Qui Tam

Amendments to public disclosure provision in new health care law

Posted on March 25, 2010
The Patient Protection and Affordable Care Act (Public Law 111-148) includes a provision that changes the False Claims Act's definition of "public disclosure."In section 10104 of the new law is the following provision:"Section 3730(e) of title 31, United States Code, is amended by striking paragraph (4) and inserting the following:'(4) (A) The court shall dismiss an action or claim under this section, unless opposed by the Government, if substantially the same allegations or transactions as alleged in the action or claim were publicly disclosed?'(i) in a Federal criminal, civil, or administrative hearing in which the Government or its agent is a party;'(ii) in a congressional, Government Accountability Office, or other Federal report, hearing, audit, or investigation; or'(iii) from the news media,unless the action is brought by the Attorney General or the person bringing the action is an original source of the information...

New Jersey hospital settles qui tam suits involving Medicare outlier payments

Posted on March 22, 2010
Robert Wood Johnson University Hospital Hamilton will pay $6.35 million to settle allegations of Medicare fraud raised in two whistleblower suits, the Dept. of Justice reported. The suits had alleged that the New Jersey hospital fraudulently inflated its charges to Medicare patients to obtain larger reimbursements from the federal health care program...

Stimulus funds oversight board reports on investigations and audits

Posted on March 16, 2010
The Recovery Accountability and Transparency Board has issued its quarterly report, outlining its efforts to prevent fraud, waste and abuse in the use of stimulus funds.The funds, which were authorized by the American Recovery and Reinvestment Act of 2009, include federal funds for education, health care and entitlement programs; and $275 billion for federal contracts, grants and loans...

Alpharma resolves FCA suit involving Kadian

Posted on March 16, 2010
Alpharma, a subsidiary of King Pharmaceuticals, will pay $42.5 million to resolve allegations thatit improperly marketed the morphine-based drug Kadian.The Justice Department's press release outlined the alleged violations: paying health care providers to promote or prescribe the drug, and making misrepresentations about its safety and efficacy...

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Atlanta nursing home chains pay $14 million to settle fraud allegations

Posted on March 01, 2010
The Justice Department announced that Atlanta-based Mariner Health Care Inc. and SavaSeniorCare Administrative Services LLC will pay the U.S. and several states $14 million to settle fraud allegations brought under the False Claims Act.The suit, originally brought by whistleblower Adam Resnick, alleged that the defendants solicited kickback payments from Omnicare, the nation?s largest pharmacy specializing in dispensing drugs to nursing home patients...

Brookhaven Memorial Hospital will pay $2.92 Million to resolve FCA suit

Posted on February 25, 2010
Brookhaven Memorial Hospital Medical Center will pay $2.92 million to settle a False Claims Act suit that alleged the the hospital defrauded Medicare. The Justice Department press release says the suit charged that the hospital fraudulently inflated its charges to Medicare patients to obtain enhanced reimbursement from the federal health care program...

States and water districts join qui tam suit against PVC pipe manufacturer

Posted on February 16, 2010
A whistleblower lawsuit accuses J-M Manufacturing, the corporate predecessor of JM Eagle, of supplying defective PVC pipe to states and municipalities across the country. Nevada, Virginia, Delaware, Tennessee and thirty-nine California municipalities and water districts have joined the suit...

New Jersey amends its False Claims Act

Posted on February 09, 2010
New Jersey has amended its False Claims Act to bring it into compliance with the federal Deficit Reduction Act. If the Inspector General of the Dept. of Health and Human services finds that the state law is in compliance, the state is entitled to to enhanced recovery in Medicaid fraud cases...

Medical device maker settle FCA suit for $3.76 million

Posted on February 05, 2010
Atricure Inc., a medical device manufacturer, has agreed to pay the United States $3.76 million to resolve civil claims that it marketed its medical devices for uses that had not been approved by the FDA.The Dept. of Justice had alleged that the company violated the False Claims Act by promoting its surgical ablation device to treat atrial fibrillation, a use that is not approved by the FDA...

