Posts Tagged ‘Halifax Hospital’

James Hoyer Client Wins Whistleblower of the Year Award

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At TAF Awards ceremony (Pictured L-R): James Hoyer Partner Elaine Stromgren, Elin Baklid-Kunz, Attorney Marlan Wilbanks

James Hoyer Managing Partner Chris Casper was proud to be local counsel, along with lead-counsel Marlan Wilbanks, for Elin Baklid-Kunz, whistleblower in the $86-million dollar Halifax Hospital settlement.  Elin was named the Taxpayers Against Fraud Education Fund Whistleblower of the Year, at an awards ceremony in Washington, D.C.

Upon receiving the award, Elin expressed her sincere gratitude and talked about the often difficult road whistleblowers face to do the right thing.  She said her family and attorneys provided her with incomparable support to help her through the process.

Elin first came to America from Norway as an au pair to learn English and pursue the American dream.  She started working at Halifax in 1994 while pursuing her Masters of Business Administration at Stetson University.  She became Halifax’s Compliance Officer in 2005 and was promoted to Director of Physician Services for Halifax Health Systems in 2008.

As Director of Physician Services, Elin became concerned that Halifax was making improper payments to doctors for referrals, in violation of the Stark Law.  The Stark Law is intended to prevent incentives to doctors which could entice them to make referral decisions based upon financial gain, instead of the patient’s best interest.  Elin also encountered an internal report that indicated Halifax neurosurgeons were performing medically unnecessary surgeries and admitting patients who did not meet admissions criteria.  This led to what she believes were millions of dollars in fraudulent charges to Medicaid and Medicare.   After reporting her concerns to Halifax and having them fall upon deaf ears, Elin felt she had no choice but to file a False Claims Act case on behalf of U.S. taxpayers.

Elin was presented the Whistleblower of the Year award by Cheryl Meads, whistleblower in the $96 million case against GlaxSmithKline which settled in 2010.  Meads commended Elin for her action and  not just standing by when American taxpayers were being defrauded and patients were being harmed.  She ended with a quote from Bobby Kennedy saying, “Few will have the greatness to bend history itself; but each of us can work to change a small portion of events, and in the total; of all those acts will be written the history of this generation.”

We applaud Elin for doing her part to stand on the right side of history.

 

James Hoyer Cases Among Largest False Claims Settlements of 2014

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Peggy Ryan

A James Hoyer case tops the list of the 10 largest False Claims, Stark Law, and Anti-Kickback settlements of 2014, as compiled by Becker’s Hospital Review.  Endo Pharmaceuticals $193-million settlement with the federal government for off-label marketing of its Lidoderm pain patch comes in at number one.  James Hoyer client Peggy Ryan is the whistleblower who first exposed the massive fraud.

Coming in at number four on the list is another James Hoyer case in which we served as co-counsel, the $85 million Halifax Hospital settlement.

Becker’s reports this year is on track to be a record-breaking one for government recoveries in the healthcare industry. These two James Hoyer cases and several others settled this year have contributed substantially to the return of taxpayer dollars.  The False Claims Act allows private citizens to bring civil actions on behalf of the federal government to recover money when fraud is suspected.

Here are the top four settlement recoveries so far in 2014, as compiled by Becker’s Hospital Review:

1. (James Hoyer Case) Endo Health Solutions — a pharmaceutical company — and its subsidiary, Endo Pharmaceuticals, agreed to pay $192.7 million to resolve criminal and civil claims stemming from Endo’s marketing of Liboderm for uses not approved by the Food and Drug Administration. The settlement included a deferred prosecution agreement and forfeiture totaling $20.8 million and $171.9 million to be paid to the federal government, the states and the District of Columbia.

2. Baton Rouge, La.-based Amedisys, one of the country’s largest providers of home health services, and its affiliates agreed to pay $150 million to resolve allegations brought under the False Claims Act, Stark Law and the Anti-Kickback Statute. The lawsuit filed against Amedisys was brought under the qui tam, or whistle-blower, provision of the False Claims Act by former employees of the company. The lawsuit alleged Amedisys submitted improper claims to Medicare for reimbursement from 2008 to 2010 for therapy and nursing services that were medically unnecessary or provided to patients who were not homebound. The lawsuit also alleged the company engaged in improper financial relationships with referring physicians.

