whistleblower

Paris-based global financial institution BNP Paribas has agreed to pay $80 million to settle allegations that it knowingly submitted or caused the submission of false claims for payment guarantees issued by the U.S. Department of Agriculture (USDA), the U.S. Department of Justice announced last week.

The United States filed a lawsuit against BNP Paribas in connection with its receipt of payment guarantees under USDA’s Supplier Credit Guarantee (SCG) Program.  The program provided payment guarantees to U.S.-based exporters for their sales of grain and other agricultural commodities to importers in foreign countries.  The program encouraged American exporters to sell American agricultural commodities to foreign importers and covered part of the losses if the foreign importers failed to pay.  The SCG Program regulations provided that U.S. exporters were ineligible to participate in the SCG Program if the exporter and foreign importer were under common ownership or control.

The judgment entered by the court resolves the government’s allegations that BNP Paribas participated in a sustained scheme to defraud the SCG Program.  American exporters and Mexican importers who were under common control improperly obtained SCG Program export credit guarantees for transactions between the affiliated exporters and importers.  In some cases, the underlying transactions were shams and did not involve any real shipment of grain.  BNP Paribas accepted assignment of the credit guarantees from the American exporters, even though it knew that the affiliated exporters and importers were ineligible for SCG Program financing, and a BNP Paribas vice-president, Jerry Cruz, received bribes from the exporters.  When the Mexican importers began defaulting on their payment obligations, BNP Paribas submitted claims to the USDA for the resulting losses.

On Jan. 20, 2012, Cruz pleaded guilty to conspiracy to commit bank fraud, mail fraud and wire fraud, and conspiracy to commit money laundering.  

The False Claims Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.  Had there been a whistleblower in this case, he or she would have been eligible to receive up to 30 percent of the settlement.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

Alabama-based Infirmary Health System (IHS), two affiliated clinics, and Diagnostic Physicians Group P.C. (DPG) have agreed to pay $24.5 million to settle allegations that they knowingly submitted or cause the submission of false claims to the Medicare program, the U.S. Department of Justice announced earlier this week.

Two IHS affiliated clinics—IMC-Diagnostic and Medical Clinic, in Mobile, and IMC-Northside Clinic, in Saraland, Alabama—allegedly had agreements with DPG to pay the group a percentage of Medicare payments for tests and procedures referred by DPG physicians, in violation of the Stark Law and the Anti-Kickback Statute.  Also named in the lawsuit was Infirmary Medical Clinics P.C. (IMC), an affiliate of IHS that directly owns and operates approximately 30 clinics in the Mobile area, including the two clinics involved in this lawsuit.

The Anti-Kickback Statute and the Stark Law are intended to ensure that a physician’s medical judgment is not compromised by improper financial incentives.  The Anti-Kickback Statute prohibits offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by federal health care programs, including Medicare.  The Stark Law forbids a hospital or clinic from billing Medicare for certain services referred by physicians who have a financial relationship with the entity.

IMC allegedly purchased IMC-Diagnostic and Medical Clinic from DPG and agreed to pay DPG a share of the revenues the clinics collected, including Medicare revenues from diagnostic imaging and laboratory tests.  After IMC acquired the IMC-Northside Clinic in 2008, the physicians practicing there joined DPG and entered into an agreement with the same key terms as the earlier agreement with IMC-Diagnostic and Medical Clinic.  The government contended that these payments were illegal kickbacks and constituted a prohibited financial relationship under the Stark Law, and that an attorney for DPG warned employees of both IMC and DPG that the compensation being paid to the physicians likely violated the law.  Nevertheless, the agreements allegedly were neither modified nor terminated for another 18 months.

The lawsuit was originally filed by Dr. Christian Heesch, a former DPG employee, under the whistleblower provision of the False Claims Act.  The Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.  Dr. Heesch will receive $4.41 million as his portion of the settlement.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

HSBC has agreed to pay $10 million to settle allegations that the company knowingly submitted or caused the submission of false claims to federal housing and mortgage programs, the U.S. Attorney’s Office for the Southern District of New York announced last week.

HSBC performs or oversees the performance of certain administrative activities in connection with residential mortgage loans, such as collecting mortgage payments and pursuing foreclosure when borrowers become delinquent. In pursuing foreclosure on behalf of HSBC, outside counsel and other third-party providers of foreclosure-related services, such as title companies and process servers, incur fees and expenses. HSBC has routinely submitted reimbursement requests to the Federal Housing Administration (FHA) and Federal National Mortgage Association (Fannie Mae) for these foreclosure-related fees and expenses.

