Dental Management Company Preyed On Vulnerable Children; Will Return $24 Million To Taxpayers
January 27, 2010 by nick
The United States announced on January 20, 2010, the settlement of False Claims Act allegations against FORBA Holdings LLC, a dental management company that provides business management and administrative services to 69 clinics nationwide known as “Small Smiles Centers.”
Under the agreement, FORBA will pay the United States and participating states $24 million, plus interest, to resolve allegations that it caused bills to be submitted to state Medicaid programs for medically unnecessary dental services performed on children insured by Medicaid, which is funded jointly by the federal and state governments. These services included performing pulpotomies (baby root canals), placing crowns, administering anesthesia (including nitrous oxide), performing extractions, and providing fillings and/or sealants.
FORBA has further agreed to put in place various remedial measures designed to prevent similar unlawful conduct from occurring in the future. The government’s investigation of individual dentists is ongoing, and FORBA is cooperating with that investigation by providing information about dentists who may have violated professional standards.
“We will not tolerate Medicaid providers who prey on vulnerable children and seek unjust enrichment at taxpayers’ expense,” said Daniel R. Levinson, Inspector General of the U.S. Department of Health and Human Services. “This settlement reaffirms our commitment to protect the health and well-being of Medicaid beneficiaries and to ensure the integrity of this essential health care program.”
The government’s investigation was initiated by three lawsuits filed under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private citizens to sue on behalf of the United States and share in any recovery. As part of today’s resolution, the three whistleblowers will receive payments totaling more than $2.4 million from the federal share of the settlement.
If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.
Chevron Will Pay Over $45 Million For Underpaying Royalties
January 27, 2010 by nick
On December 23, 2009, the Department of Justice reported the settlement of a False Claims Act case involving Chevron Corporation, Texaco, Unocal Incorporated and their affiliates (the Chevron companies), for violating the False Claims Act by knowingly underpaying royalties owed on natural gas produced from federal and Indian leases. The companies have agreed to pay the United States $45,569,584.74 to resolve the allegations.
The case was initiated by whistleblower Harrold Wright under the whistleblower provisions of the False Claims Act, which allow private citizens to file actions on behalf of the United States and share in any recovery. Because Mr. Wright is deceased, his heirs will receive $12,303,787.88, plus interest, as part of this settlement.
Each month, companies are required to report to the Minerals Management Service the value of the natural gas produced from their federal and Indian leases and pay a percentage of the reported value as royalties. This settlement resolves claims by the United States that the Chevron, Texaco and Unocal companies systematically under reported the value of natural gas they took from federal and Indian leases from March 1988 to November 2008 and so paid less in royalties then they owed.
Specifically, the companies were alleged to have 1) improperly deducted the cost of boosting gas up to pipeline pressures, 2) used affiliate transactions to fraudulently reduce the reported value of gas taken from federal and Indian leases, and 3) improperly reported processed gas as unprocessed gas to reduce royalty payments.
“This settlement successfully ends long-standing litigation and ensures that taxpayers receive their fair share of royalty revenues from energy production on federal and American Indian lands,” said Interior Secretary Ken Salazar. “Most of the $45 million settlement will be disbursed to appropriate federal, state and American Indian accounts that were affected by Chevron companies’ underpayment of natural gas royalties and improper deductions.”
The suit brought by Mr. Wright alleges that a number of companies systematically underpaid royalties due for their production of natural gas from federal and Indian lands. The Justice Department previously settled with Burlington Resources Inc. for $105.3 million, Shell Oil Company for $56 million and Dominion Exploration and Production Company for $2 million.
If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.
Oklahoma Hospital To Pay $13 Million To Resolve False Claims Act Allegations
January 27, 2010 by nick
On December 22, 2009, the Department of Justice released the settlement of a False Claims Act case involving St. John Health System of Tulsa, Oklahoma. The health provider has agreed to pay the United States $13,229,348.88 to settle allegations that it submitted false claims to Medicare and Medicaid.
Specifically, the United States determined that St. John made payments to 23 individual physicians or physician groups to induce referrals for medical services. Federal law prohibits healthcare providers from billing federal health care programs for referrals from doctors with whom they have a financial relationship, unless that relationship falls within certain exceptions.
St. John’s fraudulent financial relationships were disclosed in a report filed by the health provider to the Department of Health and Human Service’s Office of Inspector General. The report suggested that the agreements with physicians may have violated federal law.
“The resolution of this matter yielded a substantial recovery for taxpayers, and it underscores our commitment to ensure that services reimbursable by federal health care programs are based on the best interests of patients rather than the personal financial interests of referring physicians,” said Tony West, Assistant Attorney General for the Department’s Civil Division.
If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.
Three Health Agencies Sued For Using Unqualified ‘Home Health Aides’
December 24, 2009 by nick
On December 17, 2009, the office of the New York Attorney General announced a $24 million settlement to a False Claims Act lawsuit involving three home health agencies. The agencies utilized hundreds of “home health aides” with little or no required training. These aides were sent to the homes of New York’s elderly, frail and indigent to provide sensitive medical care they were not qualified to administer. As a result, Medicaid was billed millions of dollars for illegitimate services.
Under the terms of the settlement, B&H Health Care Services, Inc., known as Nursing Personnel Home Care, Excellent Home Care Services, LLC, and Extended Nursing Personnel CHHA, LLC, will return $23,963,100 to Medicaid–a program jointly funded by the state and federal governments. Of this amount, the State of New York will receive a total of $14,377,860.
The settlements were initiated by lawsuits filed under the whistleblower provisions of the False Claims Act, which allow private citizens to file suit on behalf of the United States for fraud and share in any recovery. Maurice Keshner will receive approximately $1,693,343 from New York’s recovery from Nursing Personnel. Deborah Yannicelli will receive approximately $994,080 from New York’s recovery from Extended and Excellent. The Act also provides protection against job retaliation for whistleblowing.
Medicaid requires home health aides – who primarily care for elderly patients, administer medication, and provide services such as catheter care, colostomy care and wound care – to successfully complete a training program licensed by the Department of Health or the State Education Department. All such aides must receive a minimum of 75 hours of training, including sixteen hours of supervised practical training conducted by a registered nurse.
If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.
