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false claims act 578 articles

Whistleblower Key in Recovering $8.5 Million from Tennessee Hospice Provider

A Tennessee hospice provider will pay the U.S. $8.5 million plus interest to settle a whistleblower lawsuit brought by a former nurse who claimed the company defrauding Medicare and Medicaid with false claims. The settlement resolves allegations lodged against Caris Healthcare L.P. by whistleblower Barbara Hinkle, a registered nurse who formerly worked for the hospice provider.  Ms. Hinkle sued Caris on behalf of the U.S. government under the whistleblower provisions of the False Claims Act. According to the U.S. Attorney’s Office for the Eastern District of Tennessee, which helped prosecute the case, Caris sought and admitted patients into its hospice ... Read More

Whistleblowers’ Nursing Home Fraud Suit Leads to $30 Million Settlement

Two whistleblowers who filed False Claims Act allegations against a large Kentucky-based nursing home corporation have helped the U.S. government and the state of Tennessee recover more than $30 million for Medicare. The whistleblowers, both former employees of Signature Healthcare LLC, accused the company of defrauding Medicare by providing rehabilitation therapy services that were not reasonable, skilled, or needed by patients. Signature owns about 115 skilled nursing facilities, including seven in Tennessee’s middle district, where the whistleblowers filed their complaint in federal court. One of the whistleblowers, Kristi Emerson, told The Tennessean she worked at Signature Healthcare of Columbia for more ... Read More

Whistleblower Accuses CVS Caremark of Medicare Drug Pricing Fraud

A recently unsealed lawsuit filed by a whistleblower against CVS Caremark accuses the corporation of overcharging Medicare and Medicaid for prescription drugs. The bombshell lawsuit could potentially return hundreds of millions of dollars in taxpayer funds to the government health care programs if the whistleblower’s False Claims Act allegations hold up in court. Sarah Behnke, who worked as an actuary for Aetna, claims CVS Caremark was good at negotiating lower prices with drug manufacturers as Aetna’s pharmacy benefit manager, but it did not pass those savings on to the government. The purpose of having companies such as Aetna, which provides ... Read More

Whistleblower Helps U.S. Recover $1.7 Million in Bogus Medicare Claims

A whistleblower has helped the U.S. recover more than $1.7 million from Allegiance Health Management, Inc., a Shreveport, Louisiana-based hospital owner and manager, the U.S. Department of Justice announced last week. Ryan Ladner, a former employee of an Allegiance-owned hospital in Hattiesburg, Mississippi, filed suit on behalf of the U.S. government, alleging the company submitted and caused other hospitals to submit False Claims to Medicare for services that were “not medically reasonable or necessary,” federal officials said. Mr. Ladner filed the complaint under the whistleblower provisions of the False Claims Act, a longstanding federal law that allows private parties to ... Read More

Walmart Pays $825,000 to Settle Whistleblower’s Medicaid Allegations

Walmart Stores and Sam’s Club have agreed to pay the U.S. and Minnesota $825,000 to resolve allegations that they violated the federal and state False Claims Acts for violating Medicaid rules for automatic prescription refills. U.S. Attorney Gregory Brooker and Minnesota Attorney General Lori Swanson jointly announced the settlement, which they said stemmed from a lawsuit filed by a whistleblower under the False Claims Act. Minnesota is one of about 20 states that does not allow Medicaid beneficiaries to have their prescription drugs automatically refilled. Instead, the state’s Medicaid program, called Medical Assistance, requires beneficiaries to request refills. The state’s ... Read More

Whistleblower Case Leads To $114 Million Judgement Against Ex-Diagnostic Lab CEO, Others

Three whistleblower lawsuits played a key role in a $114 million judgment against Health Diagnostics Laboratory CEO LaTonya Mallory and two other individuals who allegedly co-conspired to pay physicians kickbacks for patient referrals and causing the submission of false claims to Medicare for diagnostic tests that patients didn’t need. According to the U.S. Department of Justice, the government intervened in the whistleblower lawsuits and consolidated them in federal court in Charleston, South Carolina. During a two-week jury trial, federal prosecutors presented evidence that Ms. Mallory and co-defendants Floyd Calhoun Dent III and Robert Bradford Johnson paid kickbacks to doctors disguised ... Read More

Whistleblower Key in Recovering $1.2 Million From Florida Pain Clinic

A doctor who filed a whistleblower lawsuit against a Jacksonville, Florida-based pain management clinic was instrumental in helping the U.S. government recover more than $1.2 million for Medicare, TRICARE, and other federally subsidized health care programs. U.S. Attorney Maria Chapa Lopez of the Middle District of Florida said Riverside Spine & Pain Physicians agreed to pay the U.S. $1,204,415 to settle a complaint filed by Dr. Carissa Stone, a former employee of the clinic. Dr. Stone filed the lawsuit under the whistleblower provisions of the False Claims Act, alleging the clinic billed Medicare and other U.S. health care programs for ... Read More

Whistleblower Helps New York Recover $4.3 Million From Beer Distributor

A whistleblower was instrumental in helping New York state land a $4.3 million settlement with Oak Beverages Inc., a beer and wine distributor that allegedly defrauded the state of nearly $2 million in bottle deposits. New York Attorney General Barbara Underwood and Rockland County District Attorney Thomas Zugibe announced the settlement, saying that the company admitted it falsely inflated the number of empty bottle returns it received. State authorities investigated the whistleblower’s allegations and determined that the company failed to turn over approximately $1.86 million in unpaid deposits to the state — a violation of the state’s Bottle Bill. Additionally, ... Read More

The Arc of Anchorage Settles False Claims Act Allegations

The Arc of Anchorage, an organization supporting Alaskans with intellectual and developmental disabilities, has agreed to pay nearly $2.3 million to settle a False Claims Act complaint alleging it defrauded Alaska’s Medicaid Program. In an April 24 announcement, the Alaska Department of Law said the State of Alaska accused Arc of Anchorage of billing Medicaid for services that it never provided and billing for overlapping services with the same provider. Additionally, the state further alleged that Arc of Anchorage failed to repay funds owed to the Medicaid program that the organization had identified in fiscal audits. The allegations constitute violations ... Read More

Oklahoma Ambulance Provider Settles Whistleblower Kickback Allegations

An Oklahoma ambulance service provider will pay $300,000 to settle a whistleblower lawsuit alleging it violated the federal False Claims Act and Anti-Kickback Statute by engaging in an unlawful kickback scheme with a former Texas contractor. According to Tulsa World, a whistleblower lawsuit provided the basis for allegations lodged by federal officials. The complaint alleged that Emergency Medical Services Authority (EMSA), its former president and CEO Stephen Williamson, and contractor Paramedics Plus LLC controlled a slush fund that they used to pay out more than $20 million in kickbacks, including $50,000 or more for Mr. Williamson’s personal benefit. The State ... Read More