Health care benefits company settles FCA suit

Posted on February 05, 2010
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Florida congressman introduces "Defund the Crooks Act"

Posted on January 25, 2010
Rep. Alan Grayson (D-Fla.) has introduced a bill (H.R. 4444) that would impose new restrictions on the award of government contracts to organizations that have violated state or federal law.The bill would amend the Federal Acquisition Regulations to prevent the award of contracts to and require the termination of contracts with "covered organizations...

Dental fraud suit settled for $24 million

Posted on January 22, 2010
The Dept. of Justice announced that it has settled a False Claims Act suit against a dental management company. The company, FORBA Holdings LLC agreed to pay $24 million to resolve allegations that it provided medically unnecessary dental services to children insured by Medicaid...

Feds join whistleblower suit against Johnson & Johnson

Posted on January 15, 2010
The U.S. Dept. of Justice has joined a whistleblower suit alleging that pharmaceutical manufacturer Johnson & Johnson violated the False Claims Act.The complaint alleges that J&J paid millions of dollars in kickbacks to Omnicare, the nation?s largest pharmacy specializing in dispensing drugs to nursing home patients...

Chevron settles royalties underpayment qui tam suit for $45 million

Posted on December 28, 2009
Chevron Corp., Texaco, Unocal and affiliated companies will pay the federal government $45.6 million to resolve claims that they violated the False Claims Act by knowingly underpaying royalties owed on natural gas produced from federal and Indian leases...

Whistleblower Kopchinski named most influential person in business ethics for 2009

Posted on December 22, 2009
Ethisphere, a think tank that focuses on business ethics, corporate social responsibility, anti-corruption and sustainability, has named Pfizer whistleblower John Kopchinski the most influential person in business ethics for 2009. Kopchinski received a relator's share of $51...

Three home health agencies settle whistleblower suits for $24 million

Posted on December 22, 2009
Attorney General Andrew M. Cuomo and U.S. Attorney Benton J. Campbell today announced a settlement with three home health agencies resolving qui tam lawsuits that alleged violations of the federal and New York State False claims acts.The settlement arises from the agencies? use of hundreds of home health aides who had received little or no required training...

U.S., Calif. and Florida recover $69 million from Schering-Plough

Posted on December 22, 2009
Schering-Plough has agreed to pay a total of $69 million to the federal government and the states of California and Florida to settle allegations that it deliberately inflated the cost of drugs, causing Medicaid to overpay pharmacy reimbursements.The press release from the California Attorney General's Office (which includes a copy of the settlement agreement) notes that this is one of several whistleblower suits filed by Ven-A-Care of the Florida Keys, Inc...

University of Phoenix settles qui tam suit for $78.5 million

Posted on December 22, 2009
The University of Phoenix has agreed to pay $78.5 million to resolve allegations that it violated the False Claims Act. The suit, which was pursued by the qui tam plaintiffs after the government declined intervention, alleged that the university defrauded the government by paying counselors incentives for enrolling students...

Florida will receive $8.5 million in whistleblower suit

Posted on December 10, 2009
Florida Attorney General Bill McCollum announced that the state will receive $8.5 million from a settlement with Roxane Laboratories, Inc., and its corporate affiliates. The settlement resolves allegations that Roxane set and reported false and inflated prices for drugs, leading to overpayments by the Florida Medicaid program...

Qui tam cases made up nearly $2 billion of FY 2009 FCA recoveries

Posted on December 03, 2009
The Justice Department announced that settlements and judgements in cases involving fraud against the government reached $2.4 billion in fiscal year 2009. Of that amount, nearly $2 billion was attributable to cases brought by whistleblowers under the qui tam provisions of the federal False Claims Act...

