Archive for 2017

Defense Contractor Agrees to Pay $9.2 Million to Settle False Billing Allegations

Huntington Ingalls Industries Inc. (HII), a publicly traded company headquartered in Newport, Virginia, has agreed to a $9.2 million settlement of allegations that it violated the False Claims Act by knowingly overbilling the government for labor on U.S. Navy and Coast Guard ships at its shipyards in Pascagoula, Mississippi. Under the settlement, HII will make a payment of $7.9 million which, combined with earlier repayments, will result in the settlement recovery of approximately $9.2 million.

“Contractors that knowingly bill the government in violation of contract terms will face serious consequences,” said Acting Assistant Attorney General Chad A. Readler of the Justice Department’s Civil Division. “This settlement demonstrates, once again, that we will not tolerate defense contractors who falsely charge the armed forces or any agency of the United States.”

“Our Armed Forces depend on defense contractors to follow the rules, and this civil settlement, the second largest in the District’s history, should remind all those who conduct business with the United States Government that they are expected to abide by the rules,” said Acting U.S. Attorney Harold Brittain, who also noted three earlier guilty pleas in a related criminal matter in the Southern District of Mississippi. Two individuals pleaded guilty in United States v. N. R. Holden & R.G. Gardner, Criminal No 1:15-cr-42 HSO-RHW, and were sentenced in 2015. Another individual pleaded guilty in United States v. R.M. Wilson, Criminal No 1:16-cr-34-LG-RHW, and was sentenced in 2016. According to Acting U.S. Attorney Brittain, “the Southern District of Mississippi will remain vigilant in identifying and prosecuting those involved in nefarious activities and fraudulent billing, which ultimately result in substantial cost overruns on Navy and Coast Guard shipbuilding projects.”

Special Agent in Charge of the Naval Criminal Investigative Service (NCIS) Southeast Field Office, Mike Wiest, says “Corruption, fraud and bribery are not victimless crimes. Overcharging for work not done is not only criminal on its face, investigating those crimes siphoned resources and time which would have been better invested in protecting the nation. Multiple federal agencies spent years investigating this lack of integrity, to help hold accountable those who would squander American taxpayer dollars.”

Click here to read the whole story from the Department of Justice.

 

Owner of Home Health Agency Sentenced to 75 Years in Prison for Involvement in $13 Million Medicare Fraud Conspiracy

The owner and director of nursing of a Houston home health agency was sentenced today to 75 years in prison for her role in a $13 million Medicare fraud scheme.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Abe Martinez of the Southern District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office, Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services-Office of Inspector General’s (HHS-OIG) Dallas Region and Special Agent in Charge D. Richard Goss of the Houston Field Office of IRS-Criminal Investigation Division (IRS-CI) made the announcement.

Marie Neba, 53, of Sugarland, Texas, was sentenced by U.S. District Judge Melinda Harmon of the Southern District of Texas. In November 2016, Neba was convicted after a two-week jury trial of one count of conspiracy to commit health care fraud, three counts of health care fraud, one count of conspiracy to pay and receive health care kickbacks, one count of payment and receipt of health care kickbacks, one count of conspiracy to launder monetary instruments and one count of making health care false statements.

According to the evidence presented at trial, from February 2006 through June 2015, Neba and others conspired to defraud Medicare by submitting over $10 million in false and fraudulent claims for home health services to Medicare through Fiango Home Healthcare Inc., owned by Neba and her husband, Ebong Tilong, 53, also of Sugarland, Texas. The trial evidence showed that using the money that Medicare paid for such fraudulent claims, Neba paid illegal kickbacks to patient recruiters for referring Medicare beneficiaries to Fiango for home health services. Neba also paid illegal kickbacks to Medicare beneficiaries for allowing Fiango to bill Medicare using beneficiaries’ Medicare information for home health services that were not medically necessary or not provided, the evidence showed. Neba falsified medical records to make it appear as though the Medicare beneficiaries qualified for and received home health services. Neba also attempted to suborn perjury from a co-defendant in the federal courthouse, the evidence showed.

Click here to read the whole story from the Department of Justice

 

Registered Nurse Who Owned Two Houston Home Health Companies Convicted in $20 Million Medicare Fraud Scheme

A federal jury today convicted a registered nurse who was the owner of two home health companies in Houston for her role in a $20 million Medicare fraud scheme involving fraudulent claims for home health services.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Abe Martinez of the Southern District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office and Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services-Office of Inspector General’s (HHS-OIG) Dallas Region made the announcement.