3. Cincinnati, Ohio-based Omnicare — the nation’s largest provider of pharmaceuticals and pharmacy services to nursing homes — agreed to pay $124.24 million to settle allegations that it violated the False Claims and Anti-Kickback Statute. The government alleged Omnicare offered improper financial incentives to skilled nursing facilities in return for their continued selection of Omnicare to supply drugs to elderly Medicare and Medicaid beneficiaries. The government also alleged the improper relationship resulted in Omnicare and the facilities submitting fraudulent claims for reimbursement to Medicare and Medicaid.

4. (James Hoyer Case) Daytona, Fla.-based Halifax Hospital Medical Center and Halifax Staffing agreed to pay $85 million to resolve allegations they violated the False Claims Act and the Stark Law. The government alleged Halifax knowingly violated the Stark Law by executing contracts with six medical oncologists that included an incentive bonus that improperly included the value of prescription drugs and tests the oncologists ordered and Halifax billed to Medicare. The government also alleged Halifax knowingly violated the Stark Law by paying three neurosurgeons more than fair market value for their work, and the hospital admitted patients who did not need to be admitted, then billed Medicare for their care.

Click her to read the entire list.

 

 

Halifax Votes to End Whistleblower Suit

After five years, a fiercely fought legal battle that cost Halifax Health more than $110 million in settlement and legal costs is drawing to a close.  The James Hoyer law firm is local counsel in the Halifax case. The Halifax Health Board of Commissioners voted unanimously Monday to settle remaining claims in a whistleblower lawsuit for $1 million plus $4.5 million in legal fees for the whistleblower’s attorneys. That’s on top of an $85 million settlement in March and about $29.5 million in legal fees. Officials at the public hospital say their decision to settle was not an admission of wrongdoing but to minimize potential legal risk. “We are disappointed in paying anything for providing exceptional care, but we are looking forward to putting this behind us and moving forward,” Halifax Health CEO Jeff Feasel said in a prepared statement. “Unfortunately, in situations like this, avoiding future appeals and legal fees is the right business decision.” Although parties have agreed to the settlement terms, a filing still must be entered in federal court in Orlando to dismiss the case, hospital officials said. The board also voted Monday night to evaluate the performance of the chief executive officer and legal counsel, as well as hold town hall meetings to answer questions from the public. No dates have been set. Click here to read more in the Daytona Beach News-Journal.

 

Halifax Hospital Partially Settles Whistleblower Case for $85 Million

Halifax Hospital agreed to pay a record-setting $85 million to settle part of a whistleblower case pending against the company.  The James Hoyer Law Firm serves as local counsel in the case, along side the Wilbanks & Bridges Law Firm in Atlanta.  As reported in the Orlando Sentinel, the lawsuit alleges Medicare fraud and more than a decade of illegal kickbacks to doctors.

The “agreement in principle” requires that Halifax pay the settlement amount over a period of five years.

In addition, Halifax must agree to a corporate integrity and compliance program “to make sure that something like this doesn’t happen in the future,” said the court transcript.

The lawsuit was first filed in 2009 by Halifax Health employee Elin Baklid-Kunz, a former compliance officer for the 678-bed Daytona Beach hospital, where she is still employed.

The suit was filed under the federal False Claims Act which allows private citizens to file suit on behalf of taxpayers, when fraud against the government is suspected.  As a result, the bulk of the $85 million will be returned to the public coffers.  Baklid-Kunz will receive 15 percent to 25 percent of the award, for bringing the fraud to the government’s attention, as provided under the qui tam provision of the False Claims Act.

The second part of this case is slated to go to trial in July.  Those charges involve allegations that Halifax Hospital inappropriately admitted patients to their emergency room and then billed Medicare and Medicaid for their care.  That portion of the case could result in damages and penalties of up to $400 million.

UPDATE:  Halifax agreed to settle the second portion of the case for $1 million in July of 2014.

Click on the video below to watch a report by WFTV in Orlando about the settlement.

 

Orlando TV Investigates Halifax Hospital

The ABC TV station in Orlando reported on allegations that Halifax Hospital put patient’s safety at risk, through unnecessary surgeries and inappropriate admissions, in order to get more money from Medicare and Medicaid. The allegations are part of a whistleblower lawsuit, in which the James Hoyer Law Firm is co-counsel.  The suit was filed by Halifax employee  Elin Kunz.  Kunz discovered the company was over-billing Medicare and tried to get the administration to correct the problem, but she says when they refused, she decided to blow the whistle.  WFTV 9 talked to Kunz in this investigative report to expose the allegations.