False Claims Act Summary for 2019 – Individual Accountability

The US Justice Department announced on January 9, 2020 that nearly $ 3 billion was recovered by the Department of Justice in False Claims Act cases. While many of the settlements were made by corporations, individuals were also required to settle claims against them for large amounts.

In addition to some of the settlements noted in our healthcare, procurement, and other types of fraud articles, some notable settlements involving individuals included the following:

  • The owners of seven Osteo Relief Institutes along with the clinics paid $7.1 million to settle claims they knowingly billed for injections that were not medically necessary and for knee braces that were not necessary. The injections were used to treat osteoarthritis into a patient’s knee. The government claimed that the injections weren’t needed, were used without clinical support, and they claimed other violations.
  • The DOJ settled a claim with the majority owner and CEO and a former director of operations of Vanguard Healthcare LLC for $250,000 in addition to a $18 million settlement of the False Claims Act case against the company. The charges claimed that five nursing homes of the company submitted false Medicare and Medicaid claims for nursing home services – that were “grossly substandard or worthless, including allegations that the facilities failed to administer medications as prescribed, failed to provide standard infection control or wound care, failed to take prophylactic measures to prevent pressure ulcers, and failed to meet basic nutrition and hygiene needs of their residents.”
  • The CEO of Diabetic Care Rx LLC and the VP of the same company settled False Claims Act charges for $300,000 – in addition to settlements by the company itself and another company for $21 million. The claims include false billing to Tricare, the government health plan for military members and families. The allegations included a “kickback scheme to generate referrals of prescriptions for expensive pain creams, scar creams, and vitamins, regardless of patient need.”

In False Claims Act cases, the ability of the defendants to pay the settlement is considered.

If you are aware that anyone in your company or any company, or any individual person, is defrauding a government agency, you may have a whistleblower case. Whistleblowers who give valuable information may be entitled to a percentage of any settlement or verdict. To learn your whistleblower rights, call the California Law Offices of Stephen A. Danz and Associates. We have a strong track record of success in qui tam cases. For help now, call us at 877-789-9707 or fill out our online contact form to schedule an appointment.