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False Claims Act

A South Florida Woman Sentenced to 3 Years for Role in Health Care Fraud Conspiracy

On November 7, 2022 (Tampa, FL), the DOJ announced that a Pompano Beach woman was sentenced to three years in federal prison for her role in a conspiracy to commit health care fraud, and for making a false statement in a matter involving a federal health care benefit program. As part of her sentence, the court ordered her to pay approximately $12 million to the affected government health programs and an insurance company, which obligation is joint and several with other coconspirators.

DC Circuit Adopts Pro Tanto Rule for FCA Settlement Offsets

On August 30, 2022, the U.S. Court of Appeals for the DC Circuit issued its opinion in United States v. Honeywell International, Inc. —F. 4th—, 2022 WL 3723020 (DC Cir. 2022). The DC Circuit held that the pro tanto rule is the appropriate approach to calculating settlement credits under the False Claims Act (“FCA”). The DC Circuit concluded that pro tanto is the settlement offset rule that best coheres with the FCA and the precedents interpreting it, and applying this rule will generally promote judicial… Read More »DC Circuit Adopts Pro Tanto Rule for FCA Settlement Offsets

Bayer to Pay $40 Million to Resolve Alleged Use of Kickbacks and False Statements

On September 2, 2022, the Department of Justice (DOJ) announced Bayer Corporation, and its related entities, Bayer HealthCare Pharmaceuticals Inc., Bayer HealthCare LLC and Bayer AG (collectively “Bayer”) agreed to pay $40 million to resolve alleged violations of the False Claims Act in connection with the drugs Trasylol, Avelox and Baycol. The Settlement Agreement can be found here. According to the DOJ, the settlement arose from two whistleblower lawsuits. The cases are captioned United States ex rel. Simpson v. Bayer Corp. Civ. No. 05-cv-3895 (D.N.J.), and United States… Read More »Bayer to Pay $40 Million to Resolve Alleged Use of Kickbacks and False Statements

DOJ’s False Claims Act Civil Case Settlements and Judgments Exceed $5.6 Billion in Fiscal Year 2021 (Over $5 Billion Attributable to the Health Care Industry)

The Department of Justice announced that it obtained more than $5.6 billion in settlements and judgments from civil cases involving fraud and false claims against the government in the fiscal year ending September 30, 2021. This is the largest annual total in False Claims Act history, and the largest since 2014. The DOJ’s Fraud Statistics Overview can be found HERE. Once again, the leading source of the DOJ’s FCA settlements and judgments was attributable to matters involving the health care industry – over $5 billion… Read More »DOJ’s False Claims Act Civil Case Settlements and Judgments Exceed $5.6 Billion in Fiscal Year 2021 (Over $5 Billion Attributable to the Health Care Industry)

U.S. Attorney’s Office Files Suit Against Philadelphia Pharmacy and Pharmacist for Illegally Dispensing Opioids and Health Care Fraud

On January 27, 2022, the DOJ announced that the United States filed a civil lawsuit against a Philadelphia-based pharmacy and pharmacist. The Complaint can be found below. The United States alleges that this civil lawsuit was brought to hold the pharmacy and its then-owner/pharmacist accountable for the illegal dispensing of controlled substances, including opioids, and fraud on Medicare and other federal health care programs. According to the Complaint, the pharmacy is alleged to have been the top retail pharmacy purchaser of oxycodone in the entire… Read More »U.S. Attorney’s Office Files Suit Against Philadelphia Pharmacy and Pharmacist for Illegally Dispensing Opioids and Health Care Fraud

Three Pharmaceutical Manufacturers Agreed to Pay a Total of $447.2 Million to Resolve Alleged False Claims Act Violations for Price-Fixing of Generic Drugs