Pursuant to the National Housing Act, FHA offers mortgage insurance programs whereby it insures lenders against losses on mortgage loans, including expenses related to mortgage servicing, and specifically, expenses incurred in foreclosure proceedings. HSBC has been an approved servicer of FHA-insured loans for many years. In order to obtain and maintain FHA approval to service FHA-insured loans, HSBC was required to submit and did submit annual certifications stating that it adhered to all FHA handbooks, regulations and policies. One such handbook requires servicers to create and maintain a quality control program that reviews all aspects of servicing operations, including foreclosure fees and charges.

HSBC has also been an approved servicer of loans held by Fannie Mae. Fannie Mae is a government sponsored enterprise that purchases mortgage loans as part of its mission to promote liquidity in the housing market. Fannie Mae has been under the conservatorship of the Federal Housing Finance Agency since September 2008. As part of its obligations as a loan servicer for Fannie Mae, HSBC was required to create and implement audit and control systems to ensure compliance with Fannie Mae’s requirements. Specifically, as a servicer of Fannie Mae loans, HSBC was required to ensure that all costs submitted to Fannie Mae for reimbursement were reasonable, customary and necessary.

As set forth in the settlement, contrary to program requirements and HSBC’s certifications, HSBC failed to implement and maintain the requisite quality controls, failed to oversee the foreclosure-related charges it submitted to FHA and Fannie Mae for reimbursement, and caused millions of dollars in losses to FHA and Fannie Mae as a result.

The lawsuit was originally filed by an unnamed whistleblower under the qui tam provision of the False Claims Act.  The Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.  The original whistleblower suit remains under seal as the government continues its investigation.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

Florida-based Baptist Health Systems has agreed to pay $2.5 million to settle allegations that the company knowingly submitted or caused the submission of false claims to federal health care programs such as Medicare, Medicaid, TRICARE, and the Federal Employee Health Benefits Program, the U.S. Department of Justice announced today.

This settlement resolves allegations that two neurologists in the Baptist Health network misdiagnosed patients with various neurological disorders, such as multiple sclerosis, which caused Baptist Health to bill for medically unnecessary services.  Although Baptist Health placed one of the physicians at issue on administrative leave in October 2011, it did not disclose any misdiagnoses to the government until September 2012.

The improper conduct at issue in this case included Medicaid patients.  Medicaid is funded jointly by the states and the federal government.  The state of Florida, which paid for some of the Medicaid claims at issue, will receive $19,024 of the settlement amount.

The government’s investigation was initiated by a qui tam, or whistleblower, lawsuit filed under the False Claims Act by Verchetta Wells, a former Baptist Health employee.  The act allows private citizens to file suit for false claims on behalf of the government and to share in the government’s recovery.  Wells will receive $424,155.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

Amedisys Home Health Companies have agreed to pay $150 million to settle allegations that the company knowingly submitted or caused the submission of false claims to Medicare, the U.S. Department of Justice announced last week.  Amedisys is one of the nation’s largest providers of home health services and operates in 37 states, the District of Columbia, and Puerto Rico.

Allegedly, certain Amedisys offices improperly billed Medicare for ineligible patients and services.  Amedisys allegedly billed Medicare for nursing and therapy services that were medically unnecessary or provided to patients who were not homebound, and otherwise misrepresented patients’ conditions to increase its Medicare payments.  These billing violations were the alleged result of management pressure on nurses and therapists to provide care based on the financial benefits to Amedisys, rather than the needs of patients.    

Additionally, this settlement resolves certain allegations that Amedisys maintained improper financial relationships with referring physicians.  The Anti-Kickback Statute and the Stark Statute restrict the financial relationships that home healthcare providers may have with doctors who refer patients to them.  The United States alleged that Amedisys’ financial relationship with a private oncology practice in Georgia – whereby Amedisys employees provided patient care coordination services to the oncology practice at below-market prices – violated statutory requirements.

Amedisys also agreed to be bound by the terms of a Corporate Integrity Agreement with the Department of Health and Human Services – Office of Inspector General that requires the companies to implement compliance measures designed to avoid or promptly detect conduct similar to that which gave rise to the settlement.    

This settlement resolves seven lawsuits pending against Amedisys in federal court – six in the Eastern District of Pennsylvania and one in the Northern District of Georgia – that were filed under the qui tam, or whistleblower, provisions of the False Claims Act, which allow private parties to bring civil actions on behalf of the United States and share in any recovery.  As part of today’s settlement, the whistleblowers – primarily former Amedisys employees – will collectively split over $26 million.  

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.