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criminal 188 articles

Whistleblower nurse sues Minnesota hospital for deadly care, wrongful termination

A nurse with more than three decades of emergency room experience has filed a lawsuit against United Hospital in St. Paul, Minn,, alleging slow and improper care and irresponsible attitudes of some trauma physicians resulted in numerous patient deaths that could have been avoided with proper treatment. Sandra White, a registered nurse who helped manage United Hospital’s emergency room, told KSTP that the care she witnessed there for 17 months “was the worst she has ever seen.” Ms. White also said that 8-10 patient deaths could have been avoided in those few months had United Hospital followed a better protocol. ... Read More

Four Florida executives face prison time for WellCare Medicaid fraud scheme

A federal jury in Tampa, Florida found four high-ranking officials of a Florida health maintenance organization (HMO) operator guilty of multiple charges, including health care fraud, making false statements relating to health care matters, and making false statements to a law enforcement officer, the U.S. Justice Department announced this week. The federal grand jury indicted the WellCare  Health Plans Inc. executives on March 2, 2011, charging them with various criminal violations stemming from a scheme the company devised to defraud Florida’s Medicaid program. On Monday, June 10, the jury convicted WellCare Health Plans Inc. CEO Todd Farha, 45, of two ... Read More

National Medicare fraud crackdown uncovers $233 million in false billings

A federal crackdown on Medicare fraud in eight cities nationwide has led to charges against 89 individuals, including doctors, nurses, and other licensed medical professionals, for their alleged participation in fraud schemes that resulted in about $233 million in false Medicare billings, the U.S. Justice Department has announced. The crackdown was the sixth such operation orchestrated by the Medicare Fraud Strike Force since it was first formed in 2007. The task force now operates under the federal Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative created by the Justice Department and the Department of Health and ... Read More

Whistleblower exposes fraud; ISTA Pharmaceuticals settles criminal, civil charges for $33.5 million

ISTA Pharmaceuticals Inc., a unit of Bausch+Lomb, has pleaded guilty to several criminal and civil charges for conspiring to introduce a misbranded drug into the market and pay illegal kickbacks to physicians who prescribed the drug for unapproved uses. ISTA’s guilty pleas are part of a $33.5-million settlement with the U.S. government to resolve its criminal and civil liability involving its marketing, distribution, and selling of Xibrom.According to the U.S. Justice Department, the settlement arose from two whistleblower lawsuits filed against ISTA under the False Claims Act (FCA), which has qui tam provisions that enable private individuals to take legal ... Read More

C.R. Bard agrees to pay settle whistleblower fraud allegations for $50 million

Medical products manufacturer C.R. Bard has agreed to pay the U.S. nearly $50 million to resolve allegations that it provided illegal financial rewards to customers and physicians for choosing its products to treat prostate cancer – a violation of the federal False Claims Act (FCA) and the Anti-Kickback statute. The settlement resolves a lawsuit filed in the U.S. District Court for the Northern District of Georgia by Julie Darity, a former C.R. Bard manager for brachytherapy contracts. Ms. Darity sued C.R. Bard under the qui tam or whistleblower provisions of the False Claims Act, which allows private citizens to sue ... Read More

Whistleblowers expose fraud in private Texas college group

American Commercial Colleges Inc. (ACC) has agreed to pay the United States up to $2.5 million plus interest to resolve allegations brought by two whistleblowers under the False Claims Act (FCA) that the school falsely reported it complied with certain eligibility requirements of federal student aid programs. The scheme allowed the for-profit private school to collect taxpayer money to which it was not entitled. Title IV of the Higher Education Act of 1965 mandates that in order to participate in federal student aid programs, for-profit colleges such as ACC must not obtain more than 90 percent of their annual revenues ... Read More

U.S. recovers $3.95 million from Montana hospitals for False Claims Act and Stark Law violations

Two Montana hospitals have agreed to pay nearly $4 million plus interest to the federal government to resolve allegations that they violated the False Claims Act (FCA) and the Stark Law by providing incentive pay to doctors who referred patients to the hospitals. The False Claims Act is designed to facilitate the recovery of money from persons and companies (usually government contractors) who defraud the federal government. The FCA contains a “qui tam” or “whistleblower” provision that allows individuals not affiliated with the federal government to sue on its behalf and receive a percent of the recovery. The Stark Law is ... Read More

OSHA orders reinstatement of engineer fired for raising safety concerns at Kansas nuclear site

BURLINGTON, KS – The U.S. Occupational Safety and Health Administration (OSHA) has ordered Enercon Services Inc., an engineering services firm based in Kennesaw, Ga., to reinstate and pay back wages to a senior engineer who alleges he was fired for raising safety concerns at a Kansas nuclear energy facility. After investigating the claim, OSHA found the engineer’s termination was a violation of whistleblower provisions under the Energy Reorganization Act. The agency proposed that Enercon pay $261,153 in back wages, compensatory damages, interest and attorney’s fees to the engineer. The investigation determined that Enercon fired the licensed professional civil and structural ... Read More

U.S. joins whistleblower lawsuit against hospice provider for Medicare fraud

The federal government is joining a whistleblower lawsuit filed by a California physician under the False Claims Act (FCA) against the largest for-profit hospice provider in the United States. The lawsuit accuses Chemed Corp.’s Vitas Healthcare of certifying patients as eligible for hospice so it could receive money from Medicare for unneeded hospice services. The whistleblower complaint was filed by Dr. Charles Gonzalez, who worked for Vitas in Los Angeles from 2004 to 2011. Dr. Gonzalez accuses the company of “padding its profits at the expense of taxpayers” for deliberately providing hospice care to patients who didn’t qualify. “Many of ... Read More

Nurse’s whistleblower lawsuit leads to $7.3-million health care fraud settlement

A Plano, Texas-based health care provider has agreed to pay $7.3 million to settle allegations that a company it recently acquired violated the False Claims Act (FCA) by intentionally overbilling Medicare for an anemia drug used to treated dialysis patients. Laura Davis, a nurse, filed the whistleblower lawsuit on behalf of the federal government against U.S. Renal Care. The “qui tam” lawsuit alleges that Dialysis Corporation of America (DCA), which became part of U.S. Renal Care in June 2010, submitted false claims to Medicare when it charged the program for the “overfill” in vials of the drug Epogen. Overfill is ... Read More