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Whistleblower Successes

					
Whistleblower reward laws and whistleblower reward programs enable qualifying whistleblowers to recover anywhere from 10 to 30 percent of the government’s recovery. These whistleblower reward laws include: the federal False Claims Act; State False Claims Acts; the Securities and Exchange Commission Whistleblower Program; the Commodity Futures Trading Commission Whistleblower Program; and, the Internal Revenue Service Whistleblower Program. We have collected summaries of recent successes in cases brought by whistleblowers, and you can read them below. You can also review our annual Top Ten Lists.


Members of the 91pornWhistleblower Lawyer Team have served as lead counsel on cases that have recovered roughly $1.3 billion for the government and hundreds of millions in whistleblower awards. You can read more about the results we have achieved for our clients in Our Successes.


If you believe you have information about fraud which could give rise to a claim for a whistleblower reward, please contact us to speak with one of our experienced whistleblower attorneys.

				

			

			
						
					
			

	
		
		

			

				
				
March 4, 2020

				 STG Healthcare of Atlanta, Inc. and senior executives Paschal Gilley and Mathew Gilley have agreed to resolve fraud allegations by paying $1.75 million.  The case against the hospice was launched by two former employees, Serita Samuel and Miranda Eskridge, who alleged in a qui tam suit that STG Healthcare submitted false claims to Medicare and Medicaid that arose from illegal payments to so-called back-up medical directors, and that were on behalf of patients who were not terminally ill and thus ineligible for palliative care.  ; 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Home Health and Hospice, 
													  Medicaid, 
													  Medicare, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 28, 2020

				 Nursing home chain Diversicare Health Services, Inc. has agreed to pay $9.5 million to resolve whistleblower-brought allegations of submitting claims to Medicare and Medicaid for medically unnecessary rehabilitation therapy services.  According to separate qui tam complaints by former employees, Mary Haggard and Bryant Fitzmorris, between 2010 to 2015, Diversicare unnecessarily placed beneficiaries in the highest category of reimbursement in order to receive higher payouts, and submitted forged pre-admission evaluation certifications to Medicaid.  As part of the settlement, Diversicare has entered into a Corporate Integrity Agreement for five years, Haggard will receive approximately $1.4 million, and Fitzmorris will receive approximately $145,450.  ; 				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medicaid, 
													  Medicare, 
													  SNF, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 28, 2020

				 Sanofi-Aventis U.S., LLC has agreed to pay $11.85 million to resolve allegations of paying kickbacks to Medicare patients in connection with a multiple sclerosis drug called Lemtrada.  According to the press release, Lemtrada costs nearly $100,000 per patient per year, and Medicare co-pays can be many thousands of dollars per year.  In order to break down barriers to access for Medicare patients, Sanofi allegedly provided kickbacks to them via payments to a purportedly independent charitable foundation, The Assistance Fund (TAF), which helps covers the co-pays in violation of the Anti-Kickback Statute.  The scheme was reported by a partnership formed by Sanofi's predecessor, Genzyme Corporation, which will receive about $2.7 million for their role in the case.  				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicare, 
													  Pharma Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 28, 2020

				 The SEC has awarded $7 million to an anonymous whistleblower whom the agency described as having provided extensive and sustained assistance in a successful enforcement action.  No other information on the underlying action was disclosed.  				 					 

						
Tagged in:
													  Anonymity, 
													  SEC Whistleblower Reward Program, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 19, 2020

				 Guardian Elder Care Holdings, Inc. has agreed to pay $15.5 million to settle claims of defrauding Medicare and Medicaid.  In a qui tam suit filed in 2015, whistleblowers Philippa Krauss and Julie White alleged that from 2011 to 2017, the Pennsylvania-based nursing home chain pressured its therapists to provide medically unnecessary rehabilitation to patients suffering from dementia or dying in hospice care in order to boost its profits.  During the subsequent government investigation, Guardian Elder Care self-disclosed that it had also billed federal healthcare programs for services performed by two excluded individuals.  As part of the settlement, Guardian Elder Care has entered into a chain-wide Corporate Integrity Agreement with the Department of Health and Human Services, and Krauss and White will split a $2.8 million relator's share.  ; 				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Home Health and Hospice, 
													  Improper Medical Personnel, 
													  Lack of Medical Necessity, 
													  Medicaid, 
													  Medicare, 
													  Provider Fraud, 
													  SNF, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 14, 2020

				 Tennessee-based Cookeville Regional Medical Center Authority (CRMC) has agreed to pay $4.1 million to settle allegations of violating the Anti-Kickback Statute, Stark Law, and False Claims Act from 2012 to 2017.  In a qui tam suit that initiated the investigation, an unnamed whistleblower alleged that CRMC submitted claims to Medicare and TennCare that arose from improper financial arrangements with physicians at its wholly owned subsidiary, CRMC MSO-Sub 1, Inc., d/b/a Tennessee Heart.  $3.6 million of the settlement proceeds will go to the United States, $453,000 will go to the State of Tennessee, and $779,000 will go to the whistleblower.  				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medicare, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 11, 2020

				 Tenet Healthcare Corporation and its affiliated hospital, Desert Regional Medical Center, have agreed to pay $1.4 million to settle allegations that they knowingly charged Medicare for medically unnecessary cardiac monitors, in violation of the False Claims Act.  According to former DRMC employee, Michael Grace, the devices were implanted between 2014 to 2017, exposing beneficiaries to unnecessary risk and causing the government unnecessary expenses.  For exposing the fraud, Grace will receive a $240,789 share of the recovery.  				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medicare, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 4, 2020

				 Southeastern Retina Associates (SERA), which operates in parts of Tennessee, Georgia, and Virginia, has agreed to pay $1.5 million and enter into a five-year Corporate Integrity Agreement with the U.S. Department of Health and Human Services for allegedly defrauding Medicare and Medicaid.  The investigation was launched by a qui tam suit filed by an unnamed whistleblower, which alleged that between 2009 to 2016, the practice improperly billed exams at a higher rate than appropriate, and used a billing code called Modifier 25 to bill for exams that were not separately billable from other services billed the same day.  For exposing the misconduct, the relator in this case will receive a $270,000 share of the settlement.  				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medical Billing Fraud, 
													  Medicare, 
													  Provider Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 31, 2020

				 A bidder in the sale of a loan from the Department of Energy has agreed to pay $29 million to resolve allegations of colluding to rig the auction of the loan, thus depriving the agency of a fair bidding process and reducing the amount recovered by the agency.  The allegations that Hybrid Tech Holdings LLC, Hybrid Technology LLC, and Ace Strength International LTD exerted pressure on two other bidders to suppress their bids during the live auction were made by whistleblowers William Baldiga and the FAH Liquidating Trust in a qui tam suit.  The relators will share in $5.2 million of the recovery.  ; 				 					 

						
Tagged in:
													  Bribery and Bid-Rigging, 
													  FCA Federal, 
													  Government Loan Programs, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 22, 2020

				 The SEC announced a reward of $45,000 to a harmed investor-turned-whistleblower who provided significant information that helped the SEC shut down a fraudulent scheme targeting retail investors, and enabled the SEC to recover assets to return to victims.  				 					 

						
Tagged in:
													  Anonymity, 
													  Securities Fraud, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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													False Claims Act					  							State & Local False Claims Acts					  							SEC Program					  							CFTC Program					  							IRS Program					  					

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