Friday, January 22, 2010

FORBA Pays U.S. $24 Million in Settlement based on Three Qui Tam Lawsuits

The United States and FORBA Holdings LLC agreed on a $24 million settlement to resolve allegations that FORBA caused reimbursement claims for unnecessary dental procedures performed on low-income children to be submitted to Medicaid.

FORBA, a dental management company which provides management and business services to clinics nationwide known as “Small Smiles Centers,” will pay the U.S. and affected states, and will provide information about individual dentists that may have been involved. That investigation is ongoing.

The government’s case was based on three lawsuits filed under the qui tam, or whistleblower, provisions of the False Claims Act. The whistleblowers will share more than $2.4 million of the settlement.

The allegedly medically unnecessary procedures performed on children, included pulpotomies (baby root canals) and placing crowns, among others.

Click here to read the full article, “National Dental Management Company Pays $24 Million to Resolve Fraud Allegations"

U.S. Files Suit Against J&J for Paying Kickbacks Based on Whistleblower Suits

Drug manufacturer Johnson & Johnson, of New Brunswick, N.J., and two of its subsidiaries are the targets of a complaint filed by the U.S. government under the False Claims Act.

The government alleges that J&J paid millions of dollars in kickbacks to Omnicare Inc., to increase the purchase and recommendation of J&J drugs to nursing home pharmacies. Omnicare is the nation’s largest pharmacy that specializes in supplying nursing home patients with necessary drugs.

According to the complaint, J&J allegedly paid kickbacks to Omnicare by various means, including in the form of payments purportedly for “data,” “grants,” and “educational funding.”

In November 2009, Omnicare agreed to pay $98 million to settle a False Claims Act lawsuit with the U.S. and several states, for taking kickbacks from J&J, among other allegations.

This case is based on two combined whistleblower lawsuits from the District of Massachusetts.

Click here to read the full article, “U.S. Files Suit Against Johnson & Johnson for Paying Kickbacks to Nation’s Largest Nursing Home Pharmacy"

Thursday, January 21, 2010

Minnesota Hospital Pays in Whistleblower Lawsuit for Alleged False Claims to Medicare

Wheaton Community Hospital, located in Wheaton, MN, along with the city of Wheaton and an area doctor, have agreed to pay $846,461 to settle a False Claims Act lawsuit.

The lawsuit was originally filed as a qui tam action by Steven Radjenovich, a physician who formerly practiced at Wheaton Community Hospital. Radjenovich will receive $203,150 from the settlement.

The hospital allegedly billed Medicare for unnecessary hospital stays and acute care services.

Click here to read the full article, “Minnesota Hospital settles whistleblower suit"

Chevron Pays $45.5 Million for False Claims; Whistleblower Heirs Receive $12.3 Million

Chevron will pay $45.5 million to settle claims that it violated the False Claims Act. The government claims the company knowingly underpaid royalties owed on natural gas produced on federal and Indian lands.

The settlement resolves a charge that Chevron, Texaco and Unocal under-reported gas production between March 1998 and November 2008 in order to reduce their royalty payments.

Part of the $45.5 million will be distributed to state, federal and American Indian accounts, while $12.3 million will go to the heirs of the deceased whistleblower, Texarkana resident Harrold Wright. Wright originally filed the suit under the whistleblower provisions of the False Claims Act.

Click here to read the full article, “Chevron agrees to $45 M settlement of natural gas royalties dispute"

Woman Blows the Whistle on Genesys for Overbilling

A former internal auditor for the Genesys Regional Medical Center will receive $133,882 for her part in a whistleblower suit that resulted in a $669,413 settlement between the Center and the U.S. Justice Department.

The auditor, Wendy Domke, filed a whistleblower lawsuit against Genesys after becoming concerned that the company was overcharging Medicare in 2006.

Genesys allegedly violated the False Claims Act by “billing Medicare for higher levels of service than were actually rendered to patients,” also known as “upcoding,” according to the Justice Department.

Click here to read the full article, “Linden woman responsible for blowing whistle on Genesys’ settlement in overbilling lawsuit"

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