whistleblower act

Med Overbilling Fraud Claims Settled for $3M; Whistleblower to Get $620K

June 24, 2013

Dr. Alfred Chan, and oncologist in Lakewood, Wash., and his wife Judy Chan have agreed to pay $3.1 million to settle allegations that they defrauded federal health care programs by overbilling for cancer treatment medication, U.S. Attorney Jenny Durkan announced last week.

The government alleged that Dr. Chan, with the assistance of his wife, Judy, routinely billed federal healthcare programs such as Medicare and TRICARE for twice (or more) the amount of cancer treatment drugs actually administered to his patients, resulting in a loss to the U.S. government estimated at over $1 million.  The Chans then allegedly destroyed and falsified patients’ medical records in order to conceal the fraud. 

Upon learning of the government’s investigation, the Chans attempted to sell, transfer, and hide millions of dollars in assets in an ultimately unsuccessful attempt to prevent the government from recovering its overpayments.  In February 2011, the Chans fled to Taiwan.  A grand jury sitting in the Western District of Washington returned a criminal indictment against Alfred and Judy Chan relating to their fraudulent conduct.

The lawsuit was originally filed by Ruth Ruckman, a former employee of the Chans, under the whistleblower provisions of the False Claims Act.  Under the False Claims Act, a private citizen with knowledge of fraud against the government can sue on behalf of the government and share in the recovery.  Ruckman will receive $620,000 as her share 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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Renaissance Home Health Care Settles Medicaid Fraud Claims for $1M

June 19, 2013

New York-based Parkshore Home Health Care, dba Renaissance Home Health Care, a home health care services agency, agreed to pay $1 million to resolve allegations that it provided unqualified home health aides to home health agencies, who in turn sent these unqualified aides into the homes of Medicaid recipients throughout New York City and then billed the Medicaid program for their services., the U.S. Department of Justice announced yesterday.  The State of New York will receive $600,000 of the total.

Under the New York State Medicaid program, home health aides – who primarily care for elderly patients, administer medication and provide services such as catheter care, colostomy care and wound care – are required to complete a training program licensed by either the New York State Department of Health or the New York State Education Department.  Renaissance allegedly used home health aides who failed to receive the required training, resulting in Medicaid being billed for hundreds of thousands of dollars of services that these aides were not qualified to provide.

The lawsuit was originally filed by a whistleblower under the qui tam provisions of the False Claims Act.  Under the False Claims Act, a private citizen with knowledge of fraud against the government can sue on behalf of the government and share in the recovery.  The whistleblower’s share of the recovery is yet to be announced.

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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SAIC Settles Contract Fraud Claims for $11.75M; Whistleblower Share TBD

June 17, 2013

Virginia-based Science Applications International Corporation (SAIC) has paid $11.75 million to resolve allegations that the company violated the False Claims Act by charging inflated prices against grant money provided by the U.S. government to train first responder personnel to prevent and respond to terrorist attacks, the U.S. Department of Justice announced last week.

SAIC received federal grant money through the New Mexico Institute of Mining and Technology to provide course management, development, and instruction to first responder personnel to prevent and respond to terrorist attacks involving explosive devices.  The United States alleged that SAIC’s cost proposals falsely represented that SAIC would use far more expensive personnel to carry out its efforts than it intended to use and actually did use, resulting in inflated charges to the United States.

The lawsuit was originally filed by Richard Priem, SAIC’s former project manager for the first responder training program, under the whistleblower provisions of the False Claims Act.  Under the False Claims Act, a private citizen with knowledge of fraud against the government can sue on behalf of the government and share in the recovery.  Priem’s share 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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TesTech and Ceso Settle Fraud Claims for $2.9M; Whistleblower to Get $562K

June 7, 2013

Ohio-based companies TesTech and CESO have agreed to pay $2.88 million to resolve allegations that they knowingly submitted or caused the submission of false claims to federal agencies when they falsely claimed disadvantaged business status in order to obtain federal funds related to a number of federal transportation projects, the U.S. Department of Justice announced yesterday.

The Department of Transportation’s Disadvantaged Business Enterprise (DBE) program encourages the use of woman- and minority-owned businesses on federally funded transportation projects.  Contractors on such projects must make good-faith attempts to meet DBE participation goals as a condition of federal funding.

The settlement resolves allegations that the defendants falsely claimed disadvantaged business status for TesTech, a civil engineering firm, on numerous highway and airport construction projects in Ohio, Indiana, Michigan, and Kentucky.  The United States alleged that TesTech was owned and controlled by CESO, a non-disadvantaged firm, and that its owners, the Oakes, falsely claimed that TesTech was owned by Sherif Aziz and qualified as a minority-owned business in order to take advantage of the DBE program.

The lawsuit was originally filed by Ryan Parker, a former TesTech employee, under the whistleblower provisions of the False Claims Act.  Under the False Claims Act, a private citizen with knowledge of fraud perpetrated against the government can sue on behalf of the government and claim a share in the recovery.  Parker will receive $562,370 of the settlement amount. 

