Abri Health Plan and Universal American Financial Corp. agreed to pay $4.8 million to settle allegations that it paid sales agents for referrals, paid clients to sign up, misled clients about the scope of coverage, and sometimes enrolled them without their consent. The case was brought under the False Claims Act by a former sales…
Guidant Settles FCA Case with the DOJ
Guidant LLC agreed to pay the United States $9.25 million to settle False Claims Act allegations against it. According to the complaint, Guidant failed to give hospitals the warranty credits and rebates for the replacement of pacemakers and defibrillators still under warranty, thereby increasing the cost to federal healthcare programs including Medicare, Medicaid, Veteran’s Affairs,…
FCA Suit Against Kaplan Continues
A federal judge denied a motion to dismiss a False Claims Act case against Kaplan University, one of the largest for-profit colleges in the United States. The whistleblowers, former instructors for Kaplan, alleged that the college had manipulated student academic records and job-placement statistics, paid incentives to recruiters based on enrollment numbers, and violated the…
Five States and Feds Have Intervened Against Education Management Corp.
Minnesota became the fifth state to join the federal government in intervening in a False Claims Act case against Education Management Corp., a for-profit network of 101 schools in 31 states and Canada. Education Management Corp. is alleged to have violated federal education laws, including restrictions on recruiting practices. Tennessee, Kentucky, and Pennsylvania may also…
Employees Increasingly Blowing the Whistle
In an effort to improve their ability to stop corporate wrongdoing, the federal government and several states have increased whistleblower incentives and have created or strengthened protections against employer retaliation over the last few years. These measures appear to have been successful, as since 2005 there has been a large increase in the number of…
Details in Halifax Hospital Case
After the DOJ announced its intervention in the case last week, more information has become available on the case against Halifax Hospital. According to the allegations, Halifax paid several neurologists and oncologists on the basis of referrals made for other services at Halifax Hospital. The payment arrangements were even included in the oncologists’ contracts, according…
Possible 50 Year Sentence for Architect of $205 Million Medicare Fraud Scheme
Lawrence Duran and his girlfriend Marianella Valera face sentencing on Wednesday for a scheme which cost Medicare $205 million. Duran, Valera, and others operated American Therapeutic, a company that provided kickbacks for referrals to its group therapy services. Those who received kickbacks referred thousands of Medicare patients to American Therapeutic’s services, including many who suffered…
Johnson & Johnson Will Go to Trial in Arkansas
A judge declined to dismiss Arkansas’ case against Johnson & Johnson, leaving it to face trial in March 2010 on claims that it violated labeling and marketing regulations in connection with its anti-psychotic drug Risperdal. Johnson & Johnson allegedly marketed Risperdal for unapproved uses, including dementia and mood and anxiety disorders and downplayed the drug’s…
Court Clarifies SEC Reporting Necessary for Whistleblower Retaliation Claim
A Manhattan District Court dismissed a whistleblower’s case alleging that his former employer had fired him in retaliation for reporting TradingScreen Inc.’s securities fraud violations. In one of the first cases filed under Dodd-Frank Act’s retaliation provisions, the court clarified that in order to benefit from that law’s protections, the whistleblower had to have reported…
Bank of America Violated Sarbanes-Oxley, Must Reinstate Employee
Bank of America was ordered to reinstate a whistleblower it fired after its merger with Countrywide Financial Corp. in 2008, as well as pay $930,000 in back wages, interest, compensatory damages, and attorney’s fees. U.S. Department of Labor’s Occupational Health and Safety Administration found that Bank of America violated Sarbanes-Oxley in improperly firing the employee,…