K&M Notable Qui Tam and Whistleblower Cases
Serving Clients Nationwide in Qui Tam Cases, Fraud and Whistleblower Law
The following are notable cases that Kenney & McCafferty have handled dealing with qui tam, fraud and whistleblower claims. Please contact Kenney & McCafferty today to discuss your own specific situation.
United States ex rel Williams, et al. v. Renal Care Group, et al., Middle District of Tennessee, Case No. 3:09-00738.
On May 27, 2011 the United States District Court for the Middle District of Tennessee entered an order awarding $82.6 million to the Unbited States. In ruling for the government and KM clients Williams and Martinez, Judge Haynes stated that RCG and its parent company Fresensius Medical Care Holdings, Inc. "exhibited reckless disregrad of legal mandates" in their billing practices. The case alleges that RCG created a false billing system for its medical equipment. To read more about the RCG judgment, click here.
United States ex rel. Laura Rupert & Robin Herzog v. CareSource Management Group, Co., et al., Southern District of Ohio, Case No. C2-06-961.
On January 31, 2011, CareSource agreed to pay $26 million to settle allegations the Dayton-based company defrauded Medicaid by submitting false data and receiving reimbursements from Medicaid for health care services it did not provide. It was alleged that CareSource knowingly failed to provide screening, assessment, and case management for children with special health care needs and adults. The $26 million settlement resolves a qui tam lawsuit filed by whistleblowers Laura Rupert and Robin Herzog. Rupert and Herzog were represented by Brian Kenney and Pam Brecht of Kenney & McCafferty as well as Rick Morgan and Mary Jones of Morgan Verkamp in Cincinnati, Ohio. To read more about the CareSource settlement, click here.
United States ex rel Kayla Thornton et al. v. Hewlett Packard Corporation et al., Northern District of Texas, Case No. 3:08-cv-1180.
On November 10, 2010, Hewlett-Packard Corporation agreed to pay $16.25 million to settle allegations made in multiple whistleblower lawsuits that the technology giant defrauded the Schools and Libraries Program of the Universal Service, also known as the “E-Rate Program.” The case which was filed as a qui tam action in 2005 by the Kenney & McCafferty law firm, resolves allegations that during the 2002-2005 time period Hewlett-Packard was involved in: (1) conspiring to rig the competitive bidding of E-Rate contracts; and (2) subverting the competitive bidding processes for E-Rate contracts by illegally providing gratuities, including meals, trips, and event tickets to school district representatives in Dallas and Houston, Texas in order to improperly influence the bidding process.To read more about the Hewlett-Packard settlement, click here.
United States ex rel Stefan Kruszewski, MD v. AstraZeneca Pharmaceuticals, LP., Eastern District of Pennsylvania, Case No. 06-4004.
On April 28, 2010, AstraZeneca agreed to pay $520 million in civil fines, penalties and damages to settle allegations that the company defrauded Medicare, Medicaid and other government-funded health care programs in connection with its marketing and promotional practices for the blockbuster atypical antipsychotic Seroquel. This is the largest settlement of off-label marketing claims brought under theFalse Claims Act to date that involved civil-only fines. The $520 million settlement resolves a qui tam lawsuit filed by whistleblower Dr. Stefan Kruszewski, one of two relators to file a case. Dr. Kruszewski was represented by Brian Kenney and Tavy Deming of the Kenney & McCafferty law firm. To read more about the AstraZeneca settlement, click here.
United States ex rel Williams, et al. v. Renal Care Group, et al., Middle District of Tennessee, Case No. 3:09-00738.
On March 22, 2010 the United States District Court Judge William J. Haynes, Jr. issued an order awarding the United States $19,366,705 plus prejudgment interest on unjust enrichment claims against Renal Care Group (“RCG”), RCG Supply Company (“RCGSC”) and Fresenius Medical Care Holdings, Inc. as the successor-in-interest to RCG and RCGSC. This award to the United States arises from claims made in a whistleblower complaint alleging fraudulent Medicare and Medicaid billing practices by RCG and RCGSC that violated the False Claims Act. Philadelphia-area law firms Kenney & McCafferty and Egan Young filed the Complaint. To read more about the RCG settlement, click here.
United Statesex rel Amanda Richards et al. v. Advanced Pain Centers, et al., Eastern District of Missouri., Case No. 04:08-cv-66.
On March 9, 2010, The U.S. attorney's office for the Eastern District of Missouri announced a civil settlement with Abdul Naushad, his wife, Wajiha Naushad, and the clinics, which do business as Advanced Pain Centers. The settlement also resolves claims against Naushad's billing company, Ultimate Practice Solutions, and its owner Azeem Meo, of Carmel, Ind. Federal attorneys alleged that the defendants submitted false claims to Medicare, Missouri Medicaid and TRICARE for spinal decompression services. The claims were for one-on-one physical therapy services. To read more about the Advanced Pain Centers settlement, click here.
United States ex rel Stefan Kruszewski, MD v. Pfizer, et al., Eastern District of Pennsylvania, Case No. 07-cv-4106.
On September 2, 2009, Pfizer, Inc. announced it agreed to plead guilty to criminal conduct and to pay 2.3 billion in criminal and civil fines, penalties and damages to settle allegations made in multiple whistleblower lawsuits that the pharmaceutical giant defrauded Medicare, Medicaid and other government-funded health care programs in connection with its market practices for four of its drugs. The settlement is the largest qui tam settlement in U.S. history. As part of the record settlement, Pfizer agreed to pay $300 million to resolve allegations that it engaged in off-label marketing of its blockbuster atypical antipsychotic Geodon, which generated over $1 billion dollars in sales in 2008. The allegations were first made in a qui tam lawsuit filed by Kenney and Deming on behalf of Harrisburg psychiatrist, Dr. Stefan Kruszewski. Pfizer also agreed to pay $100 million to resolve allegations that it improperly marketed its antibiotic Zyvox. That case was filed by Ronald Rainero, a former Pfizer sales manager from New Jersey. To read more about the Pfizer settlement, click here.
