qui tam

HSBC Settles False Claims for $10M

Submitted by mma on July 7, 2014
July 7, 2014
Image: 

HSBC has agreed to pay $10 million to settle allegations that the company knowingly submitted or caused the submission of false claims to federal housing and mortgage programs, the U.S. Attorney’s Office for the Southern District of New York announced last week.

HSBC performs or oversees the performance of certain administrative activities in connection with residential mortgage loans, such as collecting mortgage payments and pursuing foreclosure when borrowers become delinquent. In pursuing foreclosure on behalf of HSBC, outside counsel and other third-party providers of foreclosure-related services, such as title companies and process servers, incur fees and expenses. HSBC has routinely submitted reimbursement requests to the Federal Housing Administration (FHA) and Federal National Mortgage Association (Fannie Mae) for these foreclosure-related fees and expenses.

Pursuant to the National Housing Act, FHA offers mortgage insurance programs whereby it insures lenders against losses on mortgage loans, including expenses related to mortgage servicing, and specifically, expenses incurred in foreclosure proceedings. HSBC has been an approved servicer of FHA-insured loans for many years. In order to obtain and maintain FHA approval to service FHA-insured loans, HSBC was required to submit and did submit annual certifications stating that it adhered to all FHA handbooks, regulations and policies. One such handbook requires servicers to create and maintain a quality control program that reviews all aspects of servicing operations, including foreclosure fees and charges.

HSBC has also been an approved servicer of loans held by Fannie Mae. Fannie Mae is a government sponsored enterprise that purchases mortgage loans as part of its mission to promote liquidity in the housing market. Fannie Mae has been under the conservatorship of the Federal Housing Finance Agency since September 2008. As part of its obligations as a loan servicer for Fannie Mae, HSBC was required to create and implement audit and control systems to ensure compliance with Fannie Mae’s requirements. Specifically, as a servicer of Fannie Mae loans, HSBC was required to ensure that all costs submitted to Fannie Mae for reimbursement were reasonable, customary and necessary.

As set forth in the settlement, contrary to program requirements and HSBC’s certifications, HSBC failed to implement and maintain the requisite quality controls, failed to oversee the foreclosure-related charges it submitted to FHA and Fannie Mae for reimbursement, and caused millions of dollars in losses to FHA and Fannie Mae as a result.

The lawsuit was originally filed by an unnamed whistleblower under the qui tam 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 original whistleblower suit remains under seal as the government continues its investigation.

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.

Cross-Post On: 
None

Medtronic Settles False Medicaid Claims for $2.8M

Submitted by mma on July 2, 2014
July 2, 2014
Image: 

Medtronic Inc. has agreed to pay $2.8 million to settle allegations that the company knowingly submitted or caused the submission of false claims to state Medicaid programs for replacement insulin infusion pumps, the Pennsylvania Attorney General’s office announced earlier this week.

Allegedly, Medtronic—doing business as Medtronic Diabetes—improperly solicited Medicaid recipients to replace their insulin infusion pumps, in violation of a federal Anti-Solicitation Rule and similar state laws, leading to false claims filed to state health care programs such as Medicaid.

The lawsuit was originally filed by former Medtronic 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 recovery.  The whistleblowers’ portion of the settlement has 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.

Cross-Post On: 
None

U.S. False Claims Act Case Against Lance Armstrong to Proceed

Submitted by mma on July 1, 2014
July 1, 2014
Image: 

A federal judge for the United States Court of Appeals for the District of Columbia ruled last week that the U.S. Justice Department may proceed with its False Claims Act lawsuit against Lance Armstrong, alleging that the cyclist defrauded the government when he accepted sponsorship money from the U.S. Postal Service  while taking performance-enhancing drugs, The Wall Street Journal reported. 

Armstrong argued that the case should be dismissed on the grounds that USPS willfully ignored the doping prevalent in the sport while reaping millions of dollars from the publicity generated by the cyclist provided under the sponsorship.  Attorneys for the embattled cyclist also argued that the suit is time-barred under applicable statutes of limitation, as the government’s allegations involve events that occurred more than nine years prior to the filing of the lawsuit.  The Justice Department took the position that Armstrong’s cycling team defrauded the government when it accepted the sponsorship money while violating the terms of the sponsorship agreement, which required the team to follow the bylaws of cycling’s governing bodies.  Armstrong admitted to doping last year and was stripped of his seven Tour de France titles. 

Floyd Landis, a former teammate of Lance Armstrong, initiated the lawsuit 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 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.

Cross-Post On: 
None

Omnicare to Settle False Medicare Claims for $124M; Whistleblower to Get $17M

Submitted by mma on June 25, 2014
June 25, 2014
Image: 

Ohio-based Omnicare, the nation’s largest provider of pharmaceuticals and pharmaceutical services to nursing homes, has agreed to pay $124.24 million to settle allegations that the company knowingly submitted or caused the submission of false claims to federal health care programs, the U.S. Department of Justice announced today.

The settlement resolves allegations that Omnicare submitted false claims by entering into below-cost contracts to supply prescription medication and other pharmaceutical drugs to skilled nursing facilities and their resident patients to induce the facilities to select Omnicare as their pharmacy provider.  The facilities were participating providers under agreements with Medicare and Medicaid.   In addition to the facilities’ own claims for reimbursement from Medicare for short-term rehabilitation treatment rendered to patients, Omnicare submitted additional claims for reimbursement to Medicare and Medicaid for drugs Omnicare supplied.   Of the $124.24 million to be paid by Omnicare, $8.24 million will go to various states which jointly funded the Medicaid programs impacted by Omnicare’s conduct.

