The False Claims Act enables a private citizen with unique knowledge of fraud committed against the federal government (such as health care fraud, contract fraud, and tax fraud) to file a lawsuit under seal (not accessible to the public) seeking treble (triple the amount) damages on behalf of the government... Read more about the False Claims Act
Two Southwest Missouri health care providers have agreed to pay the United States $34,000,000 to settle allegations that they violated the False Claims Act by engaging in improper financial relationships with referring physicians, the Justice Department announced last month. The two Defendants are Mercy Hospital Springfield f/k/a St. John’s Regional Health Center, and its affiliate, Mercy Clinic Springfield Communities f/k/a St. John’s Clinic. Among other health care... full text
The United States has intervened and filed a complaint in a lawsuit against UnitedHealth Group Inc. (UHG) that alleges UHG obtained inflated risk adjustment payments based on untruthful and inaccurate information about the health status of beneficiaries enrolled in UHG’s largest Medicare Advantage Plan, UHC of California, the Justice Department announced last month.
UHG is the nation’s largest Medicare Advantage Organization, with more than 50 Medicare Advantage and Drug... full text
Indiana University Health Inc. (IU Health) and HealthNet Inc., have agreed to pay a total of $18 million to resolve allegations that they violated federal and state false claims laws by engaging in an illegal kickback scheme related to the referral of HealthNet’s OB/GYN patients to IU Health’s Methodist Hospital, the U.S. Department of Justice announced last month. Under the settlement agreement, IU Health and HealthNet each will pay approximately $5.1 million to the United States... full text
Energy & Process Corporation (E&P) of Tucker, Georgia, has agreed to pay $4.6 million to resolve the government’s lawsuit filed under the False Claims Act alleging that it knowingly failed to perform required quality assurance procedures and supplied defective steel reinforcing bars (rebar) in connection with a contract to construct a Department of Energy (DOE) nuclear waste treatment facility, the U.S. Department of Justice announced last month.
The lawsuit alleged that... full text
Quest Diagnostics Inc. has agreed to pay $6 million to resolve a lawsuit by the United States alleging that Berkeley HeartLab Inc., of Alameda, California, violated the False Claims Act by paying kickbacks to physicians and patients to induce the use of Berkeley for blood testing services and by charging for medically unnecessary tests, the U.S. Department of Justice announced last month. Quest, which is headquartered in Madison, New Jersey, acquired Berkeley in 2011, and ended... full text
Energy & Process Corporation (E&P) of Tucker, Georgia, has agreed to pay $4.6 million to resolve the government’s lawsuit filed under the False Claims Act alleging that it knowingly failed to perform required quality assurance procedures and supplied defective steel reinforcing bars (rebar) in connection with a contract to construct a Department of Energy (DOE) nuclear waste treatment facility, the U.S. Department of Justice announced yesterday.
The lawsuit alleged that... full text
CA Inc. (CA) has agreed to pay $45 million to resolve allegations under the False Claims Act that it made false statements and claims in the negotiation and administration of a General Services Administration (GSA) contract, the Department of Justice announced earlier this month. CA is an information technology management software and services company headquartered in New York, New York.
The settlement resolves allegations related to a GSA contract awarded to CA for software... full text
TeamHealth Holdings, as successor in interest to IPC Healthcare Inc., f/k/a IPC The Hospitalists Inc. (IPC), has agreed to resolve allegations that IPC violated the False Claims Act by billing Medicare, Medicaid, the Defense Health Agency and the Federal Employees Health Benefits Program for higher and more expensive levels of medical service than were actually performed (a practice known as “up-coding”), the Department of Justice announced earlier this month. Under the settlement... full text
Medstar Ambulance Inc., including four subsidiary companies and its two owners, Nicholas and Gregory Melehov, have agreed to pay $12.7 million to resolve allegations that the Massachusetts-based ambulance company knowingly submitted false claims to Medicare, the Department of Justice announced last month.
The settlement resolves allegations that Medstar submitted false claims to Medicare for ambulance transport services. Specifically, the United States alleged that Medstar routinely... full text
Shire Pharmaceuticals LLC and other subsidiaries of Shire plc (Shire) will pay $350 million to settle federal and state False Claims Act allegations that Shire and the company it acquired in 2011, Advanced BioHealing (ABH), employed kickbacks and other unlawful methods to induce clinics and physicians to use or overuse its product “Dermagraft,” a bioengineered human skin substitute approved by the FDA for the treatment of diabetic foot ulcers, the U.S. Department of Justice... full text
