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whistleblower 794 articles

Ohio health care companies settle whistleblower allegations

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Three Ohio health care companies and their executives will pay nearly $20 million to settle whistleblower allegations that they billed Medicare for medically unnecessary rehabilitation therapy and hospice services. Foundations Health Solutions Inc., Olympia Therapy Inc., Tridia Hospice Care Inc., and their executives, Brian Colleran and Daniel Parker, have agreed to pay approximately $19.5 million to resolve allegations, the U.S. Department of Justice said Monday, July 17. The settlement resolves two lawsuits filed by three former employees of Olympia Therapy and Tridia Hospice under the whistleblower provisions of the False Claims Act. FHS is the corporate successor to Provider Services ... Read More

Whistleblower: Wells Fargo Defrauded Mortgage Borrowers

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A former Wells Fargo banker has filed a lawsuit against the banking giant, accusing it of firing him in retaliation for standing up against an alleged practice of defrauding borrowers by blaming them for delays in processing mortgage applications that were the bank’s fault, then hitting them with the resulting fees. According to the Los Angeles Times, Mauricio Alaniz, a former banker at a Wells Fargo Beverly Hills unit, alleges in his federal lawsuit that the bank’s mortgage-processing and underwriting division was understaffed, resulting in chronic delays that weren’t the borrowers’ fault. Borrowers applying for mortgages are typically locked into ... Read More

Hospice groups settle whistleblower suits

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Two subsidiaries of the Compassionate Care Hospice Group have agreed to settle separate False Claims Act lawsuits filed by whistleblowers who claim the companies defrauded Medicare and other federal health care programs. The U.S. Attorney’s office for the Northern District of Georgia said that Compassionate Care Hospice of Atlanta will pay the U.S. $2.4 million to resolve allegations that it paid illegal kickbacks to five doctors in exchange for patient referrals and certifying patients as eligible for hospice services when they weren’t. Compassionate Care Hospice of Atlanta provided payments to a medical director in return for referrals and also created ... Read More

Whistleblower Alleges Gentiva Defrauded Medicare

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A whistleblower lawsuit against Gentiva Health Services unsealed July 10 alleges the company defrauded Medicare by misclassifying home health care patients as hospice patients in order to boost reimbursements. Alan Stewart, an Area Vice President with Gentiva, filed the complaint in 2014 under whistleblower provisions of the False Claims Act. He alleges Gentiva launched a “new financial plan” in 2013 that involved recoding many patients receiving home health care as hospice patients, even when those patients did not require hospice services. According to McKnight’s, more than half of the patients who migrated from home health care to hospice care were ... Read More

Whistleblower Helps U.S. Recover $155 Million

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One of the nation’s largest vendors of electronic health records software, eClinicalWorks, and certain of its employees will pay a total of $155 million to settle a whistleblower lawsuit alleging they misrepresented the capabilities of their software and paid kickbacks to customers in exchange for promotional favors. The U.S. Department of Justice said that the Westborough, Massachusetts-based software firm “falsely obtained” government-required certification for its electronic health records software by concealing from its certifying agency the software’s noncompliance with federal certification requirements. The American Recovery and Reinvestment Act of 2009 established the Electronic Health Records (EHR) Incentive Program to encourage ... Read More

U.S. Joins Whistleblower Disabled-Housing Suit

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The United States government announced it is joining a False Claims Act lawsuit against the City of Los Angeles filed by a whistleblower who accuses the city of failing to develop housing for the disabled despite accepting millions of dollars in federal funds earmarked for that purpose. The lawsuit, filed by wheelchair user Mei Ling, alleges Los Angeles and the CRA/LA (previously known as the Community Redevelopment Agency of the City of Los Angeles) falsely certified they complied with federal accessibility laws while accepting housing grants from the federal Department of Housing and Urban Development (HUD). To receive the federal ... Read More

Whistleblower Case against Gilead Sciences Revived

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A whistleblower lawsuit against drugmaker Gilead Sciences Inc. alleging the company misled federal drug regulators into approving adulterated HIV drugs has been revived by a federal appeals court. The Recorder reports that the Ninth Circuit Court of Appeals ruling reverses a California Court’s dismissal of the case. The appellate court said in its opinion that the claims made by whistleblowers Jeff and Sherilyn Campie, both former Gilead employees, are sufficient and satisfy the requirements of a False Claims Act complaint. The Campies accuse Gilead of using synthetics from a manufacturer in China to lower the production costs of its HIV ... Read More

National Guard Whistleblower Gets Help From U.S. Senator

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U.S. Senator Claire McCaskill (D-MO) has gone to bat for a Missouri National Guard whistleblower who was fired in 2014, less than a week after voicing complaints about toxic working conditions and lack of proper tools needed to do his job. According to the St. Louis Post-Dispatch, Sen. McCaskill sent a letter to the Missouri National Guard July 13 asking what its leaders’ intentions are in light of a Department of Defense determination that Guard officer Michael Sandknop was wrongfully terminated in retaliation for his complaints. In a 34-page report on Mr. Sandknop’s case, Department of Defense Inspector General Glenn ... Read More

Medicare Advantage whistleblower suit recovers $32.5M

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Medicare Advantage plan providers Freedom Health, Optimum Healthcare, and their affiliates agreed to pay the U.S. government and State of Florida a combined $32.5 million to settle a whistleblower lawsuit that alleged the companies exaggerated patient diagnosis codes and overstated the resources it had available to patients. The whistleblower lawsuit was filed in federal court in Tampa in 2009 by Dr. Darren Sewell, who worked for Freedom and Optimum for five years, most recently as a vice president. Dr. Sewell alleged that the companies violated the False Claims Act by submitting false information to Medicare about their members’ medical conditions ... Read More

J&J Dropped From Whistleblower Suit

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Johnson & Johnson is being dropped from a whistleblower lawsuit accusing it of promoting its HIV/AIDS drugs for off-label purposes and other wrongdoing, but most of the same claims against subsidiary company Janssen can move ahead, a federal judge ruled. According to the New Jersey Law Journal, New Jersey federal Judge Michael Shipp granted and denied parts of J&J’s motion to dismiss the whistleblower case by releasing the drug giant from the suit but allowing allegations against its Belgium-based Janssen subsidiary to stand. Judge Shipp said that J&J was off the hook because “mere ownership of a subsidiary does not ... Read More