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
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
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
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.
In the Fall of 2018, the DOJ announced Health Management Associates, LLC (HMA), a defunct U.S. hospital chain headquartered in Naples, Florida, would pay over $260 million in a global settlement to resolve criminal and civil claims relating to a scheme to defraud the United States. The $260 million global settlement was the result of eight qui tam cases filed in various district courts and transferred to the U.S. District Court for the District of Columbia as part of a multi-district litigation. See DOJ Press… Read More »Feb. 8, 2021 – Florida District Court Awards Whistleblower $952,480.00 in Attorney Fees Against Hospital Chain in False Claims Act Case
Relator filed the action in the United States District Court for the Middle District of Florida, pursuant to the qui tam provisions of the False Claims Act, 31 U.S.C. § 3730(b) the “Civil Qui Tam Action”). The Civil Qui Tam Action alleges that Defendants submitted or caused to be submitted false and/or fraudulent claims for payment to Medicare and other government payors, by falsifying documentation in order to fraudulently establish Durable Medical Equipment companies to bill for medically unnecessary DME equipment and engaging in improper… Read More »DOJ Reports Florida Business Woman Agrees to $20.3 Million Civil False Claims Act Settlement