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Medical Device Manufacturer Biotronik Settles False Claims Act Allegations for $4.9 Million

Biotronik has agreed to pay $4.9 million to settle claims it offered kickbacks to doctors.
Image source: Wikimedia Commons

Biotronik, Inc., a medical device manufacturer, has agreed to pay $4.9 million to settle claims it unlawfully engaged in kickback schemes and prohibited financial arrangements in violation of the False Claims Act and its terms forbidding kickback schemes pertaining to Medicare and Medicaid patients. The company settled with the Department of Justice in May, 2014, and has not admitted to any liability in the matter. The whistleblower, a former Biotronik employee, is set to receive $840,000 in exchange for his willingness to come forward.

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Bone Growth Stimulator Manufacturer Biomet Inc. Settles Allegations It Defrauded the Government

Biomet, Inc. has agreed to pay $6 million to settle claims it paid office staff to influence doctors to purchase bone growth stimulators.
Image source: Wikimedia Commons

New Jersey-based Biomet, Inc. has agreed to pay $6.07 million to settle False Claims Act allegations involving kickbacks pertaining to its bone growth stimulator products. Under the False Claims Act, any medical device manufacturer, drug company, hospital, or medical professional may face possible liability if Medicare or Medicaid patients are referred to a service, procedure, or course of treatment in exchange for financial gain or other incentives provided to the referral source. In today’s case, the allegations against Biomet include inappropriate financial relationships, unlawful inducements, and kickback schemes in violation of the False Claims Act’s federal Anti-Kickback Statute.

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Houston-based One Step Diagnostic Agrees to Settle False Claims Act Case for $2.6 Million

One Step Diagnostic, a diagnostic imaging company, has agreed to pay over $2 million to settle allegations of unlawful kickbacks.
Image source: Wikimedia Commons, user Personalo

Houston-based One Step Diagnostic, which operates several medical imaging diagnostic centers around Houston, Texas, has agreed to pay $2.6 million to the federal government in order to settle claims it engaged in unlawful kickbacks and inappropriate financial relationships in violation of the False Claims Act and federal Stark Law. The Department of Justice, in keeping with its mission to eradicate costly healthcare fraud, announced the settlement on October 17, 2004, following a concerted effort by the Justice Department’s Civil Division, the U.S. Attorney’s Office for the Southern District of Texas, and the Department of Health and Human Services – Office of Inspector General.

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CA District Court Reiterates Need for Strong Evidence in Whistleblower Lawsuits in Serco Judgment

Serco False Claims Act case

Military contractor Serco, Inc. was recently victorious in a bid to avoid False Claims Act liability under the argument it did not actually defraud the government out of money.
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We have covered the False Claims Act evidentiary standard from a number of different angles. At the pleadings phase of these cases, there is a near 50/50 split between the circuit courts as to the specificity of alleged fraud necessary to overcome a motion to dismiss under Federal Rule of Civil Procedure 12(b)(6). Also at issue, as described in today’s case United States of America ex rel. Kelly v. Serco, Inc., is the distinction between a true intentional-fraud False Claims Act case and the less-serious breach of contract claim, which requires an inquiry into the subtle difference between background or underlying fraud and the actual submission of false claims to the government.

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UPDATE: Judge Orders Trinity Industries to Mediation as Possible Half-Billion Dollar Verdict Looms

Trinity Industries has been ordered to mediate with the whistleblower in the high-profile guardrail design case.
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As we have steadily reported over the past couple months, the False Claims Act case against Trinity Industries has resulted in a tumultuous trial, mistrial, $175 million verdict, and the possibility for a treble damages imposition of $525 million. In the latest procedural milestone in the case, United States District Court Judge Rodney Gilstrap has ordered Trinity and the whistleblower plaintiff, Joshua Harman, to participate in a hopefully productive mediation session to determine a workable whistleblower reward – which could reach up to 30 percent of the overall verdict or recovery. If the damages against Trinity are tripled, Mr. Harman could receive up to $157.5 million dollars.

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Dignity Health Agrees to Settle False Claims Act Case for $37 Million

Dignity Health recently settled allegations that it overbilled for routine services like the placement or maintenance of a pacemaker.
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Healthcare fraud is one of the most detrimental – and costly – forms of fraud, as it not only could increase premium rates for innocent policyholders, but can even compromise the quality of patient care. One of the most common forms of healthcare fraud involves illegal “upcoding” or unnecessary admittance of patients who are not in need of inpatient care. This practice typically involves a team effort between hospital management companies, physicians, and staff – and is an extremely costly enterprise.

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Benefits of U.S. False Claims Act Explored at Historic Canadian Charbonneau Commission

Canadian lawmakers are exploring the possible implementation of a False Claims Act similar to the American version.
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The United States False Claims Act has proven successful in recovering tens of billions of dollars in fraud, waste, and intentional deceit. As the False Claims Act gains increasing domestic notoriety, other nations are showing a growing interest in this sort of incentivizing, anti-fraud program. Our Northern neighbor Canada recently allowed testimony from several top U.S. False Claims Act experts as to the effectiveness of the statute and how it could positively impact Canada’s growing fraud problem, which is infested with scammers and con artists targeting – among other areas – Canada’s construction industry.

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Columbia University Settles Embarrassing Grant Fraud Case

Grant fraud at columbia university

Columbia University recently settled False Claims Act allegations involving mismanagement of federal grant money allocated for AIDS research.
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New York City-based Columbia University, one of the world’s most renowned medical research institutions, has recently come under fire for mismanaging millions of dollars in federal grant money earmarked for AIDS and HIV-related research. The allegations found in the government’s complaint specifically involve the mismanagement of employees and the falsification of employee work hours – which were subsequently charged to the grant for reimbursement.

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North Florida Shipyards Agree to Pay $1 Million to Settle False Claims Act Allegations

False Claims Act allegations settled

A shipyard has agreed to settle False Claims Act allegations that it set up a front business to win a contract from the SBA for repair of several military watercraft.
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The Small Business Administration is a federal agency tasked with assisting Americans interested in opening and maintaining a small business. Funding is directed each year to the SBA as an investment in the American economy, much of which is allocated to offering small business loans and grants to those who are eager to get started, but do not have the capital to do so. Moreover, the SBA routinely works with historically disadvantaged groups to get their business off the ground – providing entrepreneurial opportunities that would otherwise be nothing more than a dream for many individuals.

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State University of New York Expected to Pay $1 Million to Settle Audit Fraud Allegations

The SUNY Research Foundation is facing possible False Claims Act liability for altering Medicaid data during an audit.

According to the details of an ongoing probe by the Department of Justice, State University of New York’s Research Foundation is alleged to have directed its researchers and employees to falsify the results of an audit of the state’s Medicaid program – thereby rendering a greater number of applicants eligible for benefits than would otherwise have been covered by the program. The investigation was initiated following the whistleblower lawsuit commenced by several former auditors, who courageously came forward with their allegations of fraud.

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