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fraud 614 articles

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

Top Michigan Health Official faces Manslaughter Charges in Flint water crisis

Michigan’s top medical chief will be tried on three criminal charges related to his handling of the Flint water crisis, including two charges of involuntary manslaughter for the deaths of two elderly men who died from Legionnaires disease amid the water crisis. Nick Lyon, who continues to serve as director of Michigan’s Health and Human Services Department, is the highest-ranking public official to date to be charged in connection to the Flint water crisis. According to the Associated Press, Michigan District Judge David Goggins said Mr. Lyon was “corrupt” in his handling of the Legionnaires’ disease outbreak that sickened at ... Read More

U.S. Fights Opioid Epidemic With New Newark/Philadelphia Strike Force

The federal government is expanding its efforts to combat the nation’s opioid crisis and health care fraud with a new regional Medicare Fraud Strike Force operation for the Newark and Philadelphia areas. The Newark/Philadelphia Medicare Strike Force location is the tenth region-specific operation. All of the Strike Force locations monitor health care activity in a specific region for fraud affecting government health care programs. The growing crisis of opioid abuse and addiction has not just harmed tens of thousands of individuals and their families across the U.S., it has also taken its toll on the Medicare program, which loses billions ... 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

Jury Sides With Whistleblowers in School Board Retaliation Case

Two whistleblowers who were allegedly fired from California’s Montebello Unified School District (MUSD) in East Los Angeles in retaliation for calling out “lies, fraud, and corruption” within the Board’s leadership have been awarded more than $3 million. A Los Angeles Superior Court jury heard the whistleblower retaliation complaint, brought by Susanna Contreras Smith the ex-superintendent of the school district, and Cleve Pell, the district’s former operations officer, in June 2017. The plaintiffs argued they were wrongfully fired for standing up to cronyism and other misconduct by then-Board of Education and Chief Business Officer Ruben J. Rojas. Lawyers for the whistleblowers ... Read More

Fyre Festival Founder Settles SEC Fraud Allegations

One of the founders of the disastrous Fyre Festival, which left scores of guests who paid thousands of dollars to attend the much-touted luxury event stranded on a Bahamian island in tents, has agreed to a $27.4 million settlement resolving various fraud allegations with the Securities and Exchange Commission (SEC). According to the SEC, William Z. (Billy) McFarland, two companies he founded, a former senior executive, and a former contractor fraudulently induced more than 100 investors to entrust them with at least $27.4 million to fund a luxurious “once-in-a-lifetime” music event in the Bahamas. Mr. McFarland inflated key operational and ... Read More

Former Bulletproof Vest Maker Settles Whistleblower Lawsuit

The founder and former president of a bulletproof vest manufacturing company will pay the U.S. more than $1.3 million to settle allegations of fraud stemming from a whistleblower lawsuit. The U.S. Department of Justice said that to resolve the lawsuit, Robert David, the former head of now-defunct Second Chance Body Armor, will relinquish $1.2 million in assets previously frozen by the U.S. government and pay an additional $125,000 — an amount based on his ability to pay. Second Chance made many of its bulletproof vests with Zylon fiber produced by Toyobo Co. of Japan, then sold the bulletproof vests to ... Read More

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