Whistleblower

A settlement has been reached in a whistleblower class action lawsuit brought against GE Healthcare Inc regarding a company it acquired in 2004, Amersham Health Inc.  Amersham is accused of causing Medicare to make overpayments by providing false or misleading information.

The whistleblower will receive $5.1 million from the government’s recovery.

The whistleblower lawsuit, filed in 2006, alleged that Amersham Health provided false or misleading information to Medicare regarding the number of doses available from vials, causing Medicare to pay for Myoview at artificially inflated rates. Myoview is distributed in multi-dose vials of powder. In a process known as reconstitution, nuclear pharmacies mix the powder with a radioactive agent to prepare individual doses that are injected into patients as part of the cardiac imaging procedures. Certain Medicare payment rates for Myoview were based, in part, on the number of doses available from vials of Myoview.

A settlement has been reached in relation to two whistleblower class action lawsuits brought against Columbus Regional Healthcare System (Columbus Regional) and Dr. Andrew Pippas.  They are accused of submitting claims in violation of the Stark Law and submitting claims for payment to federal health care programs that misrepresented the level of services they provided. 

Under the settlement agreement, of the $25.425 million that Columbus Regional and Pippas have agreed to pay to resolve their respective civil claims, they will pay $24,666,040 to the federal government for federal healthcare program losses and $758,960 to the state of Georgia for the state share of its Medicaid losses, plus additional contingent payments not to exceed $10 million, for a maximum settlement amount of $35 million.The whistleblower's recovery amount was not disclosed.

The first of the two lawsuits was filed in May 2012.  The lawsuits alleged that that from May 2006 through May 2013, Columbus Regional submitted claims to federal health care programs for services at higher levels than supported by the documentation, and between 2010 and 2012, they submitted claims to federal health care programs for radiation therapy at higher levels than the therapy that was provided.

A settlement has been reached in a whistleblower class action lawsuit brought against St. Jude Medical Inc in St.Paul, MN, who is accused of  inflating the cost of replacement pacemakers and defibrillators purchased by the Departments of Defense and Veterans Affairs.

The whistleblowers will receive $730,000 from the settlement amount.

The case, filed in August 2008, alleged that St. Jude actively marketed its pacemakers and defibrillators by touting the generous credits available should a device need to be replaced while covered under warranty. At the same time, St. Jude allegedly knew that it failed to grant appropriate credits to the purchasers of devices in a large number of cases where a product was replaced while still under warranty. As a result, the United States contended that St. Jude submitted invoices to Department of Veterans Affairs hospitals and Department of Defense military treatment facilities that overstated the cost for replacement pacemakers or defibrillators.

A settlement has been reached in a whistleblower class action lawsuit brought against Fluor Hanford LLC who is accused of using federal funds for lobbying.

The whistleblower will receive $200,000 of the government’s settlement.

The case, filed in February 2011, alleged that Fluor used Department of Energy (DOE) funds to lobby Congress and other federal officials to increase funding for the HAMMER Center, in violation of a federal law known as the Byrd Amendment, which prohibits the use of federal funds for lobbying.

Between 2005 and 2009, Fluor contracted with the DOE to manage and operate the Hazardous Materials Management and Emergency Response (HAMMER) Center. The HAMMER Center provides homeland security and emergency response training to first responders and law enforcement personnel.

A settlement has been reached in a whistleblower class action lawsuit brought against Science Applications International Corporation who is accused of charging inflated prices under grants to train first responder personnel to prevent and respond to terrorism attacks.

The whistleblower's share of the recovery has not been determined. 

The case, filed in February 2012, alleged that SAIC’s cost proposals falsely represented that SAIC would use far more expensive personnel to carry out its efforts than it intended to use and actually did use, resulting in inflated charges to the United States.

Between 2002 and 2012, the New Mexico Institute of Mining and Technology (New Mexico Tech) received six federal grants from the Department of Justice, the Department of Homeland Security, and the Federal Emergency Management Agency to train first responder personnel to prevent and respond to terrorism events involving explosive devices.  New Mexico Tech awarded subgrants to SAIC to provide course management, development, and instruction.

A settlement has been reached in a whistleblower class action lawsuit brought against Tennessee Orthopaedic Clinics PC and Appalachian Orthopaedic Clinics PC. They are accused of knowingly billing state and federal health care programs for reimported osteoarthritis medications, known as viscosupplements.

Tennessee Orthopaedic Clinics PC will pay $1.3 million, and Appalachian Orthopaedic Clinics PC will pay $550,000. The whistleblower will receive a $323,750 share of the recovery.

