Applied ethics

A settlement has been reached in a whistleblower class action lawsuit brought against LB&B Associates Inc who is accused of made false statements to obtain contracts through the Small Business Administration.

The whistleblower will recover a total of $1.5 million of the settlement.

Originally filed in 2007, the United States alleged that in seeking certification under SBA’s 8(a) Program, LB&B falsely represented that Lily Brandon – who satisfied the criteria for a socially and economically disadvantaged person under the program – controlled the operations of LB&B, when she did not.  Securing 8(a) certification allowed LB&B to obtain 8(a) set aside contracts from various government agencies.  Throughout the performance of these contracts, Lily Brandon allegedly failed to exercise actual control over LB&B’s operations, a key component to qualifying for the set aside contracts.

A settlement has been reached in a whistleblower class action lawsuit brought against CareSource, CareSource Management Group Co and CareSource USA Holding Co. They are accused of causing Medicaid to make payments for assessments and case managements they failed to provide to children and adults.

The whistleblowers will receive a $3.1 million share of the government's recovery.

Originally filed in November 2006, the United States alleged that between January 2001 and December 2006, the CareSource entities knowingly failed to provide required screening, assessment and case management for adults, and children with special health care needs. As a result, it was alleged that CareSource received millions of dollars in Medicaid funds to which it was not entitled. The CareSource entities subsequently submitted false data to the state of Ohio so that it appeared they were providing these required services to improperly retain incentives received from Ohio Medicaid and to avoid penalties.

The whistleblowers will receive a $80,000 share of the government's recovery.

This lawsuit was originally filed in May 2008 and stemmed from a 2005 filing of a lawsuit against Kyphon Inc.  The United States' complaint alleged that Rex Healthcare routinely submitted claims to Medicare for a variety of minimally-invasive procedures during the period 2004 through 2007, which the hospital classified as inpatient admissions in order to increase its reimbursement from Medicare, despite the absence of medical necessity justifying the more expensive inpatient admissions. The government also made claims related to a variety of other minimally-invasive procedures that the hospital classified as inpatient admissions in order to increase its reimbursement when less costly outpatient visits would have been appropriate.