After a four-day trial, Evelyn Mokwuah, 52, of Pearland, Texas, was convicted of one count of conspiracy to commit health care fraud and four counts of health care fraud for her conduct at Beechwood Home Health (Beechwood) and Criseven Health Management Corporation (Criseven).  Sentencing has been scheduled for October 6, before U.S. District Judge Gray H. Miller of the Southern District of Texas, who presided over the trial.

According to evidence presented at trial, from 2008 to 2016, Mokwuah and others engaged in a scheme to defraud Medicare of approximately $20 million in fraudulent claims for home health services at Beechwood and Criseven that were not provided or not medically necessary. According to the trial evidence, Mokwuah billed for patients who were not homebound or did not qualify for home health services; Mokwuah and others falsified patient records to show patients were homebound when they were not; Mokwuah paid patient recruiters to recruit Medicare beneficiaries to Beechwood and Criseven; and Mokwuah paid doctors to sign off on falsified plans of care for the recruited beneficiaries so that Beechwood and Criseven could bill Medicare for those services.

Click here to read the rest of the story from the Department of Justice.

 

Defense Contractor Agrees to Pay $16 Million to Settle False Claims Act Allegations

Virginia Beach, Virginia-based contractor ADS Inc. and its subsidiaries have agreed to pay the United States $16 million to settle allegations that they violated the False Claims Act by knowingly conspiring with and causing purported small businesses to submit false claims for payment in connection with fraudulently obtained small business contracts, the Department of Justice announced today. The settlement further resolves allegations that ADS engaged in improper bid rigging relating to certain of the fraudulently obtained contracts. The settlement with ADS ranks as one of the largest recoveries involving alleged fraud in connection with small business contracting eligibility.

“Small or disadvantaged businesses serve as important engines of economic growth, and the United States utilizes small business set-aside contracts to aide those businesses in their development,” said Acting Assistant Attorney General Chad A. Readler of the Justice Department’s Civil Division. “When ineligible companies improperly obtain set-aside contracts, they prevent the small business community from receiving the assistance that Congress intended.

Click here to read the rest of the story from the Department of Justice.

 

Academy Medical, LLC and its owners pay $335,000 to resolve False Claims Act liability

West Palm Beach, Florida-based government contractor Academy Medical, LLC (Academy) and its owners, Edward D. Desser and Daniel M. Shaw, have agreed to pay $335,000 to resolve allegations that they took advantage of federal contracting opportunities reserved for certified service-disabled veteran-owned small businesses (SDVOSBs), announced Acting United States Attorney Grant C. Jaquith.  During the time at issue, Academy was not a SDVOSB.

“We will continue to hold accountable individuals and entities who defraud federal programs and take opportunities away from our nation’s service-disabled veterans,” said Acting United States Attorney Jaquith.  “Settlements like this one help to ensure the integrity of programs designed to help our wounded warriors succeed in starting and growing small businesses.”

The United States has long used government contracting to promote small businesses in general, and specifically small businesses owned by veterans who have service-connected disabilities.  Congress has established a targeted procurement program for the U.S. Department of Veterans Affairs (VA), which requires the VA to set annual goals for contracting with SDVOSBs.  To be eligible for these contracts, an applicant must qualify as a small business.  In addition to being a small business, a service-disabled veteran must own and control the business and handle its strategic decisions and day-to-day management.

Read the rest of the story from the Department of Justice here.

 

Whistleblower Attorney Jesse Hoyer Interviewed about For-profit College Rule Rollback

James Hoyer Partner Jesse Hoyer

James Hoyer Partner Jesse Hoyer

ABC Action News interviewed James Hoyer partner Jesse Hoyer about the recent rollback in federal rules to protect for-profit college students and taxpayers. As lead attorney on several whistleblower cases against for-profits over the past 10 years, Hoyer is an expert on for-profits and knows well their tactics to take advantage of students.  Put your cursor over the box below to play the video and watch the ABC Action News story.