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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School Settles Student Aid Fraud Claims for $2.5M; Whistleblowers May Get $170K

June 3, 2013

American Commercial Colleges Inc. (ACC), a Texas-based for-profit corporation, has agreed to pay the United States government up to $2.5 million, including interest, to resolve allegations that they knowingly submitted or caused the submission of false claims to federal student aid programs, the U.S. Department of Justice announced last week.

In order to be eligible for federal student aid programs authorized by Title IV of the Higher Education Act of 1965, for-profit colleges such as ACC must obtain no more than 90 percent of their annual revenues from Title IV student aid programs.  The other 10 percent of their revenue must come from other sources, such as student payments or private loans.  ACC allegedly violated the False Claims Act when it orchestrated certain short-term private student loans that ACC repaid with federal Title IV funds.  The short-term loans at issue in this case were not sought or obtained by students on their own; the United States contends ACC orchestrated the loans for the sole purpose of manipulating its 90/10 Rule calculations.

Under the terms of the settlement, ACC will pay the United States $1 million, plus interest, over five years, and could be obligated to pay an additional $1.5 million under the terms of the agreement.

The lawsuit was originally brought by Shawn Clark and Juan Delgado, former directors of ACC campuses in Odessa and Abilene, Texas, under the whistleblower provisions of the False Claims Act.  The False Claims Act allows private citizens with knowledge of fraud perpetrated against the government to sue on behalf of the government and share in the recovery.  Clark and Delgado will receive $170,000 of the $1 million fixed portion of the government’s recovery, and an additional $255,000 if ACC becomes obligated to pay the maximum $1.5 million contingent 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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New Calif. False Claims Act Meets Conditions for 10% Higher Award

May 31, 2013

Recent amendments to the federal False Claims Act have expanded whistleblower protections and increased penalties for violators.  The amendments came in the form of the federal Deficit Reduction Act, the Fraud Enforcement and Recovery Act, the Affordable Care Act, and the Dodd-Frank Act.

California revamped its own False Claims Act earlier this year to bring it into compliance with federal law—and qualify for a 10 percent increase in its share of False Claims Act recoveries in cases relating to the submission of false or fraudulent claims to California’s State Medicaid program.  If a State obtains a recovery as a result of a State false claims action relating to fraudulent claims under the State Medicaid program, it must share the recovery with the federal government in the same proportion as the matching funds provided by the federal government for the state’s Medicaid program, called the federal medical assistance percentage. However, when states, such as California, enact state False Claims laws that are in compliance with federal law, those states get to keep an additional 10% of the recovery, thus sharing 10% less of any recovery in proportion to the federal medical assistance percentage.

For example, if the federal medical assistance percentage for a state is 60%, then the state would retain 40% of the recovery and the federal government would be entitled to the remaining 60% of the recovery.  But if the state has its own False Claims Act that is in compliance with federal law, that state would retain 50% of the recovery, and the federal government would receive the remaining 50%.

Under the qui tam, or whistleblower, provisions of the U.S. and California False Claims Acts, a private citizen with knowledge of fraud can sue on behalf of the government and claim a share in the recovery.  Many state and federal probes into Medicare and Medicaid fraud, and government contract fraud are initiated by whistleblower complaints. 

New York’s False Claims Act law was determined to no longer be in compliance with federal law.  New York has since submitted a revised statute to the Inspector General for the U.S. Department of Health and Human Services, and awaits word on whether the revised statute meets federal requirements and qualifies for the 10% incentive.

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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ISTA Settles Healthcare Fraud Claims for $33.5M; Whistleblower to get $2.5M

May 28, 2013

ISTA Pharmaceuticals has pleaded guilty to federal felony charges of conspiracy to introduce a misbranded drug into interstate commerce and conspiracy to pay illegal remuneration in violation of the Federal Anti-Kickback Statute, the U.S. Department of Justice announced last week.  In addition to criminal fines and asset forfeiture, ISTA has also entered into a civil settlement for knowingly submitting or causing the submission of false claims to federal health care programs.

Under the Food, Drug and Cosmetic Act (FDCA), it is illegal for a drug company to introduce into interstate commerce any drug that the company intends will be used for purposes not approved by the Food and Drug Administration (FDA).  Xibrom is approved by the FDA to treat pain and inflammation following cataract surgery; however, some ISTA employees promoted Xibrom for unapproved new uses, including the use of Xibrom following Lasik and glaucoma surgeries, and for the treatment and prevention of cystoid macular edema.  Some ISTA employees were told by management not to write down certain interactions with physicians regarding unapproved new uses, and not to leave certain printed materials in physicians' offices relating to unapproved new uses, in order to avoid detection.

ISTA also pled guilty to a conspiracy to knowingly and willfully offer or pay remuneration to physicians to induce those physicians to prescribe Xibrom, in violation of the federal Anti-Kickback Statute.  Certain ISTA employees provided physicians with free Vitrase, another ISTA product, with the intent to induce such physicians to refer individuals to pharmacies for Xibrom.  ISTA also provided other illegal remuneration, including sponsoring an event for a non-profit group associated with a particular physician, a golf outing, a wine-tasting event, paid consulting or speaker arrangements, and honoraria for participation in advisory meetings which were intended to be marketing opportunities.  ISTA agreed to pay $18 million to the federal government under the terms of its plea agreement.

