On December 15, 2022, the DOJ announced that Ocenture LLC, headquartered in Jacksonville, Florida, and its subsidiary, Carelumina LLC, agreed to pay $3 million to resolve allegations* they submitted false claims to Medicare by paying and receiving kickbacks in connection with genetic testing samples.
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
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
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
On April 8, 2021, the DOJ announced in a PRESS RELEASE that Doctors Care, P.A. – South Carolina’s largest urgent care provider network – and its management company, UCI Medical Affiliates of South Carolina, Inc. (“UCI”), will pay $25 million to resolve* civil allegations of healthcare fraud in violation of the False Claims Act. Relators initiated the FCA action on August 8, 2017 with the filing of their original complaint. On September 18, 2017, Relators filed their Amended Complaint for False Claims Act Violations, a… Read More »South Carolina’s Largest Urgent Care Provider and its Management Company to Pay $22.5 Million to Settle Civil Allegations of Healthcare Fraud in Violation of the False Claims Act
On April 16, 2021, the DOJ announced in a PRESS RELEASE that Preferred Pain Management & Spine Care, P.A. (“PPM”) and its owner, Dr. David Spivey, have agreed to pay $789,292.95 to resolve civil allegations that PPM violated the False Claims Act by billing Medicare, Medicaid, and other federal health care programs for medically unnecessary urine drug testing (“UDT”). The Relator/Whistleblower will receive $118,911.12 as her share of the federal recovery in this case. According to the Qui Tam Relator’s Complaint filed on January 22,… Read More »North Carolina Pain Management Company to Pay $789,292.95 to Resolve Civil Allegations of False Claims for Urine Drug Testing
The original complaint was filed in 2019 under the qui tam or whistleblower provisions of the False Claims Act. On April 9, 2021, the United States filed its Complaint in Intervention, partially intervening in a False Claims Act case in the U.S.D.C. for the District of Delaware, bringing claims against Connections Community Support Programs, Inc. (“Connections”), to recover treble damages sustained by, and civil penalties owed to, the United States based on Connections’ conduct. A copy of the Complaint in Intervention can be found below:… Read More »United States Intervenes in False Claims Act Case Against One of the Largest Providers of OutPatient Mental Health and Substance Abuse Services in Delaware
Whistleblower, David Felten, M.D., Ph.D. (“Felten”), initially filed his qui tam complaint on August 30, 2010, alleging his then-employer, William Beaumont Hospital (the “Hospital”) was violating the False Claims Act (FCA) and the Michigan Medicaid False Claims Act. Felton alleged that the Hospital was paying kickbacks to physicians and physicians’ groups in exchange for referrals of Medicare, Medicaid, and TRICARE patients. Felten also alleged that the Hospital retaliated against him in violation of the FCA’s anti-retaliation provision and Michigan Law, by threatening and marginalizing him… Read More »March 31, 2021 – The Sixth Circuit, Addressing an Issue of First Impression, Held that the FCA’s Anti-Retaliation Provision Protects Former Employees Alleging Post-Termination Retaliation
On March 26, 2021, the DOJ issued a Press Release announcing an update on criminal and civil enforcement efforts to combat COVID-19 related fraud, including schemes targeting the Paycheck Protection Program (PPP), Economic Injury Disaster Loan (EIDL) program and Unemployment Insurance (UI) programs. As of today, the DOJ has publicly charged 474 defendants with criminal offenses based on fraud schemes connected to the COVID-19 pandemic. These cases involve attempts to obtain $569 million from the U.S. government and unsuspecting individuals through fraud across the country.… Read More »DOJ Takes Action Against COVID-19 Fraud – Historic Level of Enforcement
On March 16, 2021, the DOJ issued a Press Release announcing two South Florida men (residents of Gulf Stream and Fort Lauderdale) have agreed to collectively pay at least $4 million in a civil settlement to resolve allegations that they violated the False Claims Act by engaging in schemes to generate prescriptions for compounded drugs and refer those prescriptions to pharmacies in exchange for illegal kickbacks. The allegations maintain that many of those prescriptions were billed to TRICARE, the federal health care program providing insurance… Read More »DOJ Announces Two South Florida Former Owners of a Telemarketing Company Agreed to Pay at Least $4M to Resolve False Claims Act Allegations