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business 152 articles

Alabama nurse receives $15 million whistleblower reward for exposing Medicare fraud

A Monroeville, Ala., nurse who filed a False Claims Act lawsuit against a home health care company will receive more than $15 million for her part in helping the U.S. recover $150 million in funds that she and others claim were fraudulently taken from Medicare and other health care programs. April Brown filed her whistleblower lawsuit in a federal court in Birmingham in 2010, alleging that her employer, Baton Rouge, Louisiana-based Amedisys Inc. billed for health care services that she hadn’t provided or were provided but not medically necessary. Ms. Brown, a home health care nurse in the Monroeville area, ... Read More

U.S. Commodity Futures Trading Commission resolves its first whistleblower case

A whistleblower who provided tips that led to the first-ever recovery by the U.S. Commodity Futures Trading Commission (CFTC) since its two-year-old whistleblower program was created will receive $240,000. On Tuesday CFTC Chairman Mark Wetjen said that the whistleblower provided valuable information about violations of the Commodity Exchange Act. The whistleblower’s identity has not been disclosed in compliance with regulations that require confidentiality to protect the whistleblower from retaliation. “I am pleased to announce this first award, which illustrates that the CFTC’s Whistleblower Program is a valuable resource for the American public. Information received under the Whistleblower Program helps the agency ... Read More

Pipeline rupture leaves section of California City knee-deep in oil

Half a square mile of Glendale, Calif., in Los Angeles County is knee-deep in crude oil after an estimated 10,000 gallons of crude oil escaped from a ruptured above-ground pipeline in the early morning hours on Friday. The Los Angeles Fire Department said that it had crews in the area “hand vacuuming” the spilled oil, “mopping what’s left behind, and pressure washing the area with a sap solution,” according to Reuters. The leak was first reported about 12:15 a.m. Pacific time in the 5100 block of San Fernando Road and shot up to 50 feet in the air, according to ... Read More

Whistleblower lawsuit alleges company defrauded Medicare with false power wheelchair prescriptions

The U.S. government has intervened in a whistleblower lawsuit against Orbit Medical Inc. and its former vice president Jake Kilgore, alleging the company knowingly defrauded Medicare and other taxpayer-funded health care programs by altering and forging physician prescriptions and other required documentation in order to boost sales of its power wheelchairs and accessories. According to the U.S. Justice Department, “Orbit Medical sales representatives, at Kilgore’s direction and encouragement, knowingly altered physician prescriptions and supporting documentation to get Orbit Medical’s power wheelchair and accessory claims paid by Medicare, the Federal Employees Health Benefits Plan, and the Defense Health Agency.” Medicare will ... Read More

Teachers file whistleblower lawsuit against Minnesota school

ST. PAUL, MINN. — A Minnesota private school faces a whistleblower suit filed by two teachers who claim they were subjected to discrimination and retaliation when they raised concerns about an allegedly unsafe field trip to Thailand, wrongly claimed and misused federal funds for student lunches, and suspected cases of child abuse within the school. According to the Pioneer Press, Megan Deutschman and Ana Panone filed the whistleblower lawsuit in Ramsey County, Minn., District Court this week against the Community School of Excellence, seeking unspecified damages and attorneys’ fees as well as injunctions that would change the school’s leadership, better ... Read More

CVS submitted false claims to Medicare for improperly dispensed drugs, lawsuit alleges

A national health insurance company is suing CVS Pharmacy in federal court under the False Claims Act, alleging the drugstore chain routinely and knowingly submitted claims for the reimbursement of invalid prescriptions to federal and state Medicare and Medicaid programs. Fox Rx Inc., a provider of Medicare Part D coverage, accuses CVS of routinely submitting claims for a number of highly potent and addictive drugs, such as codeine, oxycodone, cocaine, and methamphetamine, without providing a U.S. Drug Enforcement Agency (DEA) licensing number. Adding a proper DEA number to the claim ensures prescriptions are valid and not illegally dispensed. The insurance ... Read More

Utah company settles whistleblower lawsuit alleging small business contract fraud

SALT LAKE CITY—The owner of a small Utah-based construction company will receive a $148,480 whistleblower reward for helping the U.S. government recover nearly a million dollars from another larger construction company that allegedly was conducting a scheme to defraud a Small Business Administration (SBA) program designed to help small businesses. Saiz Construction and its owner Abel Saiz filed a lawsuit against Okland Construction Co. under the qui tam provisions of the False Claims Act, which allows individuals to sue on behalf of the U.S. government if they possess evidence of fraud, waste, abuse, and other wrongdoing targeting federal agencies and ... Read More

Playboy whistleblower receives record award under anti-fraud accounting law

A federal jury in California has ordered Playboy Enterprises to pay a former accounting executive at least $6 million for wrongful termination in what is believed to be the largest compensatory damages verdict given under the 2002 Sarbanes-Oxley law. Catherine Zulfer, a longtime employee of the company, alleged she was fired after she reportedly refused to accrue $1 million in bonuses for top executives without the board’s approval and for complaining to management about “actual and suspected frauds and improprieties” in the company’s bookkeeping. Ms. Pachler claimed in her lawsuit that Playboy’s Chief Financial Officer Christof Pachler pressured her to ... Read More

Florida hospital to pay up to $90 million to partially settle whistleblower’s fraud allegations

ORLANDO, Fla.—A Florida Hospital reached an agreement with the U.S. government Monday that resolves part of a whistleblower’s lawsuit accusing the health care facility of engaging in illegal kickback schemes with cancer doctors and neurosurgeons and admitting patients unnecessarily. Daytona Beach-based Halifax Health, a 678-bed hospital that serves much of Florida’s northeast coast, will pay the U.S. between $80 million and $90 million to resolve the allegations, which were brought against it by a longtime employee. Elin Baklid-Kunz filed her whistleblower lawsuit against Halifax in 2009 under the federal False Claims Act, which allows private individuals to sue on behalf ... Read More

Fight against health care fraud gains momentum, recovers billions for Medicare

For every one dollar the U.S. government spent on investigating health care-related fraud and abuse in the last three years, it recovered more than $8.00, the U.S. Justice Department said in a statement about its annual Health Care Fraud and Abuse Control (HCFAC) program report. According to U.S. officials, the return of $8.10 for every $1 spent cracking down on health care fraud marks the highest three-year average in the HCFAC program’s 17-year history. Thanks to stepped-up measures in combatting fraud directed against Medicare, Medicaid, and other taxpayer-funded health care programs, the federal government was able to recover a record ... Read More