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False Claims Act Archives

DaVita Medical to pay $270 million in False Claims Act case

Medicare Advantage plans are owned and operated by private organizations called Medicare Advantage Organizations (MAOs). Medicare beneficiaries can enroll in and obtain healthcare through these plans. Unlike in traditional Medicare, MAOs are not paid based on services rendered but instead receive a fixed monthly amount for each beneficiary's care. Since some patients require more care than average, payments from Medicare to MAOs are "risk adjusted" to reflect the beneficiary's health status. In other words, MAOs receive higher payments for patients whose conditions require more care.

Whistleblowers get at least $27.4 mln in False Claims Act cases

The federal government intervened in eight False Claims Act lawsuits and brought criminal charges against Health Management Associates, LLC (HMA), a hospital chain that has since been sold. According to the Justice Department, HMA engaged in a scheme to defraud the U.S. The allegations include:

Lockheed Martin employee reaches False Claims Act settlement

Richard O. was an employee of Lockheed Martin Corporation working for Mission Support Alliance (MSA) in August 2009. Lockheed Martin Services, Inc. (LMSI), a Lockheed Martin subsidiary, and MSA were hired by the Department of Energy to perform environmental cleanup of the Hanford Nuclear Reservation in Washington. Through a subsidiary, Lockheed Martin was one of the owners of MSA, as well.

Another case of Medicare kickbacks brings $6.1-million settlement

It was an interesting scheme. According to allegations by the Department of Justice, Reliant Rehabilitation Holdings, Inc., wanted to induce or reward its client nursing homes for referring patients to Reliant for rehabilitation therapy. So, it sent over nurse practitioners employed by Reliant to work for those nursing homes for free or below market value.

Whistleblower to get $2,345,670 in medical kickbacks case

It has been reported that Post Acute Medical, LLC, and certain affiliates ("PAM") have agreed to pay $13,168,000 to settle claims by the Justice Department, Texas and Louisiana that they violated the False Claims Act and parallel state statutes. The nationwide operator of rehabilitation and long-term care hospitals was accused of knowingly submitting claims to Medicare and Medicaid that were the result of violations of the Physician Self-Referral Law and the Anti-Kickback Statute.

Whistleblower to receive $4.9 million in medical kickbacks case

A Texas doctor will receive $4.9 million as a reward for blowing the whistle on seven ambulance industry defendants who allegedly paid kickbacks to municipal entities in several states in exchange for lucrative ambulance business. The alleged kickbacks violated the federal Anti-Kickback Statute, which prohibits offering, paying, soliciting or receiving remuneration in order to induce referrals. The scheme allegedly resulted in false claims being submitted to Medicare and Medicaid, which violated the False Claims Act.

Lance Armstrong's ex-manager to pay $1.2 mln in False Claims case

When Lance Armstrong used banned substances to win the Tour de France, he violated the False Claims Act, which imposes legal liability on those who commit fraud against federal programs. The reason his actions violated the False Claims Act is that he had received a $32.3 million sponsorship from the U.S. Postal Service during six of his victorious tours.

Settlement: Whistleblower reveals defective bulletproof vests

It was recently reported that a former employee of Second Chance Body Armor, Inc., blew the whistle on that company's sales of defective Zylon bulletproof vests to federal, state, local and tribal law enforcement agencies through the Justice Department's Bulletproof Vest Partnership program and contracts with the General Services Administration. Unfortunately, according to the DOJ, these vests lost their ballistic capability when they were exposed to heat and humidity.

Self-referrals, lack of documentation lead to $14.7 million case

It was recently reported, that, after four different employees blew the whistle on false and inflated claims to Medicare and Medicaid, two healthcare concerns have admitted responsibility and agreed to pay a $14.7 million settlement. One was Health Quest Systems, Inc., a New York-based family of hospitals and healthcare providers delivering medical, surgical and home healthcare services. The other was Putnam Health Center (PHC), a Health Quest subsidiary based in Carmel Hamlet, New York.

Company settles major False Claims Act case for $14.4 million

In 2009, the National Energy and Technology Laboratory (NETL) awarded a $14-million cooperative agreement to a company called North American Power Group Ltd. (NAPG) to collect and analyze carbon data and to design and implement carbon sequestration wells in Wyoming. NAPG's owner, Michael Ruffatto, represented the company and authorized its invoices. Between 2009 and 2012, he billed NETL some $5.7 million for project-related costs.

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