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whistleblower 915 articles

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

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

SEC Proposes Changes to its Whistleblower Program

The Securities and Exchange Commission (SEC) has proposed a series of changes to its whistleblower program that the agency says will boost the efficiency and overall performance of its informant-driven enforcement actions. The SEC added the proposed amendments to the whistleblower program to the Federal Register July 20. The changes would provide the SEC with additional tools to ensure that whistleblowers are appropriately rewarded for their efforts, the agency said. The SEC also proposed ways to increase efficiency in the whistleblower claims review process and to clarify the requirements for whistleblower anti-retaliation protections. The SEC’s whistleblower program was established by ... Read More

Whistleblower Blows Open Medical Device Fraud Scheme

A whistleblower who sued medical device maker AngloDynamics on behalf of the U.S. government was instrumental in recovering millions of dollars in Medicare, Medicaid, and other government health care funds, the U.S. Justice Department said. Whistleblower Ryan Bliss, who formerly worked in the marketing departments of AngloDynamics and affiliated firm Biocompatibles, filed the False Claims Act lawsuit alleging the companies unlawfully peddled the LC Bead as a drug-delivery device for chemotherapy patients – a use that the U.S. Food and Drug Administration (FDA) refused to approve twice. According to the whistleblower complaint, AngloDynamics routinely made false and misleading marketing claims ... Read More

Whistleblowers Help Recover $10 Million From Alabama, Florida Nursing homes

Two management consulting companies and nine affiliated Alabama and Florida nursing homes will pay $10 million to settle a False Claims Act lawsuit filed by a whistleblower who accused the defendants of scheming to provide patients with unnecessary therapy and then billing Medicare for the unneeded services. According to the U.S. Department of Justice, Southern SNF Management, Inc., Rehab Services in Motion (doing business as Dynamic Rehab) and the nursing homes instituted corporate policies and practices that encouraged the nursing facilities to provide patients with “medically unreasonable and unnecessary therapy without regard for patients’ individual clinical needs.” The defendants then ... 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 Dentists Describe Harrowing Kool Smiles Practices

Whistleblowers who risked their careers, reputations, and potentially even their personal safety are calling out Kool Smiles, a national pediatric dental chain, for businesses practices that allegedly put children through painful and unnecessary procedures, just so they could increase their billings. Dentists Dr. Rai and Dr. Greenwald recounted their experiences at Kool Smiles to CBS News as part of a new series the network is airing about whistleblowers who risk everything to expose wrongdoing. In the Whistleblower series’ first segment, Dr. Rai told CBS News that she “lived in fear every day” about what she would face at Kool Smiles. ... Read More

Whistleblower Case Leads to $1.7M Recovery From Florida Urogynecology Group

A Florida network of urogynecologists has agreed to pay $1.7 million to settle a whistleblower’s False Claims Act lawsuit alleging the company billed Medicare for patient services that were never provided. The settlement resolves a whistleblower lawsuit filed by Holly Loebl, a former employee of FWC Urogynecology LLC, who accused the same company of knowingly misusing a certain Medicare billing code called “modifier 25,” which adds fees for extra services to Medicare billings, the U.S. Attorney in Orlando said. Orlando-based FWC Urogynecology operates more than a dozen clinics throughout Florida. Ms. Loebi filed her lawsuit under the whistleblower provisions of ... Read More

Whistleblower Sues Montana Hospital over Alleged Kickback Scheme

A newly unsealed whistleblower complaint against Kalispell Regional Healthcare accuses the Montana hospital of engaging in an extensive kickback scheme that put the profits of specialist physicians and hospital executives above patient care while defrauding U.S. and Montana taxpayers. The newly unsealed suit was originally filed in September 2016 by John Mohatt, formerly the CEO of Kalispell Regional Healthcare’s physician network. An amended False Claims Act complaint was filed in May of last year and remained under seal until recently, although the U.S. Department of Justice continues to investigate the whistleblower’s allegations, Kalispell’s Flathead Beacon reports. U.S. law prohibits hospitals ... Read More