Supreme Court hears oral arguments in False Claims Act case

Posted on December 01, 2009
The U. S. Supreme Court heard oral arguments on November 30 in the case of Graham County Soil & Water Conservation District v United States ex rel Wilson.The question before the court concerns the False Claims Act's public disclosure bar, 31 USC § 3730(e)(4)(A), which bars suits based on public disclosures ?in a criminal, civil or administrative hearing, in a congressional, administrative, or [GAO] report, hearing, audit, or investigation, or from the news media...

Nation's largest nursing home pharmacy settles qui tam suit

Posted on December 01, 2009
The U.S. Dept. of Justice announced on November 3, 2009 that the nation?s largest nursing home pharmacy, Omnicare Inc., will pay $98 million, and drug manufacturer, IVAX Pharmaceuticals of Weston, Florida, will pay $14 million to resolve allegations that Omnicare engaged in kickback schemes with several parties, including IVAX...

Congressional Research Service report on the False Claims Act

Posted on October 07, 2009
The Congressional Research Service has released a report on the False Claims Act, Qui Tam: The False Claims Act and Related Federal Statutes. CRS is a department within the Library of Congress that provides policy and legal analysis to Congressional committees and members...

Hospitals settle kyphoplasty fraud suit for $8.3 million

Posted on October 07, 2009
Six hospitals in Indiana and Alabama will pay the United States more than $8 million to settle a whistleblower lawsuit brought under the qui tam provisions of the False Claims Act, the U.S. Dept. of Justice announced on September 22.The settlement resolves allegations that, from 2000 to 2008, patients who went to these hospitals for a certain type of spinal surgery known as "kyphoplasty" were unnecessarily kept overnight at the hospital and then classified as inpatient cases to boost the hospitals' revenues...

Pfizer's payment of $2.3 billion is largest healthcare fraud settlement ever, DOJ says

Posted on September 03, 2009
The U.S. Dept. of Justice announced that Pfizer Inc. will pay $2.3 billion in civil False Claims Act damages and criminal fines to resolve allegations that the company illegally promoted a number of its drugs for off-label uses.Six separate whistleblower suits were filed against the company in this matter...

Covenant Medical Center settles FCA suit

Posted on August 25, 2009
The U.S. Dept. of Justice announced that Covenant Medical Center will pay $4.5 million to settle a False Claims Act suit.The suit alleged that Covenant violated the Stark Law, which prohibits a hospital from profiting from referrals of patients made by a physican with whom the hospital has an improper compensation arrangement...

FINRA acts to protect municipal bond investors

Posted on July 20, 2009
The Financial Industry Regulatory Authority (FINRA) announced that it will be surveying retail sales practices in the municipal securities market.FINRA investigators are conducting sweeps to gather information in three distinct areas: industry sales to retail investors; municipal securities involving swaps and derivatives for small municipalities; and sales of certain so-called municipal Gas Bonds that were underwritten and guaranteed by the now-defunct Lehman Brothers and quickly became distressed...

Sen. Grassley has questions for medical journals

Posted on July 20, 2009
Sen. Chuck Grassley, the ranking Republican member of the Finance Committee, wants leading medical journals to outline their policies on ghostwriting.Sen. Grassley has sent a letter to eight medical journals as part of his inquiry into whether drug and medical device companies are paying for draft articles and getting prominent doctors and researchers to sign on as authors, even though they may have had minimal involvement in the writing...

Whistleblower suits target fraud by ablation companies

Posted on July 20, 2009
Endoscopic Technologies Inc. (Estech), a medical device manufacturer, will pay the federal government $1.4 million to resolve a whistleblower suit alleging violations of the False Claims Act, the U.S. Dept. of Justice announced.The suit claimed that Estech promoted its surgical ablation devices for treatment of atrial fibrillation, a use that is not approved by the U...

SEC whistleblower program should emulate FCA, lawyer says

Posted on July 06, 2009
In an letter to the Financial Times, attorney Erika Kelton says that the proposed bounty program for SEC whistleblowers could be more effective.Kelton, a partner at Phillips & Cohen LLP, recommends that the program include an "action-forcing mechanism...

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