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State Enforcement Actions

					
Each state enforces its laws and defends its interests, and states often work with the federal government in investigating and prosecuting corporate frauds.  Whistleblowers with knowledge of fraud or wrongful conduct that involves state or local funds or programs may be able to bring a claim under a state or local False Claims Act, and may be eligible to receive a monetary reward and protection against retaliation.


Below are summaries of recent settlements, successful prosecutions, and enforcement actions by states. If you believe you have information about fraud which could give rise to a claim under a State or Local False Claims Act or other whistleblower reward provision, please contact us to speak with one of our experienced whistleblower attorneys.

				

			

			
						
					
			

	
		
		

			

				
				
September 12, 2016

				 Pennsylvania announced the arrest of a licensed professional counselor charged with submitting hundreds of fraudulent Medicaid claims in an alleged scheme that netted him more than $100,000 for counseling services that he never provided. Michael Clarence Johnston, 55, the former owner and operator of Vision Counseling Services in Brodheadsville, Monroe County, was charged with various criminal offenses following an investigation by the Office of Attorney General’s Medicaid Fraud Control Section. PA				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Medicaid, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 24, 2016

				 Florida obtained a court order temporarily shutting down a tech support company that, along with its owners, allegedly deceived consumers out of more than $25 million. The scam operated as Client Care Experts, formerly known as First Choice Tech Support, LLC, and is owned by CEO Michael Seward and his partner, Kevin McCormick. The defendants ran the tech support scam out of a boiler room in Boynton Beach and employed more than 200 telemarketers at the location. The order follows an effort by defendants to dissolve an earlier order obtained by Attorney General Bondi’s Office that temporarily shut down the business, froze the defendants’ assets to preserve funds for consumer restitution and appointed a receiver to oversee the operation through the conclusion of the case. The court denied the defendants’ motion to dissolve and kept the previous order in place pending the final judgment. FL				 					 

						
Tagged in:
													  Misrepresentations, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 24, 2016

				 New York and the Justice Department announced that three hospitals in the Mount Sinai Health System are paying a total of $2.95 million to resolve allegations that the hospitals knowingly retained over $844,000 in overpayments made by Medicaid in violation of the federal and New York False Claims Acts. Knowing retention of an overpayment from the government for more than sixty days is known as a “reverse false claim” and is a violation of both federal and state false claim acts. The entities involved include Mount Sinai Beth Israel (“Beth Israel”) (formerly Beth Israel Medical Center), Mount Sinai St. Luke’s (“St. Luke’s”) (formerly St. Luke’s Hospital) and Mount Sinai Roosevelt (“Roosevelt”) (formerly Roosevelt Hospital) (together, the “Hospitals”) – and the Hospitals’ former partnership group, Continuum Health Partners, Inc. (“Continuum,” and together with the Hospitals, “Defendants”). As part of the settlements, Defendants admitted that, beginning in 2009 due to a software compatibility issue, a coding error caused Defendants to submit claims for payment above and beyond what they had received from the managed care organization, and that Medicaid paid these claims as a secondary payor. In September 2010, the New York Office of the State Comptroller brought to Continuum’s attention a small number of these claims, and Defendants admitted that in late 2010 they were made aware of the coding error. 				 					 

						
Tagged in:
													  FCA Federal, 
													  FCA State, 
													  Hospital Fraud, 
													  Managed Care, 
													  Medicaid, 
													  Medical Billing Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 22, 2016

				 New York announced a settlement with HealthNow, New York, Inc., after an investigation uncovered the wrongful denial of thousands of claims for outpatient psychotherapy and more than one hundred claims for nutritional counseling for eating disorders. The wrongful denials totaled more than $1.6 million in patient claims. Under the agreement, the Buffalo-based company, a not-for profit health service corporation providing health care coverage for approximately 573,700 New Yorkers (including 291,000 who are enrolled in commercial health plans), will pay members for the wrongfully denied claims, revise its policies, and will eliminate a company policy that subjected all psychotherapy claims to review after a member’s 20th visit. Attorney General Schneiderman’s Health Care Bureau launched an investigation in 2015 into HealthNow’s administration of behavioral health benefits following the receipt of consumer complaints. The complaints alleged that HealthNow had improperly denied coverage for treatments by requiring that all outpatient behavioral health visits be preauthorized after the first 20 visits per year, and by excluding coverage for nutritional counseling for eating disorders. 				 					 