United States ex rel Steven Woodward et al. v. Eli Lilly & Co.,Eastern District of Pennsylvania, Case No. 06-5526, and United Statesex. rel. Jaydeen Vicente et al. v. Eli Lilly & Co., Eastern District of Pennsylvania, Case No. 07-1791.
On January 15, 2009, Eli Lilly announced that it agreed to pay more than $1.4 Billion in criminal and civil fines, penalties and damages arising from allegations made in multiple whistleblower lawsuits including the 2 above-referenced suits filed by K&M. The qui tam suits alleged that the pharmaceutical giant defrauded Medicare, Medicaid, and other government-funded health care programs in connection with its marketing practices for it blockbuster atypical antipsychotic, Zyprexa. The settlement is the largest qui tam settlement in U.S. history. To read more about the Zyprexa case, click here.
United States ex. rel. Lucia Paccione v. Cephalon Inc., Eastern District of Pennsylvania, Case No. 036268.
On September 29, 2008, it was announced that K&M's qui tam complaint led to the federal and numerous state governments' recovery of $425 Million in a Civil Settlement and Criminal Fine in America's largest biotechnology Medicaid fraud case. The case involved unlawful off-label marketing by Cephalon of drugs including Gabitril, Actiq, and Provigil. Click here to read more about the Cephalon settlement.
United Statesv. E-Star, Inc., Case No. 07-156.
As of June 2007, the United States had recovered over $60 million dollars from an international conglomerate and its employees for an elaborate stock and tax fraud scheme involving the sale of stock on the Taiwanese stock exchange.
United States ex rel Kelly v. Biotrax Inc., Fresensius Medical Care AG, Eastern District of Pennsylvania, Case No. 96-1441.
Fresensius, an international medical services provider, pays an $18 million judgment to settle qui tam actions for numerous improper testing schemes relating to dialysis centers, echo cardiograms and other testing services.
United States ex rel Hendricks v. Northwestern Human Resources, Inc., Eastern District of Pennsylvania, Case No. 97-4203.
Pennsylvania's largest provider of social services pleas guilty to a federal felony and agrees to pay approximately $7.8 million dollar to settle criminal and civil actions judgment for failure to comply with state and federal medicare regulations relating to staffing, coding, billing, and cost report issues .
United States ex rel Weissman v. Mediq Imaging Services, Inc. et al, Eastern District of Pennsylvania, Case No. 95-238.
One of first anti-kickback case successfully prosecuted under the False Claims Act for a mobile imaging company paying kickbacks in return for ordering tests, results in approximate 4.5 million judgment.
United States ex rel Basore v. Plummer Precision Optics, et al, Eastern District of Pennsylvania, Case No. 97-2197.
Weapons manufacturer's failure to test, falsification of reports and falsification of custom's reports leads to approximate $3 million dollar judgment, sale of company, and debarment.
United States ex rel George Brouder v. Polaroid Corporation, District of Massachusetts, Case No. CV 12427.
Polaroid agrees to pay $3.2 million for providing false bid data to the General Services Administration and TINA violations.
United States ex rel Folle v. Option Care et al, District of Nevada.
Option Care, a pharmacy chain, agrees to pay $1.4 million to settle claim that is defrauded Medicare/Medicaid in billings related to Synogis.
United States ex rel Lisa Fager v. Jackson County Ambulance Services, Southern District of Illinois, Case No. 4005.
Ambulance Company pays 1.4 million settlement as a result of fraudulent coding for services.
United States ex rel Moculzski v.Kidspeace Corporation, Eastern District of Pennsylvania, Case No.02-1846.
Kidspeace, a provider of social services agrees to pay $1.9 million to settle false claim action for failure to comply with state and federal regulations relating to staffing, coding and busing issues.
Feman v Fresensius Medical Care AG, District of New Jersey, Case No.98 - CV- 02292.
Former employee successfully sues for retaliation for investigating False Claim under subsection 3729(h) of the False Claims Act despite never having filed a False Claims action.
United States v University, Southern District of New York, Case No.486.
University settles claim for fraudulent coding for services by physicians in surgery department, wrongful termination case settled.
United States ex rel Nancy Bernard v Best Care Home Health Inc, District of Minnesota, Case No.99-1207.
Home health care agencies pay claims to settle fraudulent coding and staffing issues.
United States v Health Ventures, Inc., Eastern District of Pennsylvania , Case No.CV 3432.
National nursing home operator liable for million plus judgment as a result of qui tam relating to improper cost reports and improper coding.
United States ex rel Quaicoe v Center for Pain Management, Southern District of Texas, Case No.2000-238.
Pain management clinic sued for coding violations and not providing proper services.
United Statesex rel Denton v Health Ventures, Inc., Eastern District of Pennsylvania, Case No.CV 3432.
National nursing home operator liable for improper coding and staffing issues.
United States ex rel Hoffman v Kessler Hospital et al,District of New Jersey , CA No. 96 -1933.
Fraud related to improper coding and improper provision of lymphedema pumps and other services results in criminal prosecution and civil fines against medical doctor running the program.
United States ex rel Strelow v National Medical Care, Inc. et al, Eastern District of Pennsylvania, Case No. 96- 7423.
Improper coding and unbundling of CPT Codes leads to multi-million dollar settlement.
United States ex rel Speer v Princeton Biomedical Lab Inc et al, Eastern District of Pennsylvania, Case No.98 -CV- 2947.
Unbundling of CPT lab codes leads to judgment against and debarrment of provider.
