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False Claims Act

French Medical Device Manufacturer to Pay $2 Million in a Civil Settlement to Resolve Kickbacks to Physicians and Related Medicare Open Payments Program Violations

On May 19, 2021, the Department of Justice (Eastern District of Pennsylvania) announced in a PRESS RELEASE that Medicrea International, a French medical device manufacturer, and its American affiliate Medicrea USA Inc., agreed to pay: $1 Million to the United States and participating states to resolve civil whistleblower allegations that the companies, by entertaining U.S.-based physicians during a 2013 conference in France, violated the Anti-Kickback Statute and, through resulting claims to federal healthcare programs, the False Claims Act and similar state statutes; and  an additional… Read More »French Medical Device Manufacturer to Pay $2 Million in a Civil Settlement to Resolve Kickbacks to Physicians and Related Medicare Open Payments Program Violations

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 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

North Carolina Pain Management Company to Pay $789,292.95 to Resolve Civil Allegations of False Claims for Urine Drug Testing

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

United States Intervenes in False Claims Act Case Against One of the Largest Providers of OutPatient Mental Health and Substance Abuse Services in Delaware

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

Bristol-Myers Squibb to Pay $75 Million to Resolve False Claims Act Allegations of Underpayment of Drug Rebates Owed Through Medicaid.

On April 1, 2021, the DOJ announced in a PRESS RELEASE that Bristol-Myers Squibb (“BMS”) had agreed to pay the United States and participating states a total of $75 Million, plus interest, to resolve allegations that it knowingly underpaid rebates owned under the Medicaid Drug Rebate Program (“MDRP”)*. Relator, Ronald Streck, initiated the current civil lawsuit in the Eastern District of Pennsylvania, under the whistleblower provisions of the False Claims Act, as well at multiple state false claims acts. The government declined intervention of this… Read More »Bristol-Myers Squibb to Pay $75 Million to Resolve False Claims Act Allegations of Underpayment of Drug Rebates Owed Through Medicaid.

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

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

DOJ Takes Action Against COVID-19 Fraud – Historic Level of Enforcement

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

DOJ Announces Two South Florida Former Owners of a Telemarketing Company Agreed to Pay at Least $4M to Resolve False Claims Act Allegations

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

Department of Justice Fraud Section Year in Review 2020

In February 2021, the DOJ Fraud Section issued its annual Year in Review 2020. In 2020, the DOJ Fraud Section spearheaded one of the largest-ever National Health Care Fraud and Prescription Opioid Takedowns. The DOJ Fraud Section’s Year in Review 2020 set out notable case examples of its nationwide effort to combat health care fraud – four (4) of which occurred in Florida: United States v. Jorge Perez, et al (M.D. Fla.) This case fell under the National Rapid Response Strike Force’s (NRRSF) purview, involving… Read More »Department of Justice Fraud Section Year in Review 2020

March 5, 2021 – DOJ Reports Ohio Treatment Facilities and Corporate Parent Agree to Pay $10.5 M to Resolve False Claims Act Allegations of Kickbacks to Patients and Unnecessary Admissions

March 5, 2021 – The DOJ reported that Ohio treatment facilities and their parent company will pay $10.25 million to resolve alleged violations of the False Claims Act for improperly providing free long-distance transportation to patients and admitting patients who did not require inpatient psychiatric treatment, resulting in the submission of false claims to the Medicare program.