						
Tagged in:
													  Healthcare Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 22, 2016

				 Two Florida companies have been ordered to pay $17 million for deceptively marketing and billing for medications and services relating to the treatment of erectile dysfunction at an unlicensed medical clinic in Framingham, Massachusetts announced. The judgment, ordered by the Suffolk Superior Court, permanently prohibits Florida Men’s Medical Clinic, LLC (FMMC) and Men’s Medical Clinic, LLC (MMC) from operating unlicensed medical clinics in Massachusetts or deceptively marketing any medication or medical service relating to the treatment of erectile dysfunction in the state. Under the judgment, the two companies are also ordered to pay, between them, in excess of $17 million, with $6.3 million for restitution to Massachusetts consumers and the remainder in payments to the Commonwealth, including civil penalties. The companies have represented that they have ceased operations, and recovery of the amounts they are ordered to pay is uncertain. 				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Improper Medical Facility, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 17, 2016

				 New York announced a $1.1 million dollar settlement resolving a whistleblower case against My Pillow, Inc., a Minnesota corporation that sells pillows and other sleep-related products. The lawsuit alleged that My Pillow knowingly failed to collect and remit New York sales taxes on sales made to New York customers through its website and over the telephone. The action began when a whistleblower filed a complaint in state Supreme Court in Manhattan. Based on its investigation of the whistleblower’s allegations, the Attorney General’s Office contends that from 2011-2015, My Pillow failed to collect and remit approximately $537,000 in sales taxes on taxable sales made over the phone and through the Internet to New Yorkers. My Pillow was required to collect and remit sales taxes because the company sold products at trade shows in New York through independent contractors and other representatives, among other reasons.  The Attorney General’s Office claims that My Pillow knowingly made false records or statements concerning the sales taxes it was required to collect and remit. 				 					 

						
Tagged in:
													  FCA State, 
													  Tax Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 9, 2016

				 Michigan announced that James Mulholland, of St. Petersburg, Florida and Thomas Mulholland, of Midland, both 59, have been found guilty by a jury on 8 felonies each for the Ponzi Scheme they ran through their Lansing-based business Mulholland Financial. Starting in 2009 until they filed for bankruptcy in 2010, the brothers raised almost $2 million from investors. They made no mention that their business was in trouble and promised a 7% rate of return from the real estate profits and that the principal and interest were guaranteed and could be liquid within 30 days of making a written request. In reality almost every month from January 2009 to February 2010, Mulholland Financial lost money and new investor money began being used to pay off earlier investors. Mulholland Financial was forced to file for bankruptcy in February of 2010 due to overwhelming debt. By this time there were multiple investigations being conducted into the business practices. The case sat dormant with another agency until spring of 2016 until Schuette’s office picked up the case. Over 250 investors lost $18.3 million. 				 					 

						
Tagged in:
													  Ponzi Schemes, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 8, 2016

				 Georgia and 42 other states announced a $100 million multistate settlement with Barclays Bank PLC and Barclays Capital Inc. for fraudulent and anti-competitive conduct involving the manipulation of the London interbank offered rate, or, Libor. This is a benchmark interest rate that affects financial instruments worth trillions of dollars and has a widespread impact on global markets and consumers. Barclays has agreed to pay $100 million, of which about $93 million will be used to reimburse government and nonprofit organizations that had Libor-linked swaps and other investment contracts with Barclays and that were harmed by the activity. A multistate investigation revealed that Barclays had manipulated Libor during the financial crisis period of 2007-2008 by understating the interest rates it would need to pay to borrow money in order to avoid the appearance that Barclays was in financial difficulty and would need to pay a higher rate than some of its peers. Government entities and not-for-profit organizations were defrauded when they entered into swaps and other investment instruments with Barclays without knowing that Barclays and other banks on the U.S. dollar-Libor-setting panel were manipulating Libor and colluding with other banks to do so. , , 				 					 

						
Tagged in:
													  Financial Institution Fraud, 
													  Misrepresentations, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 8, 2016

				 Florida announced the conviction of a Florida couple in connection to an organized retail theft scheme to steal two million dollars’ worth of baby formula. Alicia Tondreau-Leve was convicted of racketeering, conspiracy to commit racketeering, dealing in stolen property as an organizer, and money laundering while her husband, Alan Leve was convicted of conspiracy to commit racketeering for their role in a multistate, multimillion dollar scheme that involved selling stolen formula through an online business named Formula Mom. FL				 			
	
		
		
	


 			




	
		
		

			

				
				
August 4, 2016

				 Ohio, along with 48 other states, announced a $125 million settlement with Cephalon and affiliated companies over allegations that Cephalon engaged in anticompetitive conduct that delayed the market entry of generic versions of Provigil, a prescription drug used to promote wakefulness and treat sleep disorders. Ohio’s total recovery is expected to be about $4 million, including an estimated $1.57 million for Ohio consumers who bought Provigil between 2006 and 2012, $1.43 million for state entities that bought Provigil, and $1 million to the Ohio Attorney General’s Office. This multistate settlement was facilitated by litigation brought against Cephalon by the Federal Trade Commission. In May 2015, the FTC settled its suit against Cephalon for injunctive relief and $1.2 billion, which was paid into an escrow account. 				 			
	
		
		
	


 			


											

						

								

									
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