Covenant Medical Center in Waterloo, Iowa has agreed to pay the United States $4.5 million to resolve allegations that it violated the False Claims Act, the Department of Justice announced today.

This settlement resolves allegations that Covenant submitted false claims to Medicare by having financial relationships with five physicians that violated the Stark Law. The United States alleged that Covenant violated the Stark Law by paying commercially unreasonable compensation, far above fair market value, to five employed physicians who referred their patients to Covenant for treatment. These physicians were among the highest paid hospital-employed physicians not just in Iowa, but in the entire United States, according to the DOJ.

For the full press release, go to: http://www.usdoj.gov/opa/pr/2009/August/09-civ-849.html.

For more information about qui tam law and health care fraud, contact Nolan and Auerbach, PA .

U.S. Senator Chuck Grassley (R-Iowa) announced in a May 18, 2009 press release that The Fraud Enforcement and Recovery Act, introduced by Senators Patrick Leahy (D-Vt.), Grassley and Ted Kaufman (D-Del), had cleared Congress that day with an approval by the House of Representatives.

The senate unanimously passed the amended bipartisan legislation, according to the release, and the bill is now headed to the President’s desk to be signed into law.

To see the press release, go to iowapolitics.com

For more information about Qui Tam law and Health Care Fraud, contact Nolan and Auerbach, PA.

The Obama Administration strongly supports enactment of S. 386 (the Fraud Enforcement and Recovery Act of 2009), according to a statement released April 20, 2009, by the Executive Office of the President. The White House’s recent endorsement of this legislation which, among other things, restores the original power of the False Claims Act, comes with broad support from law enforcement and the Department of Justice, according to an April 22 press release by Senator Patrick Leahy (D-Vt.), who introduced the Fraud Enforcement and Recovery Act (with Senators Chuck Grassley (R-Iowa) and Ted Kaufman (D-Del.) on February 5.

To read the press release and the senator’s statement, go to http://leahy.senate.gov/press/200904/042209a.html.

For more information about qui tam law and health care fraud, contact Nolan and Auerbach, PA.

As he debates on the senate floor on a bill that he cosponsored, the Fraud Enforcement and Recovery Act, Senator Chuck Grassley of Iowa released a statement reminding Americans that these fragile economic times are ideal for passing a bill aimed at empowering whistleblowers to help recover and stop health care and other types of fraud. The legislation, addressing among other things weaknesses in the False Claims Act (FCA), is necessary to encourage individuals in qui-tam type lawsuits to pursue cases that the Justice Department might or might not pursue.

Grassley says in his April 20, 2009, statement that special interests are surfacing, who don’t want to encourage whistleblowers to report wrongdoing and are looking to squelch the bill.

The point: We can’t keep spending, as a nation, without taking steps to combat fraud and abuse. The Fraud Enforcement and Recovery Act not only ensures that law enforcement officials and prosecutors have the tools and resources necessary to enforce our laws, but it also amends the civil False Claims Act to ensure that taxpayer money lost to fraud, waste or abuse can be recovered.

The legislation, most importantly, will ensure that the law adheres to the FCA’s original intent.

“Specifically, these amendments address a loophole that was created in the FCA by the Supreme Court decision in Allison Engine which could be used by fraudfeasors to evade liability by hiring subcontractors to perform work on government contracts.  Some defendants are already filing briefs in court seeking to have FCA cases dismissed based upon this decision, and it needs to be addressed to protect taxpayer dollars,” Grassley writes.

“We need to act now to stomp out new claims of fraud to send a message that the American taxpayers won’t be taken for a ride.”

To read the entire statement, go to: http://grassley.senate.gov/news/Article.cfm?customel_dataPageID_1502=20209.

For more information about qui tam law and health care fraud, contact Nolan and Auerbach, PA .

Our nation’s watchdog organizations, including the American Civil Liberties Union, American Federation of Government Employees, National Whistleblower Center and Project on Government Oversight, sent a letter to President Obama on April 1, 2009 urging that the government fulfill his campaign and transition policy commitments to strengthen whistleblower rights.

In the letter, the coalition asks the president to strongly endorse legislation that would protect from retaliation of federal employees who expose waste, fraud, abuse, suppression of federal research, and threats to public health and safety, and give them access to jury trials. The legislation would also direct federal government agency heads to institute “no-retaliation” policies for employees.

The groups are concerned that a signing statement issued by the president on March 11, attached to H.R. 1105, the omnibus spending bill, contradicts those earlier steps and could have a chilling affect on lawful whistleblowing disclosures, according to a press release about the letter on Project on Government Oversight’s website.

To read the letter, click here. For a copy of the POGO press release, go to http://www.pogo.org/pogo-files/alerts/whistleblower-issues/wi-wp-20090401.html.

For more information about qui tam law, whisleblowers and health care fraud, contact Nolan and Auerbach, PA.

The State of California has joined a qui tam action against seven private laboratories to recover hundreds of millions of dollars in false claims submitted to the state’s Medi-Cal program for the poor, according to a March 20 press release by the California Office of Attorney General.

The lawsuit contends that the medical labs systematically overcharged the Medi-Cal program during the past 15 years. The defendants, including Quest Diagnostics and Laboratory Corporation of America, allegedly engaged in illegal kickbacks and overcharging the state by up to 400% for blood, urine and other lab tests. It is estimated that damages could amount to hundreds of millions of dollars.

Filed under California’s False Claims Act, the qui tam lawsuit asks for relief in the amount of triple the amount of California’s damages, civil penalties of $10,000 for each false claim; and recovery of costs, attorneys’ fees and expenses.

