qui tam lawsuit

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.

Genzyme Corp. (Genzyme) has agreed to pay $22.28 million to resolve allegations, under the False Claims Act, that they knowingly marketed and caused false claims to be submitted to federal and state health care programs for use of a “slurry” version of its Seprafilm adhesion barrier, the Justice Department announced today. 

 Seprafilm is a thin film intended to reduce adhesions after surgery by forming a bio-resorbable barrier between abdominal tissue and organs. Genzyme sales representatives allegedly taught doctors and other staff to cut the Seprafilm sheets into small pieces, add saline and allow the pieces to dissolve until the desired consistency was reached.  This mixture was referred to as “slurry.” Genzyme sales representatives traded recipes for slurry, and trained each other in how to create it. The slurry was used in laparoscopic or “key hole” surgeries by inserting a catheter filled with the mixture into the body and squirting it into the abdominal cavity. Seprafilm is FDA-approved for use in open abdominal surgery but not for minimally invasive surgeries, such as laparoscopic or key hole surgery.  As a result of this conduct, Genzyme knowingly caused hospitals and other purchasers of Seprafilm to submit false and fraudulent claims to federal health care programs for uses of Seprafilm that were not approved and therefore not reimbursable.

The lawsuit was originally filed by Christopher Russo and Joseph Fuentes, two former Genzyme employees, under the whistleblower provision 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. Russo’s and Fuentes’ share 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 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.

Cardiologist Dr. Elie H. Korban (Korban) will pay $1.15 million to resolve False Claims Act allegations that he billed Medicare and Medicaid for medically unnecessary cardiac stent placements, the Justice Department announced today.

Cardiac stents are mesh tubes placed in coronary arteries of patients to keep their arteries open during the treatment of coronary heart disease.  The government alleges that Korban placed cardiac stents in Medicare and Medicaid patients when the stents were not medically necessary and improperly billed Medicare for work performed by substitute doctors when he was available to perform the services himself. 

As part of the settlement, Korban entered into an Integrity Agreement with the Department of Health and Human Services Office of Inspector General intended to deter wrongful conduct in the future.  The agreement requires enhanced accountability and monitoring activities to be conducted by both internal and independent external reviewers. 

The lawsuit was originally filed by Dr. Wood M. Deming, another cardiologist, under the whistleblower provision 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. Deming’s share 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 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.

Northrop Grumman Corp. (Northrop ) has paid the United States $11.4 million to settle a government claim for penalties provided under the Federal Acquisition Regulation (FAR) and False Claims Act allegations stemming from its failure to abide by a 2002 settlement agreement, the Justice Department announced earlier this week.

Northrop allegedly charged federal contracts certain costs for deferred compensation awards to key employees, even though it had promised not to do so as part of an earlier settlement. In 2002 Northrop agreed that it would limit the amount of deferred compensation it would include in proposals for subsequent contracts.  The government’s contracting officer found that Northrop had failed to honor this commitment and should be assessed a penalty equal to twice the amount of the unallowable costs claimed.  Northrop challenged the decision and the Department of Justice responded to the suit with counterclaims alleging that in addition to the FAR penalties, Northrop also had violated the False Claims Act by passing along these unallowable costs to the government in indirect rates applicable to hundreds of contracts with the government.  The government alleged that as a consequence of Northrop’s knowing misrepresentations, it was induced to pay more than $1.9 million in unallowable costs in thousands of vouchers and invoices.

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 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.