Hoyer is outraged by the move to eliminate the so-called “borrower defense” rule, as well as action to prevent students from joining together in a class action suit to seek restitution from for-profit colleges that rip them off. Hoyer explained that this is a predatory industry taking billions of dollars in taxpayer money every year and that the rules were intended to protect students and taxpayers.

The borrower defense rule would have relieved students of their loan debt if a for-profit college was found to have committed fraud. Attorney’s General from 18 states are suing the Department of Education and Secretary Betsy DeVos to try and get the rule reinstated.

Noticeably absent from the AGs was Florida Attorney General Pam Bondi, a reliable supporter of the Trump administration. Hoyer called Bondi’s absence unfortunate, saying the AGs number one allegiance should be to protect the consumers and taxpayers of Florida.

 

Payday Lender Lead Generator: $104M Settlement for Selling Sensitive Consumer Data

Here’s one for the consumer.  Blue Global Media agreed to settle charges by the Federal Trade Commission that it tricked consumers into filling out online loan applications, then sold their sensitive data to anyone who would pay for it.

Here’s the FTC’s news release on the settlement:

FTC Halts Operation That Unlawfully Shared and Sold Consumers’ Sensitive Data

Lead generation firm earned millions by falsely promising to match consumers with low-rate loans

The operators of a lead generation business have agreed to settle charges brought by the Federal Trade Commission that the company misled consumers into filling out loan applications and sold those applications – including consumers’ sensitive data – to virtually anyone willing to pay for the leads.

In its complaint, the FTC alleges that Blue Global Media, LLC and its CEO Christopher Kay operated dozens of websites that enticed consumers to complete loan applications that the defendants then sold as “leads” to a variety of entities without regard for how the information would be used or whether it would remain secure.

The websites, which operated under such names as 100dayloans.com, 1hour-advance.com, cashmojo.com and clickloans.net, offered services to consumers seeking a variety of loans, including payday and auto loans. The company claimed it would search a network of 100 or more lenders, and connect each loan applicant to the lender that would offer them the best terms. The FTC charged that, in reality, the defendants:

  • sold very few of the loan applications to lenders;
  • did not match applications based on loan rates or terms; and
  • sold the loan applications to the first buyer willing to pay for them.

The company also promised to protect and secure the sensitive information consumers provided, such as Social Security numbers and bank account numbers, claiming the information was only provided to “trusted lending partners.” The FTC alleges, however, that the company provided the complete loan application data submitted by consumers to any potential buyer without conditions and with little regard to how it would be used. The complaint further alleges that this sensitive personal and financial information was shared and sold indiscriminately without consumers’ knowledge or consent. When consumers complained that their information was being misused, Kay and his company did not investigate or take preventative action, the FTC alleges.

As part of the settlement with the FTC, the defendants are prohibited from misrepresenting that they can assist in providing loans on favorable rates and terms, that they will protect and secure personal information collected from consumers, and the types of businesses with which they share consumers’ personal information. Under the stipulated order, the defendants also are required to investigate and verify the identity of businesses to which they disclose consumers’ sensitive information, and must obtain consumers’ express, informed consent for such disclosures.

The settlement includes a judgment for more than $104 million, which represents the revenue defendants obtained by selling consumers’ loan applications as leads. The judgment is suspended based on defendants’ inability to pay.

The Commission vote authorizing the staff to file the complaint and proposed stipulated final order was 2-0. The FTC filed the complaint and proposed stipulated final order in the U.S. District Court for the District of Arizona.

NOTE: The Commission files a complaint when it has “reason to believe” that the law has been or is being violated and it appears to the Commission that a proceeding is in the public interest. Stipulated final orders have the force of law when approved and signed by the District Court judge.

The Federal Trade Commission works to promote competition, and protect and educate consumers. You can learn more about consumer topics and file a consumer complaint online or by calling 1-877-FTC-HELP (382-4357). Like the FTC on Facebook (link is external), follow us on Twitter (link is external), read our blogs and subscribe to press releases for the latest FTC news and resources.

 

Detroit Area Medical Biller Sentenced to 50 Months in Prison for Her Role in a $7.3 Million Dollar Healthcare Fraud Scheme

A Detroit-area medical biller was sentenced today to 50 months in prison for her role in a $7.3 million Medicare and Medicaid fraud scheme involving medical services that were billed to Medicare and Medicaid but not rendered as billed.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Daniel L. Lemisch of the Eastern District of Michigan, Special Agent in Charge David P. Gelios of the FBI’s Detroit Division, and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office, made the announcement.