This is one of the largest, if not the largest, single state qui tam intervention against multiple laboratories, in history.

To read the full press release, go to: http://ag.ca.gov/newsalerts/release.php?id=1705&. For more about qui tam law and Healthcare Fraud, contact Nolan and Auerbach, PA.

As Bernard Madoff was planning his guilty plea in a history-making fraud case, Securities and Exchange Commission Chairman Mary. L. Schapiro announced that the SEC is considering offering cash rewards to whistleblowers who expose financial wrongdoing, according to a March 12, 2009 Washington Times article. The practice of offering cash bounties to securities fraud whistleblowers would be similar to financial rewards given to people who help to expose insider-trading. Having this power, Schapiro said in the article, would enable the SEC to pursue cases more aggressively.

For the full article, go to: http://washingtontimes.com/news/2009/mar/12/sec-considers-cash-bounties-to-whistleblowers/.

For more about qui tam whistleblower law, contact Nolan and Auerbach, PA.

Weill Medical College of Cornell University has agreed to pay $2,606,751 to resolve civil charges that the New York City-based college defrauded the government in connection with federal research funds awarded under grants made by the National Institutes of Health (NIH).

A whistleblower, who filed a qui tam complaint under the False Claims Act, first brought the case to government’s attention.

Weill Medical College made false statements to the NIH and the Department of Defense (DOD) in connection with the school’s federal grant applications. In particular, the principal research investigator who sought funding for the grants failed to disclose to the government the full extent of her various active research projects, according to a March 6, 2009 press release by the U.S. Attorney Southern District of New York.

For the complete release, go to http://www.usdoj.gov/usao/nys/pressreleases/March09/weillmedicalcollegesettlementpr.pdf.  For more information about the False Claims Act, contact Nolan and Auerbach, PA .

The United States is intervening in a whistleblower suit that alleges that Community Health Systems Inc. (CHS) and three of its hospitals in New Mexico violated the False Claims Act (FCA) by presenting the government with false claims for federal matching Medicaid funds.

According to the U.S. Department of Justice, which made this announcement March 6, 2009, the suit was filed under the qui tam or whistleblower provisions of the FCA by Robert Baker, a former revenue manager in CHS’s corporate office.

The relator’s complaint alleges that, beginning in 2000, CHS and its hospitals improperly obtained federal funds through the New Mexico Sole Community Provider Fund (SCPF) and Sole Community Hospital Supplemental Payments (SCHSP) Medicaid programs.

To review the DOH press release, go to http://www.usdoj.gov/opa/pr/2009/March/09-civ-200.html. Or, for more information about the False Claims Act or qui tam whistleblower law, contact Nolan and Auerbach, PA.

The fate of a bill amending the False Claims Act (FCA) is in Senate hands. The False Claims Clarification Act of 2009, introduced by Sen. Chuck Grassley (R-Iowa) (S. 458), could fuel government’s ability to recover taxpayers’ dollars lost to fraud and abuse by increasing government accountability and extending whistleblower protection. Under the new legislation, the attorney general would be required to submit an annual report to Congress about settlements made under the FCA. This would help determine if the Department of Justice is using the act as it is intended and ensure that qui tam relators are protected from the court’s potential abuse of provisions to seal a case.

To review the legislation, go to http://thomas.loc.gov/cgi-bin/query/z?c111:S.458: Or, for more information about qui tam whistleblower law, contact Nolan and Auerbach, PA.

According to the U.S. Attorney Richard B. Roper of the Northern District of Texas, Harris Methodist HEB Hospital, a 284 bed acute-care facility, will pay $1.9 million to settle allegations that it violated the False Claims Act by improperly submitting claims for payment for orthopedic-related items and services.  These claims were identified as having taken place between March 15, 2004 and September 1, 2005.

According to the hospital in its own news release, the parent company of Harris Methodist HEB Hospital (Texas Health Resources) did a self report by telling the Office of Inspector General of Health and Human Services about it identification of a physician contract that did not comply with federal regulations. This triggered an investigation based on information provided by Harris Methodist HEB that Medicare and Texas Medicaid programs paid for orthopedic items and services referred to the hospital by a physician group that received free rent from the hospital, a violation of Stark self-referral law (also known as Physician Self-Referral Law).

The Stark law was created to forbid physicians from profiting from their own referrals.  This law acts to sanction improper physician referrals and to stop the potential for over-utilization. In this fashion, physicians and other health care professionals are able to exercise independent judgment for what is in the best interests of their patients as opposed to themselves.

To read the full story click here or on the following to read more about the False Claims Act and the Stark Laws .

If you believe you have information concerning a violation of the False Claims Act and want to read more about Nolan & Auerbach, P.A. you may contact us.

A federal law that takes effect in January 2007 requires the country’s hospitals and nursing homes to educate their employees and officers on how to detect and report fraud. This requirement applies to companies that earn at least $5 million a year in Medicaid business. Under the False Claims Act, whistleblowers have received millions of dollars for disclosing large-scale fraud.

To read more, click here.

Last month, the United States intervened in a qui tam lawsuit accusing Renal Care Group Inc. (RCG) and Renal Care Group Supply Company (RCGSC) of fraudulently billing Medicare. The suit alleges that RCG and RCGSC fraudulently billed for supplies and equipment provided to End Stage Renal Disease (ESRD) patients who received dialysis treatments at home. Both companies are owned by Fresenius Medical Care Holdings Inc. which was also named in the lawsuit.