Act and caused the submission of false claims to Medicare for the procedures in which these Abbott products were used.

The lawsuit was originally brought by Steven Peters and Douglas Gray, former Abbott employees, 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.  Peters and Gray will receive over $1 million 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.

The Justice Department secured $3.8 billion for settlements and judgments from civil cases involving fraud against the government in the 2013 fiscal year, the U.S. Department of Justice announced today.

This amount, which is the second largest annual recovery of its type in history, brings total recoveries under the False Claims Act, since 2009, to $17 billion – nearly half the total recoveries since the Act was amended 27 years ago in 1986.

The Justice Department’s efforts recovered more than $3 billion for the fourth year in a row. As in previous years, the largest recoveries were related to health care fraud, which reached $2.6 billion. Procurement fraud (related primarily to defense contracts) accounted for another $890 million – a record in that area.

Of the $3.8 billion the department recovered in 2013, $2.9 billion was the result of lawsuits filed under the qui tam provisions of the False Claims Act. During the same period, the department paid out more than $345 million to the individuals who exposed fraud and false claims by filing a qui tam complaint. 

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 uncover fraud of every kind perpetrated against our 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.