The case, filed in February 2012, alleged that the clinics knowingly purchased deeply discounted viscosupplements that were reimported from foreign countries and billed them to state and federal health care programs in order to profit from the reimbursement system, when such reimported viscosupplements were not reimbursable by those programs.  Allegedly, the reimported product included labeling in foreign languages and in English for additional uses not approved in the United States, which demonstrated that the product was reimported.  Moreover, because the product was reimported, the government alleged there was no manufacturer assurance that it had not been tampered with or that it was stored appropriately.   

A settlement has been reached in a whistleblower class action lawsuit brought against Frazier Masonry Corp, F-Y Inc, CTI Concrete & Masonry Inc, Masonry Technology Inc, Masonry Works Inc, Russell Frazier and Robert Yowell.  They are accused of misrepresenting their disadvantaged small business status in connection with military construction contracts.

The whistleblower will receive a $393,383 share of the recovery.

This settlement stems from other cases, the first of which was filed in 2012.  The United States alleged the defendant masonry subcontractors and their principals misrepresented to the prime contractors that they were small businesses, and that these misrepresentations caused the prime contractors to falsely certify that they had complied with the small business provisions of the contracts in claiming payment.  Russell Frazier previously pleaded guilty in related criminal proceedings to causing false statements.

A settlement has been reached in a whistleblower class action lawsuit brought against Hencorp Becstone Capital LC  who is accused of making false statements and claims to the Export-Import Bank of the United States (Ex-Im Bank) in order to obtain loan guarantees.

The whistleblowers will receive $608,000 of the settlement. 

The case, filed in February 2013, alleged that Ricardo Maza, a Peruvian-based former Hencorp business agent, created false documentation to obtain Ex-Im Bank guarantees on fictitious transactions on which no products were sold or exported, and that Hencorp acted recklessly by outsourcing key credit review functions to Maza without adequate supervision or oversight.  The government alleged that Maza then diverted the proceeds of the loans to himself and to his friends and business associates in Peru, and that the transactions resulted in losses to the Ex-Im Bank when the loans were not repaid.  In 2012, Mario Mimbella, 64, of Miami, Florida, the purported U.S.-based exporter on three of the fraudulent transactions, pled guilty to making false records for his participation in the scheme and was later sentenced to prison.

A settlement has been reached in a whistleblower class action lawsuit brought against US Investigations Services Inc (USIS) and its parent company, Altegrity, who are accused of failing to perform required quality control reviews in connection withbackground investigations that USIS held with the U.S. Office of Personnel Management (OPM).

According to the settlement details, the companies have agreed to forgo their right to collect payments that they claim were owed by OPM, valued at least at $30 million, in exchange for a release of liability under the False Claims Act.  

The whistleblower's portion of the recovery has not been determined.

The case, originally filed in July 2011, alleged that beginning in at least March 2008 and continuing through at least September 2012, USIS deliberately circumvented contractually required quality reviews of completed background investigations in order to increase the company’s revenues and profits.  Specifically, USIS allegedly devised a practice referred to internally as “dumping” or “flushing,” which involved releasing cases to OPM and representing them as complete when, in fact, not all the reports of investigations comprising those cases had received a contractually-required quality review.  The government contended that, relying upon USIS’ false representations, OPM issued payments and contract incentives to USIS that it would not otherwise have issued had OPM been aware that the background investigations had not gone through the quality review process required by the contracts.

A settlement has been reached in a whistleblower class action lawsuit brought against Baptist Health, which owns four Jacksonville hospitals, Memorial Hospital, Specialty Hospital, Lake City Medical Center, Orange Park Medical Center, University of Florida Health Jacksonville, and Century Ambulance Service Inc. 

The whistleblower will receive a $1.2 million share of the recovery.

According to the settlement terms, Baptist Health will pay $2.89 million; Memorial Hospital, Specialty Hospital, Lake City Medical Center and Orange Park Medical Center will pay a combined $2.37 million; University of Florida Health Jacksonville will pay $1 million; and Century will pay $1.25 million.

The case, filed in 2011, alleged that the hospitals routinely ordered ambulance transfers via Century that were medically suspect, costing Medicare, Medicaid, Tricare and the Federal Employees Health Benefits Program millions in unnecessary billings. Additionally, the complaint claimed that the hospitals routinely ordered life support ambulance transfers that were medically unnecessary. In association with this alleged healthcare fraud, Century was accused of knowingly up-coding claims from basic to advanced life support. Century was also accused of transporting patients unnecessarily and needlessly driving patients to their own homes as if it were an emergency.