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FCA 135 articles

U.S. Attorney General Nominee Vows to Uphold False Claims Act

Stepping back from previous criticism of the False Claims Act, William Barr, Donald Trump’s nominee for U.S. Attorney General, pledged he would stand by the law that authorizes whistleblowers to sue on behalf of the U.S. government and American taxpayers. Mr. Barr, who served as the attorney general in President George H.W. Bush’s administration from 1991 to 1993, once described the False Claims Act as an “abomination” and displayed an appetite to challenge the law, which he viewed as unconstitutional. In 1989, Mr. Barr wrote that the whistleblower provision of the False Claims Act replaced the Judicial Department’s prosecutorial discretion ... Read More

False Claims Act Suit Alleges Kansas City Clinic Defrauded Medicare

A Kansas chiropractic clinic faces a False Claims Act lawsuit seeking more than $1.4 million on allegations that it wrongfully billed Medicare for neuropathy treatments that didn’t qualify for reimbursement or were never provided to patients. The lawsuit, filed Dec. 21 in federal court, accuses Kansas City Health & Wellness Clinic and its owners, brothers Ryan Schell and Tyler Schell, of soliciting Medicare beneficiaries with ads claiming they could heal peripheral neuropathy and “rejuvenate the nerve fibers,” according to Kansas City’s KCUR 89.3. Peripheral neuropathy results from damage to the peripheral nerves, causing weakness, numbness, and stabbing, burning, or tingling ... Read More

Montana’s Kalispell Hospital Network Settles Whistleblower Lawsuit for $24 million

Kalispell Regional Healthcare System of Kalispell, Montana and six affiliates have agreed to pay $24 million to settle allegations stemming from a whistleblower lawsuit that they engaged in an extensive kickback scheme. The government alleged that Kalispell Regional maintained arrangements with referring physicians that violated the Stark Law, the Anti-Kickback Statute, and the federal False Claims Act. U.S. law prohibits hospitals and other health care providers from engaging in kickback arrangements and other schemes that provide money or other gifts for patient referrals. Services billed to Medicare, Medicaid, and other federal health care programs that were influenced by illegal kickbacks ... Read More

Defense Contractor Pays $7.8 Million To Resolve Fraud Allegations

A defense contractor has agreed to pay $7.8 million to settle allegations with the U.S. government that it illegally exploited military contracts set aside for small businesses. The U.S. Attorney’s Office for the Southern District of Georgia said that Arena Event Services Inc., which does business as Arena Americas, coordinated with Military Training Solutions LLC (MTS) to obtain the small business contracts. Congress mandates that a certain amount of government contracts go to small businesses as a way to encourage small business growth. These contracts prohibit the small business from being affiliated with a non-small business, while also limiting the ... Read More

DaVita’s HealthCare Partners Pays $270 Million to Settle Medicare Fraud Allegations

HealthCare Partners Holdings, a unit of DaVita Medical Holdings, has agreed to pay $270 million to settle allegations stemming partly from a whistleblower lawsuit alleging the companies caused Medicare to overpay on insurance claims submitted by Medicare Advantage plan providers. According to the U.S. Department of Justice, HealthCare Partners, an independent physicians association based in California, contracted with insurance companies to provide medical services to Medicare Advantage patients. Unlike traditional Medicare, which pays health providers for patient services they provide to beneficiaries, Medicare Advantage Plans are paid a fixed, monthly amount to provide health care to Medicare recipients who enroll ... Read More

Whistleblower Helps Medicare Recover $4 Million From Florida Dermatology Practice

A dermatologist who filed a whistleblower lawsuit against a Florida dermatology practice alleging it defrauded Medicare and Medicaid has helped the U.S. government recover $4 million. Dermatology Healthcare, a Tampa-based provider of dermatology care to residents of assisted living facilities, agreed to settle the government’s claims of fraud, which originated with a False Claims Act lawsuit filed by Dr. Theodore A. Schiff, according to an announcement by U.S. Attorney Maria Chapa Lopez. Dr. Schiff filed the lawsuit under the whistleblower provisions of the False Claims Act, alleging Dermatology Healthcare failed to adequately supervise the administration of superficial radiation therapy to ... Read More

Whistleblower Suit Ends in $21 Million Recovery from Ambulance Kickback Schemers

A sprawling whistleblower lawsuit implicating an ambulance company, its affiliated companies, and several municipal clients in an illegal kickback scheme has been settled, federal prosecutors announced. East Texas Medical Center Regional Healthcare System and East Texas Medical Center Regional Health Services (“the ETMC defendants”) their affiliated ambulance company, Paramedics Plus, and other defendants agreed to pay the U.S. more than $21 million to resolve the allegations, according to the U.S. Department of Justice. The government’s case against the ambulance industry defendants stems from a complaint filed by Dr. Stephen Dean under the whistleblower provisions of the False Claims Act. The ... Read More

Whistleblower’s False Claims Lawsuit Recovers $5.25 Million From Lincare

Lincare Inc., a major U.S. supplier of medical oxygen and other respiratory therapies, has agreed to pay the U.S. $5.25 million to settle a whistleblower lawsuit alleging it violated the federal False Claims Act and Anti-Kickback Statute by offering illegal discounts to Medicare beneficiaries. Based in Clearwater, Florida, Lincare operates about 1,000 locations across the U.S. According to a False Claims Act lawsuit filed by whistleblower Brian Thomas and supported by the federal government, Lincare attempted to gain a competitive edge in the marketplace by unlawfully waiving or reducing co-insurance, co-payments, and deductibles for beneficiaries who participated in a Medicare ... Read More

Whistleblower Key in Mississippi Hospital’s $1.1 Million Medicare Fraud Settlement

A Mississippi public hospital has agreed to pay the U.S. more than $1.1 million to settle a whistleblower lawsuit alleging it unlawfully billed Medicare for services patients didn’t need. Grenada Lakes Medical Center, which is operated by the University of Mississippi Medical Center, agreed to settle the government’s False Claims Act allegations accusing the hospital of falsely billing Medicare for medically unnecessary and unreasonable psychotherapy services it provided to beneficiaries of the government health care program. According to the U.S. Justice Department, starting in January 2005 and continuing until April 2013, the Grenada Lakes Medical Center submitted claims for intensive ... Read More

Whistleblower Awarded $17 Million for Exposing Medicare Fraud

A whistleblower who filed a False Claims Act lawsuit against Prime Healthcare Services, one of the nation’s largest hospital chains, and its founder and chief executive officer, has received an award of $17,225,000 for helping the U.S. recover $65 million in Medicare funds. The U.S. Department of Justice said that Karin Berntsen, the former Director of Performance Improvement at Alvarado Hospital Medical Center in San Diego, brought the suit under the whistleblower provisions of the False Claims Act. Ms. Berntsen alleged that Prime Healthcare Services, Prime Healthcare Foundation, Prime Healthcare Management, and CEO Dr. Prem Reddy routinely admitted Medicare patients ... Read More