Bilking Money from Medicare Does Not Pay – Walgreens and Bay Sleep Clinic Settle FCA Whistleblower Lawsuits for Over $50 Million Dollars

Our Los Angeles based False Claims Act (“FCA”) focused attorneys report that after a qui tam whistleblower lawsuit was filed against Walgreens, Walgreens recently paid $50 million to settle allegations of kickback and violations of the FCA.  In the settlement agreement, Walgreens settled allegations that it violated the law by giving discounts on prescriptions to hundreds of thousands of Medicare, Medicaid and Tricare beneficiaries to induce them to obtain their prescriptions from Walgreens.  In addition, Walgreen employees were instructed to enroll customers who were specifically beneficiaries of these federal and state government programs between January 2007 and December 2015.  Each time the employee would enroll a new government beneficiary, Walgreens would pay that employee a bonus for increasing the numbers in the prescription discount program.  As result of the settlement, Walgreens paid $46 million dollars to the federal government and admitted that it conducted against the law.  In addition, Walgreens paid almost $4 million to settle state civil fraud claims.

Our Sand Francisco based FCA lawyers report that a former employee of Bay Sleep Clinic who was a technician and marketer helped the government recover $2.6 million dollar whistleblower settlement.   The main allegations from the Complaint revolve around allegations of the sleep clinic using unlicensed technicians, unapproved locations, and physician kickback referrals.  Bay Sleep Clinic has around 20 facilities throughout Northern California.  In addition, the Complaint alleged that the defendant facilities, owners, and physicians fraudulently billed Medicare for sleep studies that were done by unlicensed persons in locations that were not approved, unlawfully prescribed durable medical equipment (“DME”), and paid kickbacks to physicians to get referrals.  Such actions are direct violation of the Anti-Kickback Statute (“AKS”) and enforced by the Justice Department.

The FCA is used to stem out fraud related to billing, staffing, and kickbacks. Examples of these are when financial companies are supposed to abide by state and federal laws and chose to ignore them.  They also bills for services that were not provided or the bill was submitted at an improperly higher rate of reimbursement for the services.  In addition, financial companies are often fount to illegally bill the government for substandard services by fraudulently certifying otherwise. Alternatively, these companies may realize that they have credit from their services that they have to repay to the government, but the companies do not reimburse the government within the 60 day time frame.  See these blogs for more examples of the FCA.

If you witness any potential false claims in California (i.e. requests for reimbursement to the government, not actually rendering work when reimbursement is received, or receiving and knowingly retaining an overpayment) by your company, or you are retaliated against for voicing your concern about potential wrongdoing, immediate action is vital.  Contact the experienced employment law attorneys at Stephen Danz & Associates for a free consultation to discuss your circumstances and legal options.