News & Cases

Regulators have known since the last presidential election that stringent rules for banking institutions are not one of the Trump administration’s priorities.

The Dodd-Frank Act has been protecting consumers from risky behavior by banks since the aftermath of the 2008 crisis. Now, the administration is effectively removing this stringent oversight, with the sole exception of Wall Street’s giants.

Financial institutions that benefit from the rollback include American Express, Capital One, SunTrust, U.S. Bank, and many others. Meanwhile, the likes of Bank of America, JPMorgan, and Citibank will continue to be scrutinized as they have been since the financial collapse.

While the government vows to only burden with complex rules the large global banks that could potentially destabilize the whole financial system, members of the opposition believe the Dodd-Frank rollback is increasing the risk for the American taxpayer....

The U.S. Attorney for the Eastern District of Pennsylvania has just announced a $25 million settlement to resolve allegations that Abbott Laboratories and its spinoff AbbVie Inc. unlawfully marketed its drug TriCor to physicians, offering kickbacks and promoting off-label uses. The alleged misconduct resulted in fraudulent claims being submitted to Medicaid and Medicare, amounting to millions of dollars.

TriCor has been approved by the FDA to treat certain types of cholesterol imbalance. Misconduct involving marketing of the drug was first brought to light in a whistleblower lawsuit filed by the Kelley/Uustal law firm in 2012. The insider information that eventually led attorney John Uustal’s team to secure a settlement, was provided by Amy Bergman, who used to be a sales rep. at Abbott.

The False Claims Act allows whistleblowers to file a qui tam action on behalf of defrauded U.S. taxpayers. When the information they provide is original and useful for holding fraudster’s accountable, the tipsters receive a reward between 15 and 30 percent of the total recoveries...

Northrop Grumman, a defense contractor, has agreed to pay $27.45 million to settle claims of fraudulent billing.

An investigation led by the Air Force Office of Special Investigations (“AFOSI”), the Defense Criminal Investigative Service (“DCIS”), and the FBI uncovered an international scheme to defraud the U.S. Air Force. The agencies found out that employees at Northrop Grumman Systems Corporation (“NGSC”) illegally profited by inflating their work hours on bills for two contracts with the armed forces.

According to the DOJ, the company billed the Air Force for working hours claimed by employees assigned to the Middle East who had not actually worked those hours. From January 2011 to October 2013, the NGSC deliberately mischarged the Air Force for 12 to 13.5 hour work days when, in fact, the workers were not working overtime, but engaging in activities such as sports and partying (among themselves and with their families) and enjoying their five-star accommodations.

By overstating the number of hours worked, employees personally profited, defrauding American taxpayers by roughly $5 million....

Three whistleblower suits have unveiled a large scam involving unlawful repackaging and reselling of drugs by AmerisourceBergen Corporation. The lawsuits were filed by Michael Mullen, former Amerisource employee, Omni Healthcare Inc., an oncology practice, and pharmacy workers Daniel Sypula and Kelly Hodge. To resolve civil liability, the company settled for $625 million.

According to The Department of Justice, the wholesale medical company had been contaminating drugs, bribing, illegally labeling drugs, and creating sham patients for at least thirteen years, via a company named Medical Initiatives Inc., which shut down in 2014. This is not the first time Amerisource has been taken to court or forced to pay in relation to criminal activity. In 2017, it paid $260 million in a misbranded drugs case.

According to allegations, Medical Initiatives took part in a massive fraudulent scheme between 2001 and 2014. They purchased bottles of several drugs and transferred the drugs into prefilled syringes. Some of the drugs involved were Procrit, Aloxi, Kytril, Anzemet, and Neupogen. All these are used by cancer patients undergoing chemotherapy treatment. By selling those prefilled syringes, the company unlawfully produced more doses than it purchased, profiting to the tune of around $100 million. ...

Earplug manufacturer 3M will pay $9.1 million to resolve allegations that it knowingly sold defective products to the U.S. military. The alleged misconduct was first brought forward in a whistleblower lawsuit initiated by 3M’s competitor Moldex-Metrics in May 2016.

According to the complaint, 3M knew that its Combat Arms Earplugs Version 2 (CAEv2), were not long enough for proper insertion into the ears of users, and it, nevertheless, sold the product to the Defense Logistics Agency.