The Department of Justice announced three pharmaceutical manufacturers, Taro Pharmaceuticals USA, Inc., Sandoz Inc. and Apotex Corporation, have agreed to pay a total of $447.2 million to resolve alleged violations of the False Claims Act arising from conspiracies to fix the price of various generic drugs. These conspiracies allegedly resulted in higher drug prices for federal health care programs and beneficiaries according to the Justice Department. Copies of the civil Settlement Agreements can be found here: (1) Sandoz Executed Settlement Agreement; (2) Apotex Executed Settlement… Read More »Three Pharmaceutical Manufacturers Agreed to Pay a Total of $447.2 Million to Resolve Alleged False Claims Act Violations for Price-Fixing of Generic Drugs

Florida’s Middle District Denies Defendant’s Motion to Dismiss FCA Claims Filed by the United States; Complaint Satisfied Both Elements of the 11th Circuit’s Ruckh Proximate Cause Test

The United States brought a two-count Complaint against Defendant, alleging that he violated the False Claims Act (“FCA”), 31 U.S.C. § 3729(a)(1)(A) (Count I), and conspired to violate the FCA, 31 U.S.C. § 3729(a)(1)(C) (Count II), by causing a pharmacy to file fraudulent claims with TRICARE, a federal health program. The Complaint alleges the pharmacy paid kickbacks to a marketing company, who in turn marketed compound medications to patients and then referred those patients to the pharmacy for fulfillment of the prescriptions for those medications.… Read More »Florida’s Middle District Denies Defendant’s Motion to Dismiss FCA Claims Filed by the United States; Complaint Satisfied Both Elements of the 11th Circuit’s Ruckh Proximate Cause Test

Mail-Order Diabetic Testing Supplier and Parent Company Agree to Pay $160 Million to Resolve Alleged False Claims to Medicare

On Monday, August 2, 2021, the DOJ announced that Arriva Medical LLC (“Arriva”), a mail-order diabetic testing supplier, and its parent, Alere Inc. (“Alere”) have agreed to pay $160 million to resolve allegations that they violated the False Claims Act. According to the July 2021 Settlement Agreement: -From 2009 until December 2017, Arriva was a Florida-based mail-order supplier of diabetic testing supplies to, amongst others, beneficiaries of the Medicare program. Arriva was founded in 2009 by David Wallace and Timothy Stocksdale, who, along with other… Read More »Mail-Order Diabetic Testing Supplier and Parent Company Agree to Pay $160 Million to Resolve Alleged False Claims to Medicare

Eleventh Circuit Upholds District Court’s Dismissal With Prejudice of False Claims Act Claims alleging Contractor and Water Works Board Engaged in a Pay-to-Play Scheme

Qui Tam Relators, Startley General Contractors, Inc., Mandy Powranzas and Steven Stewart (“Relators”), brought False Claims Act claims, among others, against a competing contractor, the Water Works Board of the City of Birmingham (“BWWB”), and multiple individuals personally and in their official capacities (collectively “Defendants”). According to Relators’ Second Amended Complaint, the Defendants were involved with BWWB in a “pay to play” scheme. More specifically, Relators alleged that BWWB, its management and a host of both retired and current employees, enjoyed personal enrichment through bribery… Read More »Eleventh Circuit Upholds District Court’s Dismissal With Prejudice of False Claims Act Claims alleging Contractor and Water Works Board Engaged in a Pay-to-Play Scheme

SavaSeniorCare LLC Agrees to Pay $11.2 Million to Resolve False Claims Act Allegations

On Friday, May 21, 2021, the DOJ announced in a press release that Georgie-based, SavaSeniorCare LLC and its related entities (“Sava”) agreed to pay $11.2 million, plus additional amounts if certain financial contingencies occur, to resolve civil allegations that Sava violated the False Claims Act. A copy of the Settlement Agreement* is here -> Sava, through its subsidiaries, provides skilled nursing services and rehabilitation therapy services, including physical, occupational, and speech therapy, to patients at numerous skilled nursing facilities (“SNFs”) nationwide, and bills the Medicare… Read More »SavaSeniorCare LLC Agrees to Pay $11.2 Million to Resolve False Claims Act Allegations