The lawsuit was originally filed by two whistleblowers under the qui tam 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.  One whistleblower, a former employee of Omnicare, will receive $17.24 million 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.

Cross-Post On: 
None

KY Med Office to Settle Medicare False Claims for $3.7M; Whistleblower to Get $283K

Submitted by mma on June 23, 2014
June 23, 2014
Image: 

Elizabethtown Hematology Oncology, PLC (EHO) and its owners have agreed to pay $3.7 million to resolve allegations that they knowingly submitted or caused the submission of false claims to federal health care programs Medicare, Medicaid, TRICARE, and the Federal Employee Health Benefit Program (FEHBP), the U.S. Attorney’s office for the Western District of Kentucky announced earlier this month.

According to the settlement agreement, Dr. Rafiq Ur Rahman and Dr. Yusuf K. Deshmukh, owners of Elizabethtown Hematology Oncology, PLC (EHO), billed Medicare, TRICARE, FEHBP and Medicaid for unnecessary office visit evaluations at the same time patients were receiving chemotherapy or other types of infusion treatments. The United States and Commonwealth of Kentucky contend that EHO did this by improperly billing evaluation and management codes using Modifier-25 (allows for billing evaluation and management necessary prior to the performance of a procedure).

The United States and Commonwealth of Kentucky further contend that Dr. Rahman, Dr. Deshmukh, and EHO unnecessarily and improperly extended the duration of chemotherapy infusion treatment times for their patients in order to improperly bill Medicare, TRICARE, FEHBP and Medicaid for those additional hours of chemotherapy infusion treatments.

The lawsuit was originally filed by Dr. Ijaz Mahmood, a former employee of EHO, 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.  Dr. Mahmood will receive $283,412.90 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.

Cross-Post On: 
None

SunTrust to Pay Almost $1 Billion to Resolve False Claims Act Violations

Submitted by mma on June 19, 2014
June 19, 2014
Image: 

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.

Cross-Post On: 
None

OneWest Bank Allegedly Defrauded U.S. Mortgage Program

Submitted by mma on May 16, 2014
May 16, 2014
Image: 

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.

Cross-Post On: 
None

Baptist Health Settles False Claims for $2.5M; Whistleblower to Get $424K

Submitted by mma on May 6, 2014
May 6, 2014
Image: 

Florida-based Baptist Health Systems has agreed to pay $2.5 million to settle allegations that the company knowingly submitted or caused the submission of false claims to federal health care programs such as Medicare, Medicaid, TRICARE, and the Federal Employee Health Benefits Program, the U.S. Department of Justice announced today.

This settlement resolves allegations that two neurologists in the Baptist Health network misdiagnosed patients with various neurological disorders, such as multiple sclerosis, which caused Baptist Health to bill for medically unnecessary services.  Although Baptist Health placed one of the physicians at issue on administrative leave in October 2011, it did not disclose any misdiagnoses to the government until September 2012.

The improper conduct at issue in this case included Medicaid patients.  Medicaid is funded jointly by the states and the federal government.  The state of Florida, which paid for some of the Medicaid claims at issue, will receive $19,024 of the settlement amount.

The government’s investigation was initiated by a qui tam, or whistleblower, lawsuit filed under the False Claims Act by Verchetta Wells, a former Baptist Health employee.  The act allows private citizens to file suit for false claims on behalf of the government and to share in the government’s recovery.  Wells will receive $424,155.

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.

Cross-Post On: 
None

OK Medical Center Settles False Medicaid Claims for $1.5M; Whistleblower to Get $160K

Submitted by mma on May 1, 2014
May 1, 2014
Image: 

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.

Cross-Post On: 
None

Amedisys to Settle False Medicare Claims for $150M; Whistleblowers to Get $26M

Submitted by mma on April 29, 2014
April 29, 2014
Image: 

Amedisys Home Health Companies have agreed to pay $150 million to settle allegations that the company knowingly submitted or caused the submission of false claims to Medicare, the U.S. Department of Justice announced last week.  Amedisys is one of the nation’s largest providers of home health services and operates in 37 states, the District of Columbia, and Puerto Rico.

Allegedly, certain Amedisys offices improperly billed Medicare for ineligible patients and services.  Amedisys allegedly billed Medicare for nursing and therapy services that were medically unnecessary or provided to patients who were not homebound, and otherwise misrepresented patients’ conditions to increase its Medicare payments.  These billing violations were the alleged result of management pressure on nurses and therapists to provide care based on the financial benefits to Amedisys, rather than the needs of patients.    

Additionally, this settlement resolves certain allegations that Amedisys maintained improper financial relationships with referring physicians.  The Anti-Kickback Statute and the Stark Statute restrict the financial relationships that home healthcare providers may have with doctors who refer patients to them.  The United States alleged that Amedisys’ financial relationship with a private oncology practice in Georgia – whereby Amedisys employees provided patient care coordination services to the oncology practice at below-market prices – violated statutory requirements.

Amedisys also agreed to be bound by the terms of a Corporate Integrity Agreement with the Department of Health and Human Services – Office of Inspector General that requires the companies to implement compliance measures designed to avoid or promptly detect conduct similar to that which gave rise to the settlement.    

This settlement resolves seven lawsuits pending against Amedisys in federal court – six in the Eastern District of Pennsylvania and one in the Northern District of Georgia – that were filed under the qui tam, or whistleblower, provisions of the False Claims Act, which allow private parties to bring civil actions on behalf of the United States and share in any recovery.  As part of today’s settlement, the whistleblowers – primarily former Amedisys employees – will collectively split over $26 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.

Cross-Post On: 
None
Syndicate content