Whistleblower

A settlement has been reached in a whistleblower class action lawsuit brought against Dr. Gabriel DeCandido who is accused of defrauding the Medicare program.

According to the settlement, the court permitted the government to seize five of his vehicles and garnish $976,000 that Dr. DeCandido transferred to his wife.The whistleblower's share of the recovery is $306,000.

This case was originally filed by a whistleblower in January 2005.  The United States alleged Dr. DeCandido violated the False Claims Act by billing the Medicare program for higher levels of service than he actually rendered to patients and by billing for services not provided. The government presented sufficient evidence showing that Dr. DeCandido attempted to hide and transfer his assets to avoid having to pay a judgment to the United States.

A settlement has been reached in a whistleblower class action lawsuit brought against HealthEast Care System. Three HealthEast Care System hospitals are accused of submitting false claims to Medicare.

The two whistleblowers' recovery amounts from this lawsuit that was filed in 2008, were not specified.

The United States complaint asserts that three HealthEast Care System hospitals overcharged Medicare from 2002 to 2007 by thousands of dollars each time they performed kyphoplasty, a minimally-invasive procedure used to treat certain spinal fractures that often are due to osteoporosis. The procedure can be performed safely as an outpatient surgery, but the government contends that the HealthEast hospitals performed the procedure on an inpatient basis in order to increase their Medicare billings.

A settlement has been reached in a whistleblower class action lawsuit brought against NuVasive Inc who is accused of causing health care providers to submit false claims to Medicare and other federal health care programs.

According to the settlement agreement, the federal share of the civil settlement is $12,583,413.84, and the state Medicaid share of the civil settlement is $916,586.16. The whistleblower will receive a $2.2 million share of federal reward.

The whistleblower case was originally filed in September 2012.  The United States complaint alleged that between 2008 and 2013, NuVasive promoted the use of the CoRoent System for surgical uses that were not approved or cleared by the FDA, including for use in treating two complex spine deformities, severe scoliosis and severe spondylolisthesis.  As a result of this conduct, the United States alleged that NuVasive caused physicians and hospitals to submit false claims to federal health care programs for certain spine surgeries that were not eligible for reimbursement.  In more detail, the government complaint asserts NuVasive knowingly offered and paid illegal remuneration to certain physicians to induce them to use the CoRoent System in spine fusion surgeries, in violation of the federal Anti-Kickback Statute.  The illegal remuneration consisted of promotional speaker fees, honoraria and expenses relating to physicians’ attendance at events sponsored by a group known as the Society of Lateral Access Surgery (SOLAS).  SOLAS was allegedly created, funded and operated solely by NuVasive, despite its outward appearance of independence.      

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.

A settlement has been reached in a whistleblower class action lawsuit brought against Alaska DigiTel LLC, a former Alaska limited liability company now owned by General Communication Inc. (GCI), who is accused of submitting false claims to the Federal Communications Commission’s (FCC) Low Income Support Program.

The whistleblower will receive $260,274 from the settlement.

Originally filed in 2008, the United States alleged that Alaska DigiTel violated the False Claims Act by submitting claims to the Low Income Support Program for improperly substantiated, duplicative, or otherwise ineligible subscribers for the period from Jan. 1, 2004, though Aug. 31, 2008.

The Low Income Support Program of the Universal Service Fund, which includes the Lifeline, LinkUp and Toll Limitation Services, was created by Congress in the Telecommunications Act of 1996 and is administered by the Universal Service Administrative Company for the FCC. Under the Low Income Support Program, eligible individuals may apply for free ordiscounted phone or wireless services. Reimbursement is paid directly to Eligible Telecommunications Carriers, such as Alaska DigiTel.

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.

A settlement has been reached in a whistleblower class action lawsuit brought against Cardinal Health Inc who is accused of making payments to induce referral orders for its prescription drugs.

The whistleblowers will share in a $760,000 settlement recovery.

The whistleblower initially filed the case November 2008.  He brought to light that Cardinal paid him $440,000 in exchange for an agreement that he purchase from Cardinal prescription drugs for his pharmacies.

A settlement has been reached in a whistleblower class action lawsuit brought against DynCorp International LLC and The Sandi Group (TSG). They are accused of submitting false claims to the Department of State.

According to the settlement, DynCorp has agreed to pay the United States $7.7 million and TSG agreed to pay $1.01 million. The whistleblowers will will share a total of up to $481,710 of the government’s recovery.

Originally filed in September 2006, the United States alleged that DynCorp submitted inflated claims for the construction of container camps at various locations in Iraq and that TSG sought reimbursement for danger pay that it falsely claimed to have paid its U.S. expatriate employees working in Iraq.

A settlement has been reached in a whistleblower class action lawsuit brought against Midtown Imaging LLC, a radiology clinic, and its former owners Midtown Imaging P.A. and PBC Medical Imaging. They are accused of submitting false claims to Medicare during the period 2000 through 2008.

The whistleblowers will share in $600,000 of the government's recovery.

Originally filed in November 2009, the United States alleged that the West Palm Beach clinic is alleged to have submitted false claims to Medicare during the period 2000 through 2008 by entering into certain leasing and professional services agreements with referring physicians and physician groups that violated the Anti-Kickback Statute and Stark Law.