The SEC Whistleblower program has yet to land a big FCPA case. SEC Whistleblower Head Sean McKessy predicts that FCPA claims will materialize and believes the number of FCPA tips reported may be higher than noted. Nonetheless, others are skeptical about whether the FCPA is a viable avenue for SEC whistleblowers.
ATI Enterprises, Inc. agreed to pay the government $3.7 million to settled claims that it falsely certified compliance with federal financial aid programs. The government claims that ATI fraudulently misrepresented its job placement statistics to maintain its eligibility for financial aid programs, and that it fraudulently induced students to enroll in the school and to maintain their enrollment to increase the amount of federal dollars received.
Terry Myers tried in vain to have Shands Hospitals self report improper billing practices his company found during routine audits over several years. The improper billing concerned Shands practice of routinely admitting Medicare and Medicaid patients who were not sick enough to need inpatient care.
Following an announcement by the Centers for Medicare and Medicaid Services about the temporary moratoria on Miami and Chicago home health providers and Houston ambulance providers for Medicare, U.S. Senators Orrin Hatch, Chuck Grassley, and Tom Coburn welcomed this action by CMS to halt waste fraud and abuse within the Medicare program.
The state of Georgia publicly joined a pending federal whistleblower case against two hospital companies, Tenet Healthcare Corporation and Health Management Associates, Inc. and an entity commonly known as Clinica de la Mama. The suit alleges that Clinica operates prenatal clinics to identify and recruit pregnant, undocumented Hispanic women and refers them to Tenet and HMA hospitals that pay for the referrals because the deliveries will be paid for by Medicare and Medicaid.
Federal Officials are scaling back numerous high-profile healthcare False Claims Act investigations due to budget decline. The Department of Health and Human Services’ Office of Inspector General, which investigates Medicare and Medicaid fraud, is losing 400 staff members through 2015, about 20% of its workforce.
An unspecified number of investigations into poor quality care in hospitals are being delayed due to “significantly reduced” travel budgets and the high cost of paying experts to review medical files.
Pfizer Inc., the owner of Wyeth Pharmaceuticals Inc., will pay $491 million to resolve allegations of off-label marketing of the drug Rapamune.
Mark Campbell, the whistleblower and a former Wyeth sales representative, alleged that Wyeth illegally marketed, for over a decade, the transplant drug for uses that had not been approved by the U.S.
AccMed Healthcare Systems, LLC, also knows as the Florida Spine Care and Pain Center, have resolved allegations that it violated the False Claims Act.
The U.S. Attorney’s Office said the settlement involves Bao Pham, D.O, allegedly submitting false claims between 2004 and 2008 for non-reimbursable procedures and services by up-coding and unbundling medical services provided to beneficiaries of Medicare and Federal Office of Workers Compensation programs.
Beth Israel Deaconess Medical Center, located in Boston and one of the world’s leading teaching hospitals, will pay over $5 million to settle allegations of improper Medicare claims.
The U.S.
Zachery Wolfson, the son of Mitchell Wolfson, the chief medical officer and founding partner of Park Avenue Medical Associates (“PAMA”), reportedly filed a False Claims Act complaint that led to the New York company settling Medicare fraud allegations for $1 million.
The Department of Justice alleged that PAMA billed for psychiatry services for patients whose dementia or cognitive disorders actually made them unable to benefit from psychotherapy.
If you are aware of any person, corporation or entity that you think may be violating the Federal False Claims Act or a State False Claims Act, contact us today.