Kentucky False Claims Act Case Results in $16.5 Million Settlement

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The Kentucky False Claims Act provides incentives for Kentucky whistleblowers reporting fraudulent activities impacting the government over a broad area. It allows filing of qui tam lawsuits in Kentucky courts by whistleblowers or relators seeking prosecution of the guilty and recovery of defrauded taxpayers’ money. One area of False Claims Act involves Hospital Fraud.

Kentucky False Claims Act: Hospital Pays $16.5 Million To Settle Whistleblower Lawsuit

St. Joseph Hospital of London paid $16.5 million to settle a Kentucky False Claims Act lawsuit that accused the health care center of pervasive false billing for Medicaid and Medicare reimbursements. The hospital allegedly bribed cardiologists who superfluously referred patients for heart procedures and doctors at the hospital also performed needless surgeries to bill more. Kentucky qui tam lawsuits have led to the recovery of more than $50 million health care funds from hospitals in the last six months. Ashland-based King’s Daughters Medical Center also agreed to pay $40.9 million in June 2014 after investigations indicted it for seeking federal reimbursements for unneeded medical procedures carried out on patients.

The federal false claim act that applies to the state in the absence of any such law of its own mandates a reward amounting to 15 to 30 percent of the total amount settled for whistleblowers and initiators of qui tam lawsuits in Kentucky.

Qui Tam Lawsuit Against St. Joseph Hospital

A whistleblower lawsuit was filed in 2011 against the hospital, owned by Denver-based Catholic Health Initiatives and now part of KentuckyOne Health, for paying to cardiologists who unnecessarily referred patients for expensive heart procedures, such as bypass surgery, that were not actually needed. Three doctors from Lexington initiated the qui tam lawsuit in Kentucky according to the federal false claims act after they discovered the wrongdoing by the hospital management. They examined many patients, who were treated at St. Joseph hospital, to realize that their medical history did not require procedures they were recommended to undergo at the health care center between 2008 and 2011.

The Kentucky qui tam lawsuit led to further investigations by the authorities and one of the doctors who was accused of receiving kickbacks for unnecessarily sending patients to the hospital turned an approver. He admitted to have falsified diagnoses to refer patients to St. Joseph, which, in turn, paid money and allowed him and other doctors to seek facility fee from Medicaid and Medicare funds as a hospital subsidiary. The sham system of false billing also included hundreds of unnecessary stent insertion and other heart procedures performed on these patients.

St. Joseph hospital got $10,000 to $20,000 in health care reimbursements for each heart procedure billed, the Kentucky false claim lawyer representing the plaintiffs claimed. About $2.5 million is awarded to the three whistleblowers as per legal provisions.

Kentucky False Claims Act Lawsuit: Things To Know

Kentucky has no false claims act of its own. All whistleblower actions in the state are covered under the federal false claims act that encourages citizens to file a claim for themselves and on behalf of the state based on their information on defrauding of public money.
A qui tam litigation is a civil action and only punishable with monetary fine. However, it does not forbid any criminal action by affected individuals. St. Joseph faces over 200 medical malpractice lawsuits, claiming unnecessary medical procedures at the health care facility.
Filing a false claim lawsuit in Kentucky must be done within six years of the fraud committed or within three years of its discovery subject to a maximum of 10-year limitation.
Whistleblowers are set to 15 to 30 percent of the total recovery, including fines, punitive damages, and defrauded money, as incentive. The award is on the higher side when they fight their own Kentucky false claims lawyers without any participation of the state. When public prosecutors take up the case, they are assured of at least 15 percent of the settled amount.
A qui tam lawsuit can be brought in Kentucky against any type of fraud, leading to losses to the national exchequer or false submission or misrepresentation.
There is a provision for comprehensive protection of a Kentucky whistleblower from any retribution or retaliation.

Court our team of Kentucky false claims act lawyers to guide you through the complex legal process.

Contact a Kentucky False Claims Act Attorney

We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

CALL 1-800-632-1404

or fill out this form below for a free initial consultation.

Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

February 10, 2014

Kentucky False Claims Act A Possible Reality

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Our team of Kentucky False Claims Act lawyers was pleased to see in the news a recent string of settlements and news under the False Claims Act. The first involves Kentucky House Speak Greg Stumbo’s efforts to pass a state version of the False Claims Act. There are already state false claims acts in dozens of states, including Illinois, Indiana, Tennessee and Virginia.

Under the legislation, those found guilty would be liable for up to three times the amount they had fraudulently billed the state, and whistleblowers would be eligible to receive anywhere from 15 to 30 percent of the monies recovered as a reward for their service. Other civil penalties and attorney fees would be an additional cost for those found guilty.

While Stumbo has been unsuccessful in the past, he is hopeful that due to budgetary constraints, the Kentucky legislature will pass the state Kentucky False Claims Act this year. Stumbo pointed to successes other states and the federal government have seen using their False Claims Acts. During the 2012 fiscal year alone, according to the Taxpayers Against Fraud website, these governments saw more than $9 billion returned, $300 million of which came from a single case of Medicaid fraud in California. It makes perfect sense for Kentucky to join the other states that have already received funds that should have never been paid or incurred in the first place. More information can be found by clicking HERE.

Even though Kentucky does not have a state version of its False Claims Act, there is a federal cause of action under the qui tam statute. If you have any questions please do not hesitate to let us know today as we would be honored to speak confidentially to you about a Kentucky False Claims Act case.

FOR FALSE CLAIMS ACT HELP, PLEASE CONTACT US.

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Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

February 3, 2014

Kentucky False Claims Act Lawyer: Hospital Fraud Discussed

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Our team of Kentucky False Claims Act lawyers would like to advise that The New York Times recently reported through contributors Julie Creswell and Reed Abelson that a hospital chain has been said to scheme to inflate its bills in violation of Federal law. Health Management Associates is a for-profit hospital chain based in Naples, Florida, which kept tabs on an internal strategy that regulators and others say was intended to increase admissions, regardless of whether a patient needed hospital care, and pressure the doctors who worked at the hospital. This month the United States Department of Justice said it had joined eight separate whistleblower lawsuits against H.P.M.A. in six states.

The lawsuits describe a wide ranging strategy, including billing software system fraud, financial incentives, and threats. Those accusations include some against former Chief Executive Officers, who many of the whistleblowers point to as driving the strategy of fraud. HMA is not the only hospital chain currently being investigated, as the New York Times reported that federal regulators have multiple investigations currently pending against other questionable hospital admissions, procedures and billings, including the country’s largest hospital chain, HCA. Community Health Systems, based out of Franklin, Tennessee, sent its former Chief Executive in 2008 to HMA, and currently faces similar accusations that it inappropriately increased admissions to enhance the bottom line.

HMA also faces shareholder lawsuits and a federal securities investigation. The New York Times points out a disappointing piece of evidence, that being that many companies consider false claims settlements to be a slap on the wrist and merely a cost of doing business when such settlements run only into the tens of millions of dollars. The point is well made that a company should be punished with a $500 million dollar or more fine to serve as a deterrent to future conduct. Only time will tell if such large hundred million plus settlements in the False Claims Act could truly serve as a deterrent to the widespread fraud that currently presides across the country.

Our firm has a team of whistleblower lawyers that want to help you with potential claims. Whether it relates to appropriate medical services provided, up charging of medical products, billing fraud, governmental contract fraud including for disadvantaged or minority business enterprise, or more, please contact us as soon as possible for a free case evaluation.

If you have confidential information about a fraud against the government in Tennessee, Kentucky, Mississippi, Alabama, Arkansas or another state, please contact us as soon as possible for a free case evaluation.

FOR HELP, PLEASE CONTACT US.

CALL 1-800-632-1404

or fill out this form below for a free initial consultation.

Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

January 16, 2014

Mississippi False Claims Act Attorney Notes that Basco Will Pay $1 Million to Resolve Case

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We are attorneys that investigate False Claims Act cases nationwide, including in the states of Tennessee, Arkansas, Mississippi, Kentucky and elsewhere for Medicare fraud, tax fraud, contractor fraud and more against a range of employers including healthcare providers, medical device companies, defense contractors, and pharmaceutical companies. We stand ready to provide a free case evaluation to you; please call us today.