Dawn Bentley, 56, of Oakland County, Michigan, was sentenced by U.S. District Judge Sean F. Cox of the Eastern District of Michigan, who also ordered Bentley to pay $3,253,107 in restitution jointly and severally with her co-defendants. After a one-week jury trial in January 2017, Bentley was convicted of one count of conspiracy to commit health care fraud, wire fraud and mail fraud, as well as one count of mail fraud. Bentley was sentenced to 50 months in prison on each of the two counts, to run concurrently, followed by one year of supervised release.

Read the rest of the story from the Department of Justice here.

 

Physician and Wife to Pay $1.2 Million to Settle False Claims Act Allegations

Dr. Anindya Sen and Patricia Posey Sen will pay $1.208 million to resolve state and federal False Claims Act allegations that their medical practice billed Medicare and Tennessee Medicaid (TennCare) for anticancer and infusion drugs that were produced for sale in foreign countries and not approved by the U.S. Food and Drug Administration (FDA) for marketing in the United States, the Department of Justice announced today. Dr. Sen owns and operates East Tennessee Cancer & Blood Center and East Tennessee Hematology Oncology and Internal Medicine located in Greeneville and Johnson City, Tennessee. Mrs. Sen managed Dr. Sen’s medical practice from 2009 through 2012.

“Billing for foreign drugs that are not approved by the FDA undermines federal health care programs and could potentially risk patient safety,” said Acting Assistant Attorney General Chad A. Readler of the Justice Department’s Civil Division. “The Department of Justice is committed to maintaining the integrity of the health care system and ensuring that patient safety, not physician misconduct, determines health care decisions.”

“Medical providers and practitioners that distribute and disseminate unapproved and potentially unsafe drugs—especially those used in cancer treatment—put at risk the health and safety of the American consumer,” said U.S. Attorney Nancy Stallard Harr for the Eastern District of Tennessee. “This settlement reflects our ongoing commitment to safeguard the federal health care programs and vital care that they provide.”

Read the rest of the story from the Department of Justice here.

 

Cardiac Monitoring Companies and Executive Agree to Pay $13.45 Million to Resolve False Claims Act Allegations

AMI Monitoring Inc. aka Spectocor, its owner, Joseph Bogdan, Medi-Lynx Cardiac Monitoring LLC, and Medicalgorithmics SA, the current majority owner of Medi-Lynx Cardiac Monitoring LLC, have agreed to resolve allegations that they violated the False Claims Act by billing Medicare for higher and more expensive levels of cardiac monitoring services than requested by the ordering physicians, the Department of Justice announced today. Spectocor and Bogdan have agreed to pay $10.56 million, and Medi-Lynx and Medicalgorithmics have agreed to pay $2.89 million.

“Independent diagnostic testing facilities that improperly steer physicians to order higher levels of service will be held accountable,” said Acting Assistant Attorney General Chad A. Readler of the Justice Department’s Civil Division. “We will vigilantly ensure the appropriate use of our country’s limited Medicare funds.”

From 2011 through 2016, Spectocor, headquartered in McKinney, Texas, and Joseph Bogdan, allegedly marketed the Pocket ECG as capable of performing three separate types of cardiac monitoring services—holter, event, and telemetry. When a physician sought to enroll a patient for Pocket ECG, however, the enrollment process allegedly only allowed the physician to enroll in Pocket ECG for the service which provided the highest rate of reimbursement provided by a patient’s insurance, thus steering the ordering physician to a more costly level of service. In 2013, Medi-Lynx, a related company headquartered in Plano, Texas, began selling the Pocket ECG and allegedly adopted this same enrollment procedure. Medicalgorithmics SA, a limited liability company based in Warsaw, Poland, acquired a controlling interest in Medi-Lynx in September 2016.

“Sophisticated medical technology can be used to help doctors dramatically improve the lives of their patients, but it can also be misused to fraudulently increase medical bills,” said Acting U.S. Attorney William E. Fitzpatrick for the District of New Jersey. “Today’s settlement demonstrates that the federal government is committed to preserving the integrity of the Medicare system and ensuring that Medicare funds are spent only for patient care.”

Read the rest of the story from the Department of Justice here.