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New York Mental Health Association Alleged to Have Altered Records Prior to Medicaid Audit

The New York Mental Health Association recently settled allegations it engaged in unlawful alterations of financial records prior to a federal Medicaid audit.
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According to the details of a recent settlement under the New York False Claims Act, the Mental Health Association is alleged to have made handwritten alterations to progress notes which were subsequently submitted to Medicaid officials pursuant to an official requested audit. The settlement, which amounted to $304,000, came about after two former MHA Rockland employees began to notice the alterations and reported the misconduct under New York’s state False Claims Act statute.

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British Petroleum to Pay $7.9 Million Amid Storage and Cleanup Fraud Allegations

BP has agreed to pay $7.9 million and relinquish involvement under an environmental cleanup contract after allegedly double-billing the California government.
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In a recent environmental fraud settlement, British Petroleum (BP) has settled with the State of California for $7.9 million following allegations it double-billed for cleanup efforts after several of its Underground Storage Tanks (UST’s) began leaking. Under California law, a cleanup fund was established to help companies defray the cost of maintaining environmental-compliance during and after cleaning up affected areas. These funds are obviously provided by California taxpayers and come with several contingencies for companies looking to profit from their own cleanup efforts. Specifically, any company claiming reimbursement from the cleanup fund must agree to forgo filing an insurance claim for the same site and forgo seeking indemnification from third parties via civil litigation. In today’s case, BP is alleged to have applied for and received cleanup funds from the state while also receiving insurance payouts for the same UST area.

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Michigan Hospital Settles Self-Disclosed False Claims Act Case for Over $4 million

Michigan’s Portage Hospital has agreed to settle allegations it unlawfully billed Medicare and Medicaid for unnecessary therapy sessions.
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In a rare turn of events, the Department of Justice has actually commended Michigan-based Portage Hospital, LLC after it opted to self-report various perceived violations of the False Claims Act by a member of its physical therapy staff.

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Sixth Circuit Issues Pivotal Ruling Involving ‘Public Disclosure Bar’ in FCA Cases

The public disclosure bar works to preclude whistleblowers from filing False Claims Act lawsuits using information already available to the public. However, it is not always clear what this definition includes.
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The False Claims Act’s public disclosure bar prohibits any whistleblower from filing a claim if the facts of the claim are based on information that would be readily available to the public, regardless of whether the whistleblower actually knew about or reviewed the public information prior to initiating the lawsuit. However, recent appellate court decisions have revealed some legal tension in the definition of “disclosure,” with many defendants claiming that all whistleblower lawsuits that reach the investigatory stage should automatically bar later-filed complaints.

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SEC Announces Whistleblower Reward for Former Company Officer

SEC whistleblower award

The SEC recently awarded approximately $500,000 to a corporate whistleblower.
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Implemented by the 2010 Dodd Frank Act, the Securities and Exchange Commission (SEC) maintains a growing whistleblower program. Much like the False Claims Act, the SEC’s program is designed to offer confidential consideration of fraud claims, as well as incentives for successful prosecutions of costly and wasteful securities fraud.

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Florida-based Recovery Home Care Pays $1.1 Million to Settle Kickback Claims

Recovery Home Care has agreed to pay $1.1 million to settle allegations it unlawfully induced doctors to refer patients to its long-term care centers.
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There are three laws in place to address the impropriety of doctor kickbacks: the False Claims Act, the Anti-Kickback Statute, and the Stark Law. These are three pieces of federal legislation enacted to punish and deter intentional fraud involving taxpayer funds. In the context of healthcare fraud, the acts are often triggered when intentional fraud and lucrative kickbacks occur pertaining to patients receiving government healthcare benefits, including Medicare, Medicaid, and the military’s TRICARE.

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Physician Settles False Claims Act Accusations Regarding Kickbacks from CareFusion

A California-based healthcare consultant recently joined in a settlement along with two of his corporations to conclude a lawsuit alleging undisclosed kickbacks.
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In a recent False Claims Act settlement between Dr. Charles Denham and the federal government, officials have revealed details of an alleged kickback scheme involving Dr. Denham and the medical corporation known as CareFusion. The case was brought to light following an extensive whistleblower investigation by the Department of Health and Human Services, and it revealed a series of improper payments to Dr. Denham by CareFusion at a time when he was serving in an advisory role reviewing the safety and effectiveness of various medical products, including CareFusion’s widely-used epidermal surgical preparation solution.

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Michigan Healthcare Provider Settles Allegations of False Billing

Agility Health has agreed to pay $1 million to settle claims it unlawfully billed Medicare for rehabilitation services never rendered.
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Despite the rampant efforts by the federal government’s H.E.A.T. task force, healthcare fraud and Medicare false claims continue to plague American taxpayers. When it comes to bilking federal healthcare agencies out of money, the following methods are some of the most common:

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MetLife Home Loans LLC to Settle Mortgage Fraud Case for $125 Million

Met Life mortgage fraud settlement

MetLife’s home mortgage division recently settled allegations of unlawfully certifying residential home loans in violation of federal guidelines for underwriting and creditworthiness review.
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In the wake of the 2008 financial crisis, which was primarily fueled by the housing bubble burst, many less-than-lawful residential home loan lenders have faced serious civil and criminal penalties for participating in shoddy underwriting practices, robo-signing, lax credit reviews, and outright fraud. Over the past several years, the U.S. government has targeted many mega-banking institutions, including Wells Fargo and Bank of America, for pushing through loan applications that should have never been approved. Upon default, these government-backed mortgages triggered the payment of hundreds of millions of dollars in mortgage insurance payouts from the federal government – all for loans that should never have been approved.

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Baptist Health Medical Center to Settle False Claims Act Allegations for $2.7 Million

hospital facing False Claims Ace allegations

A recent False Claims Act settlement out of Arkansas involved allegations of fraudulent billing of Medicare for extended stays in hospital rooms.
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Medical practitioners seeking to treat Medicare patients are required to abide by the policy manuals and guidelines put out by the federal government. If a practitioner knowingly violates these mandates and intentionally bills Medicare for reimbursement despite the deviation, this could trigger False Claims Act liability.

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