False Claims Act Attorney Discusses Prior Rewards and Statistics

As attorneys that represent individuals who want to seek a claim under the False Claims Act for a qui tam violation by a company, we wanted to advise that the Justice Department has disclosed Basco Manufacturing Company, of Ohio, will pay more than One Million Dollars to resolve allegations that it violated the False Claims Act by submitting false customs declarations to avoid paying duties on aluminum extrusions from China that were at the time subject to a combined antidumping and countervailing duties of more than 400 percent. Basco engaged in a pattern of practice called transshipping.

The company said there were disagreements between it and the Department of Justice, but that it decided to settle the claims and not admit wrongdoing. Nevertheless, the govenrment alleges that Basco and others engaged in a scheem to avoid paying duties by shipping the aluminum manufactured in China through Malaysia. The claims were made known by Whistleblower James F. Valenti, who will receive a share of the recovery under the relator provisions of the False Claims Act.

Companies may not knowingly avoid paying duties. If you know of company neglecting to pay duties owed, please contact our firm immediately.

FOR HELP, PLEASE CONTACT US.

Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more.

For more information, please contact our team of whitsleblower and qui tam attorneys today, or visit our False Claims Act Litigation Source.

CALL 1-800-632-1404

or fill out this form below for a free initial consultation.

Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

January 13, 2014

Mississippi False Claims Act Lawyer Reports on Novartis Settlement

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False Claims Act Attorney Discusses Prior Rewards and Statistics

As attorneys that represent individuals who want to file a claim under the False Claims Act and assert a qui tam complaint against a business defrauding the United States Government, we wanted to provide that there has been a False Claims Act settlement for $15 million dollars against Novartis Pharmaceutical Corporation and Bioscrip, Inc. in connection with a multi-million dollar kickback scheme involving a prescription drug.

The lawsuit that was filed alleges that as a result of a kickback scheme, Medicare and Medicaid paid tens of millions of dollars in reimbursement based on false, kickback tainted claims before Exjade shipped by Bioscrip. Contemporaneous with the filing of an Amended Complaint, District Judge Colleen McMann approved a settlement to resolve the United States claim against Bioscrip and their limited financial resources that Bioscrip agrees to pay $11.6 million dollars to the United States Government, $3.3 million dollars to a group of states, and cooperate in the prosecution of claims against Novartis. Manhattan United States Attorney Preet Bharara stated that “Novartis is caught having orchestrated yet another scheme whereby it used the lure of kickbacks to co-opt a healthcare providers’ independence and in this case turn pharmacy employees at Bioscrip into sales people for Exjade. By having Bioscrip promote refills under the guise of purported counseling and education, Novartis caused patients to receive one-sided advice that did not discuss Exjade’s serious, potentially life-threatening side effects. Further, by hiding this illegal quid pro quo from federal healthcare programs, Novartis caused the public to pay tens of millions of dollars for the kickback-tainted drugs.”

Exjade is an iron chelation drug approved for use by patients who have iron overload resulting from blood transfusions. Between February 2007 and May 2012, Novartis orchestrated a scheme whereby it offered kickbacks, in the form of patient referrals under the guise of rebates, to Bioscrip, a specialty pharmacy, in exchange for Bioscrip increasing its Exjade refills through biased recommendations to patients. By orchestrating their scheme, Novartis and Bioscrip further caused pharmacies to submit tens of thousands of claims to Medicare and Medicare resulting in payments of tens of millions of dollars in reimbursements based upon these false claims.

The allegations of fraud stated in the Complaint were first brought to the attention of Federal law enforcement by a whistleblower who filed a lawsuit under the False Claims Act. The False Claims Act permits the government to recover up to three times the amount of damages incurred by the United States plus civil penalties ranging from $5,500 to $11,000 per violation. Private parties who have knowledge of fraud committed against the government may file suit on behalf of the government and share in any recovery. The United States may then intervene and file its own lawsuit for treble damages and penalties, as it did in this case.

FOR HELP, PLEASE CONTACT US.

For more information, please contact our team of whitsleblower and qui tam attorneys today, or visit our False Claims Act Litigation Source.

CALL 1-800-632-1404

or fill out this form below for a free initial consultation.

Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.