by Author | Feb 21, 2014 | False Claims Act
Tenn. Atty Gen. announced $800,000 settlement on February 20, 2014, resolving Medicaid Upcoding Fraud against Chattanooga-based mental health facility AIM Center Inc. In addition to paying $800,000 to Tennessee’s Medicaid Program, AIM Center Inc. is to enter into a five-year corporate integrity agreement (CIA) with the U.S. Department of Health and Human Services Office of Inspector General to make sure it stays compliant with federal healthcare benefit program requirements.
The principal allegation against Aim Center Inc. is that it overcharged Medicaid by submitting claims for psychosocial rehabilitation services that were more lengthy and expensive than the services actually provided.
This appears to be a case where the government also relied on the provision in the False Claims Act that penalizes healthcare providers for not returning overpayments, 31 U.S.C. § 3729(a)(1)(G), in this instance as a result of double filling.
Read More: http://legalnewsline.com/news/247359-chattanooga-mental-health-facility-resolves-false-claims-act-allegations
by Author | Feb 20, 2014 | False Claims Act
Qui Tam Whistleblower rewarded $1.28 million in a successful False Claims Act (FCA) case charging Defense Contracting Fraud that was settled by the Department of Justice on February 18, 2014, with IT firm Vector Planning and Services Inc. (VPSI), of Chantilly, Va., agreeing to pay $6.5 million to the government. The settlement resolves whistleblower allegations that VSPI inflated claims for payments under several contracts with the Navy, in violation of the FCA. Specifically, the complaint charged VPSI with overcharging the Navy for indirect costs.
The case is captioned United States ex rel. Hai Ba Trung v. Vector Planning and Services Inc., et al., 3:12-cv-02353-LAB-BGS (S.D. Calif.). Since the case was filed in 2012, this early 2014 settlement represents a fairly quick resolution by FCA standards.
Read more here: http://www.justice.gov/opa/pr/2014/February/14-civ-167.html
by Author | Feb 20, 2014 | False Claims Act
A former employee of EndoGastric Solutions stands to receive up $945,000 from a successful qui tam False Claims Act case charging durable medical equipment fraud (DME Fraud) that was settled by the Department of Justice on February 19, 2014, with EndoGastric Solutions agreeing to pay $5.25 million to the government. The settlement resolves whistleblower allegations that EndoGastric caused prescribing physicians to submit up-coded bills to Medicare and also that the DME Manufacturer paid kickbacks to healthcare providers to induce sales, in violation of the Federal Anti-Kickback Statute.
It is good to see the government continuing to pursue violations of the Anti-Kickback Statute (AKBS). That has not always been the case.
Read more here: http://www.justice.gov/opa/pr/2014/February/14-civ-173.html
by Author | Feb 15, 2014 | False Claims Act
This ruling by a federal appellate court involves their interpretation of the Alternate Remedy provision in the False Claims Act, 31 U.S.C. § 3730(c)(5). In a case of first impression, the United States Court of Appeals for the Fifth Circuit denied two relators, who had alerted the government to a multi-million Medicare and Medicaid fraud scheme, any reward for disclosing their information to the authorities because they had waited to file their whistleblower lawsuit until after the government had already indicted the defendants, rather than filing it before the criminal proceedings had begun. With the relators’ information and agreement to testify at trial, the government was able to secure guilty pleas from the defendants on fraud charges, as well as, a $43 million award for criminal restitution. Still, because they filed their qui tam complaint too late, the relators received no financial compensation.
Although the three judges were unanimous in ruling against the two relators, one of the judges wrote a concurring opinion which stated that, while the court’s conclusion was the correct one, the result was “arguably inequitable and illogical.”
The case is captioned United States of America, ex rel. Samuel Babalola; Kayode Samuel Adetunmbi v. Arun Sharma, doing business as Allergy Asthma Arthritis & Pain Center; Kiran Sharma, doing business as Allergy Asthma Arthritis & Pain Center, 2014 U.S. App. LEXIS 2823 (5th Cir. Feb 14, 2014).
by Author | Feb 14, 2014 | False Claims Act
Settlement announced in Defense Contracting Fraud false claims act qui tam case. Virginia-based defense contractor MPRI Inc. has agreed to pay $3.2 million to resolve allegations that it submitted false labor charges on a contract to support the Army in Afghanistan, the Justice Department announced on February 12, 2014. The government had alleged MPRI billed for employees who had not worked because they had been granted leave and were out of the country.
Under its contract with the Army, MPRI was supposed to provide support to the Army in its efforts to re-design and build from scratch a new Afghan Defense Sector that would establish an Afghan national security system suitable for a modern Western military, according to the government.
The qui tam whistleblower reportedly will receive $576,000 as his share of the settlement amount.
Read more: http://www.justice.gov/opa/pr/2014/February/14-civ-155.html
by Author | Feb 11, 2014 | False Claims Act
False Claims Act Healthcare Fraud Settlement: A chain of opiate addiction recovery centers, headquartered in Harrodsburg, Ky., and a Russell Springs, Ky., clinical laboratory, along with two physician owners, agreed to pay the U.S. Government $15.75 million to resolve False Claims Act civil allegations that they fraudulently billed federal health care programs (Medicare and Medicaid ) for medically unnecessary and excessive urine tests.
Read more: http://www.justice.gov/usao/kye/news/2014/2014-02-10-premiertox.html