ISTA also agreed to pay $15 million to resolve civil allegations regarding its marketing of Xibrom, which caused false claims to be submitted to government health care programs.  The United States alleged that ISTA's violations of the Anti-Kickback Statute resulted in false claims being submitted to federal health care programs.

In addition to the above, ISTA’s parent company, Bausch+Lomb (B+L), has also agreed to enter into a corporate integrity agreement to prevent future violations.

The lawsuit was originally filed by two whistleblowers under the False Claims Act.  One of the whistleblowers, Keith Schenkel, was a former employee of ISTA.  The False Claims Act allows private citizens with knowledge of fraud to sue on behalf of the government and share in the recovery.  Schenkel will receive $2.5 million as his share of the civil 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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Parkland Hospital Settles Healthcare Fraud Allegations for $1.4M

May 24, 2013

Parkland Memorial Hospital of Dallas, Texas has agreed to pay a $1.4 million settlement to resolve allegations that they knowingly submitted or caused the submission of false claims to Medicare and Medicaid, the Dallas Morning News reported recently.  Parkland has also agreed to enter into a corporate integrity agreement with federal health regulators to monitor future claims, bills, clinical quality, patient safety, ethics, and compliance.  This represents the fourth time the government has prosecuted Parkland in recent years, according to the Dallas Morning News.

Parkland allegedly submitted claims for rehabilitation consultations that were never ordered and that exposed some patients to risk of further injury.  Medical residents also allegedly performed certain procedures without the required supervision.

The lawsuit was originally filed by Dr. Lien Kyri, formerly a medical resident at Parkland Memorial Hospital, under the whistleblower provisions of the False Claims Act.  The False Claims Act allows private citizens with knowledge of fraud to sue on the behalf of the government and receive a share of the recovery.  Dr. Kyri’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 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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Ranbaxy Settles False Claims Allegations for $500M; Whistleblower to Get $48.6M

May 17, 2013

In the largest drug safety settlement of its kind to date, generic drug manufacturer Ranbaxy USA Inc. pleaded guilty to felony charges relating to the manufacture and distribution of adulterated drugs, as well as violation of the False Claims Act, the U.S. Department of Justice announced this week.  Ranbaxy agreed to pay a criminal fine and forfeiture amounting to $150 million and another $350 million for the False Claims Act violations.

Ranbaxy admitted to distributing certain batches of adulterated drugs made at two of Ranbaxy’s manufacturing facilities in India, including Sotret, an acne medication; gabapentin, a drug used to treat epilepsy and nerve pain; and ciprofloxacin, a broad-spectrum antibiotic.  Under the federal Food, Drug, and Cosmetic Act (FDCA), a drug is adulterated if the methods used in, or the facilities or controls used for, its manufacturing, processing, packing, or holding do not conform to, or are not operated or administered in conformity with, current Good Manufacturing Practice (cGMP) regulations.  Ranbaxy acknowledged that Food and Drug Administration (FDA) inspections found incomplete testing records, inadequate stability programs, and cGMP deviations in the manufacture of certain active pharmaceutical ingredients and finished products.

Ranbaxy also failed to file timely “field alerts” to the FDA for batches of drugs that had failed certain tests.  Ranbaxy admitted to making false, fictitious, and fraudulent statements to the FDA regarding the dates of stability tests and failed to conduct stability tests at prescribed intervals, resulting in unreliable test results regarding the shelf life of the drugs.  

The United States contends that Ranbaxy knowingly caused false claims to be submitted to Medicaid, Medicare, the Department of Veterans Affairs, and other federally funded healthcare programs.

The suit was originally filed by Dinesh Thakur, a former Ranbaxy executive, under the whistleblower provisions of the False Claims Act.  The False Claims Act allows a private citizen with knowledge of fraud to sue on behalf of the government and share in the recovery.  Thakur will receive approximately $48.6 million from the federal share of the settlement amount.

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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C.R. Bard to Pay $48.26M Settlement; Whistleblower to Get $10M

May 16, 2013

New Jersey-based C.R. Bard has agreed to pay the U.S. government $48.26 million to resolve allegations that it knowingly caused false claims to be submitted to Medicare for brachytherapy seeds used to treat prostate cancer, the U.S. Department of Justice announced this week.

The United States alleged that from 1998 to 2006, Bard violated the Anti-Kickback Statute when the company provided illegal remuneration to customers and physicians to induce them to purchase Bard’s seeds, in the form of certain grants, guaranteed minimum rebates, conference fees, marketing assistance and/or free medical equipment.  Hospitals ultimately submitted bills to Medicare for these seeds, which the government alleged were rendered false by Bard’s illegal kickback activity. The government alleged that Bard was liable under the False Claims Act for causing the submission of those false claims.

The lawsuit was filed by Julie Darity, a former Bard manager for brachytherapy contracts administration, under the whistleblower provisions of the False Claims Act.  The False Claims Act allows private citizens with knowledge of fraud to sue on behalf of the government and share in the recovery.  Darity will receive a little over $10 million as her share of the civil 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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