Author: Qui Tam

Leading Private Ambulance Company to Pay $2.7 Million to Settle False Claims Act Suit

American Medical Response (“AMR”), one of the country’s largest private ambulance services, will pay the United States government $2.7 million to resolve allegations that it defrauded Medicare and other federal health insurance programs.

The allegations against AMR were originally brought by several former employees, who alleged that AMR coded “basic life support” calls as “advanced life support,” which are reimbursed at a higher rate by Medicare. 

Diagnostic Sleep Companies to Pay $650,000 to Settle False Claims Act Suit

Three related companies, Areté Sleep LLC, Areté Sleep Therapy LLC and Areté Holdings LLC, have agreed to pay the United States Department of Justice $650,000 to settle claims that the Areté companies defrauded Medicare in violation of the False Claims Act.  The settlement resolves claims that Areté submitted false claims to Medicare for diagnostic sleep tests performed by technicians lacking the licenses or certifications required by Medicare’s rules and regulations. 

U.S. District Court in Tennessee Awards Government in Excess of $82 Million in FCA Suit Regarding Medicare Fraud

On May 26, 2011, Judge William J. Haynes, Jr. awarded the United States $82,642,592.00 in damages after granting summary judgment in favor of the government on its False Claims Act (“FCA”) claim against Fresenius Medical Care Holdings, Inc.  The award was based on treble damages under the FCA of $38,873,592 and $43,769,000 in civil penalties.

California to Intervene in False Claims Act Suit Targeting Educational Aid Fraud

In a recently-unsealed filing, California became the second state to join in a False Claims Act whistleblower lawsuit originally brought in 2007 against Education Management Corporation (“EMC”), a for-profit college company that operates 14 campuses in California under the “Argosy University” and “Art Institute” brands.

The suit, which was brought by two former employees,

California AG’s Mortgage Fraud Strike Force to Use State False Claims Act

In a speech delivered on Monday, May 24, 2011, California Attorney General Kamala Harris promised that her newly-formed Mortgage Fraud Strike Force would employ the state’s “robust” False Claims Act to hold those who commit mortgage fraud accountable.

“We are prepared to use it in a way that will look at all those who have made false statements or misled investors of any nature – be they individuals,

E.D.N.Y.: Medical Providers May Not Seek Contribution or Indemnity for Billing Fraud

On May 13, 2011, in a case of apparent first impression, Judge John Gleeson of the United States District Court for the Eastern District of New York held that medical services defendants may not implead their billing company where the Government, after intervening in a False Claims Act suit, asserts claims for unjust enrichment and payment by mistake.

SEC Adopts Final Regulations for Whistleblower Program

With great anticipation, the SEC adopted its final regulations governing the new whistleblower program under the Dodd-Frank financial reform legislation.  Most significantly, the SEC did away with a proposed requirement that whistleblowers first report wrongdoing internally before reporting to the SEC, despite strong opposition from corporate lobbyists.  The SEC did provide enhanced remedies for whistleblowers that decide to first report internally by reaffirming that such whistleblowers will still be eligible for an award,

Allegheny County Surfs the False Claims Wave

Allegheny County, Pennsylvania became  the first  municipal government in Pennsylvania and the fourth nationwide to adopt a false claims act.  The new ordinance, based generally on the Federal False Claims Act allows a private individual to file a complaint for false claims after the county Solicitor has investigated the allegations of the complaint and declined to intervene. 

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