CAEv2 earplugs have two different positions. They can be used alternatively as traditional earplugs and flipped over for muffling explosion noise, while letting quiet sounds go through them. While 3M’s engineers allegedly knew the earplugs could lose their seal, which would affect performance, the company did not share that information with the government. Tellingly, CAEv2 plugs are now discontinued.

3M earplug malfunction may have caused thousands of U.S. soldiers to suffer tinnitus and related conditions. Thus, the government may not only have endured losses through the purchasing of defective products, but also through the treatment of ailments related to CAEv2 use....

A new report by the Office of the Inspector General outlines the widespread utilization of hospice services covered under Medicare, while also highlighting the sytem’s flaws and some central vulnerabilities.

Because of the solace it can provide for people in the later stages of life, and their families, many Medicare beneficiaries opt for hospice care. In 2016 alone, Medicare paid $16.7 billion for hospice services utilized by 1.4 million individuals participating in the program.

Unfortunately, Medicare’ steep bills for hospice care do not always translate into quality care for its beneficiaries. The OIG found that hospices often left beneficiaries in pain, failed to provide medication, and responded poorly to a variety of health complications.

According to the report, Medicare beneficiaries are often left in the dark about crucial decisions impacting their care. In addition, hospices were found to routinely bill for the most expensive level of care without medical necessity....

Detroit’s William Beaumont Hospital system has agreed to pay $84.5 million to resolve allegations that eight physicians accepted illegal kickbacks for patient referrals in violation of the False Claims Act (“FCA”), the Department of Justice announced Thursday.

Whistleblower Dr. David Felten is set to receive a soon-to-be-determined cash whistleblower award for filing the initial qui tam lawsuit that led to the government’s recovery.

Felten Claims Beaumont Trades Cash and Office Rent for Patient Referrals

After joining Beaumont in 2005 as Vice President of Research, the globally recognized neuroscientist Dr. David Felten, (then 57) noticed several arrangements between Beaumont and its physicians that appeared to violate of the Anti-Kickback Statute and Stark Law....

Following the announcement of an $83 million whistleblower award, the SEC is looking to put a cap on tipster payouts. A recent 3-2 vote by the Commission said yes to capping awards at $30 million.

The $83 awarded to three whistleblowers last March ignited the flame of the “awards are getting too large” sentiment that guides tort reform advocates across the nation. When it comes to SEC whistleblowers, they may finally be getting their big day.

The cap is, of course, bad news for the public and good news for dishonest corporations that make billions of dollars a year, for whom having to shell out one or two hundred million is merely a tickle.

Awards are an incentive to whistleblowers, who often lose their jobs and their livelihood in their attempt to expose fraudsters. If putting caps on rewards becomes a habit, it will be bonanza time for fraudsters, but the SEC does not appear to see it that way....

Florida-based attorney John Uustal just announced he is offering up to $100,000 to the first person who comes forward with proof of “a secret conspiracy to create frivolous lawsuits.”

Uustal is a trial lawyer and author, famous for holding massive corporations responsible for their misconduct. The list of corporate titans he has successfully brought to justice includes the likes of Philip Morris, Toyota, and General Motors.

To Cheese or Not to Cheese

Uustal’s initiative was prompted by a recent class action initiative filed in Florida. In what some prominent legal professionals are referring to as “a BS lawsuit,” two McDonald’s customers are accusing the company of illegally charging for cheese.

Suing McDonald’s, “because it charges the same price for a Quarter Pounder with cheese and without cheese,” has made some people wonder whether there might be “a secret plot by big corporations to manufacture dumb lawsuits.”...

Minnesota-based Skin Care Doctors (SCD) has agreed to pay $850,000 to resolve allegations of false Medicare billings and unnecessary surgical procedures. The alleged misconduct was brought to light in a whistleblower lawsuit filed by a dermatologist who had previously worked under Skin Care's CEO, Michael J. Ebertz.

According to the False Claims Act lawsuit filed by whistleblower Dr. Jeff Samuelson, Dr. Ebertz, who is also a dermatologist, knowingly treated benign lesions as if they were pre-cancerous, routinely billing Medicare for unnecessary procedures.

he complaint also states that Ebertz overbilled Medicare for his patients' visits and encouraged other Skin Care doctors to do the same. Samuelson was co-owner of the company at the time, but he was invited to leave after he spoke out about the alleged misconduct. Dr Samuelson currently practices in California....