Articles Tagged with whistleblower

Medicare fraudFederal prosecutors say CityMD, a New York based urgent care, admitted that it overcharged Medicare. They will pay millions for ordering more expensive procedures, and billing for services provided by physicians who were not properly credentialed.

The Whistleblower Lawsuit

The federal government joined a private whistleblower lawsuit. The lawsuit had been filed under seal but made severe allegations that CityMD has now admitted to committing.

charter-school-fraud-300x214One of Ohio’s largest online charter schools is facing some serious allegations from a former employee. The whistleblower claims, Electronic Classroom for Tomorrow, purposely inflated attendance figures tied to its state funding.

The Investigation

Education regulators are reviewing the allegations. Last year, the former technology employee told the Department of Education that “school officials ordered staff to manipulate student data with software obtained following the state’s demand that it return $60 million in overpayments for the 2015-2016 school year.” This according to WCPO in Cincinnati.

nccu-300x200North Carolina Central University (NCCU) is facing a lawsuit from one of its former vice chancellors. Benjamin Durant claims he was fired from his job after raising concerns about improper spending. He filed a whistleblower lawsuit against NCCU and its chancellor, according to the Raleigh News and Observer.

The Allegations

Durant says, after he raised concerns about Chancellor Johnson Akinleye’s luxury vehicle and that UNC Board of Governors members were trying to steer a multimillion-dollar campus housing contract to a Raleigh company, he was fired.

Banner Health has agreed to pay the United States over $18 million to settle allegations that 12 of its hospitals in Arizona and Colorado knowingly submitted false claims to Medicare by admitting patients who could have been treated on a less costly outpatient basis, the Justice Department announced today.  Headquartered in Arizona, Banner Health owns and operates 28 acute-care hospitals in multiple states. The settlement resolves allegations that 12 Banner Health hospitals knowingly overcharged Medicare patients unnecessarily.  In particular, the United States alleged that from Nov. 1, 2007 through Dec. 31, 2016, Banner Health billed Medicare for short-stay, inpatient procedures provided at the 12 hospitals that should have been billed on a less costly outpatient basis.  The settlement also resolves allegations that Banner Health inflated in reports to Medicare the number of hours for which patients received outpatient observation care during this time period.

Banner Health also entered into a corporate integrity agreement with the U.S. Department of Health and Human Services – Office of Inspector General (HHS-OIG) requiring the company to engage in significant compliance efforts over the next five years.  Under the agreement, Banner Health is required to retain an independent review organization to review the accuracy of the company’s claims for services furnished to federal health care program beneficiaries. This settlement resolves a lawsuit filed in the U.S. District Court for the District of Arizona by Cecilia Guardiola, a former employee of Banner Health, under the qui tam or whistleblower provisions of the False Claims Act, which permit private citizens to bring lawsuits on behalf of the United States and obtain a portion of the government’s recovery.  Guardiola will receive roughly $3.3 million.  The case is captioned United States ex rel. Guardiola v. Banner Health and NCMC, Inc. No. 2:13-cv-02443.

Jeffrey Newman represents whistleblowers

fraud-300x188A Civil War Era Law Puts Customs Fraud in The Spotlight

The False Claims Act is shining a light on customs fraud and reshaping lawsuits around the country. Whistleblower attorneys are expecting to see an uptick in the customs fraud cases they handle related to importing goods, according to the Wall Street Journal.

Last year, a U.S. appeals-court ruling made room for more whistleblower lawsuits related to the Civil War-era law known as the False Claims Act. The Supreme Court backed the appeals court, agreeing it has broader implications.

Russian WhistleblowerBeing a Whistleblower in Russia Comes with Life Altering Complications

Russia will not be at the 2018 Pyeongchang Winter Games because of a massive doping conspiracy that came to light thanks to a native whistleblower.  Now, according to US News, that man is now living in exile and in fear for his life.

US News reports that Grigory Rodchenkov is the former head of Moscow’s anti-doping laboratory, he and some of his colleges turned whistleblower against Russia.  Rodchenkov’s allegations of state-sponsored doping and cover-up at the Sochi 2014 Winter Olympics lead to extensive investigations by both the World Anti-Doping Agency (WADA) and the International Olympic Committee.

Massachusetts Whistleblower News

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Linde AG’s Lincare unit will pay $20 million to resolve a whistleblower lawsuit accusing the company of fraudulently billing the U.S. government for oxygen and respiratory care equipment.

The settlement, confirmed by the U.S. Attorney’s Office in Massachusetts,  ends a whistleblower lawsuit filed under the False Claims Act by former employees of the respiratory therapy services provider on behalf of the U.S. government. Lincare, is one of the largest U.S. providers of oxygen and respiratory therapy services and equipment, did not admit wrongdoing. Its settlement agreement was released late Monday after the deal received the U.S. Justice Department’s approval.

A whistleblower Patty Nixon, who worked as a sales representative for the drug manufacturer Insys, says that its major drug Subsys was prescribed for patients who never should have had it.She’s a former Insys sales rep turned whistleblower. According to the company web-sire the drug contains the massively strong medication fentanyl and it is a spray that is absorbed underneath the tongue, which results in faster absorption.

Whistleblower Nixon says her job was to contact insurance companies on behalf of the patients and the doctors to get the medication approved and paid for by their insurance company. Nixon says NBC that her supervisor told her ways to trick the insurers into believing it was “medically necessary.” The medication is approved only for cancer patients but was apparently sold to patients who did not have cancer.

Prosecutors say the company paid hundreds of thousands of dollars to doctors in exchange for prescribing Subsys. Three top prescribers have already been convicted of taking bribes from Insys. Insys has denied any responsibility and insists it shouldn’t be blamed for how doctors prescribe their products. The corporation is not facing criminal charges and is still selling Subsys — some $240 million worth of Subsys just last year.

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Coffee is now being studied more closely by researchers who are seeing potential for significant disease prevention and therapeutics. They are trying to understand how the coffee and caffeine actually work within the cells as population studies show promise for therapeutics. Harvard researchers have done a study which indicates that drinking 1-3 cups of caffeinated coffee can reduce diabetes risk. The studies are looking back at data of 126,000 people over 18 years and not the more rigorous forward clinical studies but the trends are strong. Another study suggests that people who drink coffee regularly are 80% less likely to develop Parkinson’s disease. The evidence is also strong that the reported benefits of coffee is the caffeine content. Caffeine is a vasodilator and phosphodiasterase inhibitor. Parkinson’s drugs are now being develop which contain a derivative of caffeine, based on the evidence from research studies. Caffeine has also been seen to benefit asthma sufferers and headache sufferers possibly because it acts to dilate blood vessels. Drs. are now trying to understand why coffee demonstrate these benefits and how it acts on a cellular level.

The United States Internal Revenue Service (IRS) has awarded $38 million to a whistleblower informant for revealing tax fraud by a large corporation according to his lawyers. According to counsel the IRS could have collected up to $250 million based on the law under which the claim was brought. Last month another whistleblower of tax fraud was awarded over $104 million for his part in revealing tax havens in Switzerland and the names of hundreds of individuals not paying their share of U.S. taxes.

Jeffrey Newman represents whistleblowers. Jeffrey.Newman1@gmail.com