News & Cases

Orbit Medical Inc. and its partial successor, Rehab Medical Inc., agreed to pay $7.5 million to settle a Medicare fraud lawsuit. Whistleblowers Dustin Clyde and Tyler Jackson alleged the power wheelchair suppliers submitted false claims to federal health care programs for wheelchairs and accessories. Clyde and Jackson will split a $1.5 million whistleblower award for bringing the allegations to light.

Clyde and Jackson Allege Orbit Forged Medical Records to Defraud Medicare

Tyler Jackson and Dustin Clyde, two former employees of Orbit Medical, filed allegations of healthcare fraud under the Federal False Claims Act. Orbit Medical and Rehab Medical are medical equipment suppliers based in Utah and Indiana. Dustin Clyde and Tyler Jackson alleged that Orbit sales representatives adjusted physician prescriptions to get Medicare to pay power wheelchair and accessory claims....

United Parcel Service (UPS) has agreed to pay $25 million to the federal government to resolve allegations that the company submitted false claims to the government in order to hide its late delivery of overnight packages.

The civil settlement resolves claims filed under the whistleblower provisions of the False Claims Act, which allows private citizens to file suit on behalf of the United States government and to share in the government’s financial recovery.

Whistleblower Robert Fulk Says UPS Management Ignored His Report – Files Whistleblower Lawsuit

The whistleblower lawsuit against UPS was brought by Robert K. Fulk, a former UPS employee, who for his efforts will get 15 percent of the settlement or $3.75 million. Reuters quoted Fulk’s lawyer as saying her client was brushed off when he questioned his manager about the false claims. Fulk left UPS before filing his lawsuit....

Century Ambulance and nine Jacksonville, Florida hospitals will pay $7.5 million to settle allegations of healthcare fraud. The settlement resolves claims that hospitals routinely ordered medically suspect ambulance transfers, defrauding Tricare, Medicaid, Medicare and the Federal Employees Health Benefits Program out of $5 million in unwarranted billings. Whistleblower Shawn Pelletier will receive over $1.2 million for bringing the False Claims Act lawsuit.

Century Ambulance Employee Shawn Pelletier Alleges Unnecessary Transport Billings

Initial complaints were raised by former Century Ambulance employee Shawn Pelletier who filed a lawsuit under the Federal False Claims Act and the Florida False Claims Act. Pelletier alleged that hospitals and Century Ambulance were defrauding federal healthcare programs by submitting unnecessary claims for ambulance services....

Five ambulance companies in Southern California have settled at $11.5 million to resolve yet another ambulance-related healthcare fraud whistle blower lawsuit. Whistleblower Kelvin Carlisle, owner of a competitor ambulance company, alleged the five fraudulently engaged in “swapping” services with nursing homes and hospitals for exclusive rights to transport Medicare patients. Kelvin Carlisle will receive a $1.7 million whistle blower reward for exposing the allegedly fraudulent scheme.

Kelvin Carlisle Alleges Competitor Ambulance Companies’ Kickback-Scheme

Kelvin Carlisle filed the whistleblower lawsuit alleging his company, Care Medical Transportation Inc., could not compete with rival companies who were offering illegal discounts. He accused competitors of offering 50 to 100 percent discounts on non-emergency patient transport to nursing homes and hospitals. In return, the nursing homes and hospitals promised to use only those ambulance companies’ services for the lucrative Medicare transports....

A $1.4 million SEC whistleblower reward to a corporate compliance officer for reporting company misconduct has caused a tremor through GC, compliance, and audit offices of non-compliant corporations but it signals something tectonic is coming soon according to legal experts. The architect of December’s massive Bank of America $16.6B False Claims Act settlement says the SEC action affirms compliance professionals are also eligible for the more lucrative False Claims Act whistleblower rewards that can reach $100M.

Compliance Officer Scores $1.4M in SEC Whistleblower Action

On April 22 the Securities Exchange Commission (SEC) announced a $1.4 million whistleblower reward to a compliance officer who reported information and provided evidence in an SEC enforcement action against the whistleblower’s corporation....

A False Claims Act lawsuit against U.S. Bank could signal a cavalcade of similar actions against loan servicers that allegedly circumvented a key pre-foreclosure HUD requirement - steamrolling helpless homeowners to reap fast profits. Sources say Ocwen, Bank of America, Wells Fargo and other loan servicers are girding for new False Claims Act lawsuits filed by employees and ex-employees exposing yet more mortgage foreclosure misconduct to reap million dollar whistleblower rewards.

U.S. Bank Steamroller Foreclosure Process Skipped Legalities says ABLE

Advocates for Basic Legal Equality (ABLE), an Ohio based legal aid group, filed a False Claims Act lawsuit against U.S. Bank alleging this division of one of the nation’s largest banks cheated the U.S. government....

Citizens Medical Center, a county-run hospital located in Victoria, Texas, agreed to settle with the United States government to the tune of $21,750,000 in a False Claims Act whistleblower case. According to the US Justice Department, this settlement will resolve claims that the Citizens Medical Center allegedly engaged in inappropriate financial transactions with referring doctors.

Department of Justice Monitoring Health Care Providers on Physician Referrals

“The Department of Justice has longstanding concerns about improper financial relationships between health care providers and their referral sources, because those relationships can alter a physician’s judgment about the patient’s true health care needs and drive up health care costs for everybody,” stated the Principal Deputy Assistant Attorney General Benjamin C. Mizer from the US Justice Department’s Civil Division. “In addition to yielding a recovery for taxpayers, this settlement should deter similar conduct in the future and help make healthcare more affordable.”...

The U.S. Securities Exchange Commission fired a $130,000 warning shot at corporate America, fining Houston-based KBR this amount for drafting employee confidentiality agreements to thwart employee SEC whistleblowing for malfeasance. The whistleblower bar calls it an historic step forward for whistleblowers while a prominent pro-business group calls it overreaching.

Harry Barko Whistleblower Lawsuit Brought KBR’s Faulty NDAs to Light

The SEC alleged former Halliburton subsidiary KBR, Inc. included language in their employee confidentiality agreements that effectively required workers to get KBR’s legal department to sign off in advance on any disclosures, including blowing the whistle on corporate wrongdoing – even to the SEC or the Department of Justice, under penalty of firing or other discipline....

The mortgage chicanery spotlight is once again focused on Wells Fargo & Co. and Ocwen Financial Corp. A federal False Claims Act whistleblower complaint unsealed yesterday claims that Ocwen, the nation's largest mortgage servicer, was double dipping and keeping monies that should have been paid to Fannie Mae.

Ocwen Financial Corp. Facing Mortgage Servicer Fraud Case

Ocwen Financial Corp. is a leading mortgage servicer that services an estimated 1 million mortgages, collecting payments of behalf of banks and other entities. Mortgage servicers have taken over this function for many of the major banks and litigation asserting misconduct within the mortgage servicer industry abounds....

The Department of Justice isn’t talking, nor is PharMerica, but at least one report claims the embattled institutional pharmacy operator is nearing settlement with the DOJ on two lingering False Claims Act cases.

PharMerica Pharmacist’s Lawsuit Filed in 2009

Louisville, Kentucky-based PharMerica has been embroiled in one whistleblower lawsuit under the U.S. False Claims Act since 2009 filed by Jennifer Denk (later Jennifer Bluth), a former employee pharmacist who blew the whistle when she allegedly discovered that Schedule II narcotics were being dispensed under her license without physician approved prescriptions and a host of other allegations of massive healthcare fraud against the government in billing Medicare....