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March
15 , 2001
False
Claims Act Recoveries Reach
Record $1.5 Billion Level in 2000
In
November 2000, DOJ reported that the
United States collected a record $1.5
billion in civil fraud recoveries during
the 2000 fiscal yearan increase of
almost 50% above the largest previous
annual recovery in 1997.
Approximately
$1.2 billion of the settlements and
judgments were the result of qui tam
lawsuits. Payments to whistleblowers for
the 2000 fiscal year totaled more than
$173 million.
Health
care fraud cases once again topped the
list of annual recoveries, totaling more
than $840 million. This amount included
what was the largest civil fraud recovery
ever (until record-breaking Columbia/HCA
settlement in December 2000)a $385
million settlement with Fresenius Medical
Care to resolve four separate qui tam
lawsuits alleging various wrongdoing by
its kidney dialysis subsidiary. The
largest of the four suits, which resulted
in $253.3 million of the $385 million
total settlement, involved allegations of
fraudulent claims related to
intradialytic parenteral nutrition
(IDPN), a therapy for patients undergoing
dialysis. The suit alleged that a
Fresenius holding, NMC Homecare, Inc.
submitted claims for this nutritional
treatment that were based on fraudulent
medical data, billed for equipment that
was not used, and paid kickbacks to
facilities to induce referral of business
for IDPN therapy. The relators were
former NMC employee Dana R. Austin, and a
competitor of NMC, Ven-A-Care of Key West
Florida.
The
Department also recovered $170 million
from Beverly Enterprises, Inc., the
largest nursing home operator in the
United States, for alleged false billings
to Medicare involving over 400 nursing
homes around the country. That suit,
filed in 1995 by Domenic Todarello, who
formerly headed a number of Beverly
nursing homes in California and Arizona,
alleged that Beverly billed Medicare for
labor costs incurred in treating
non-Medicare beneficiaries and used phony
documents to support its claims for
payment.
A
health care fraud settlement with Quorum
Health Group, Inc., the nation's largest
hospital management chain, resolved 2 qui
tam lawsuits. The largest of the
suits was filed in January 1993 by James
Alderson, a former CFO for a
Quorum-managed hospital, and alleged that
Quorum included non-reimbursable costs in
its annual cost reports and kept a secret
set of cost report reserves identifying
the improper claims in case the scheme
was uncovered.
Also
in FY 2000, GAMBRO Healthcare, Inc. and
two subsidiaries agreed to pay a total of
$53.1 million to settle a qui tam
lawsuit alleging that the laboratories
submitted false claims for services
provided to end stage renal disease
patients. The suit was filed by relators
Jay Buford, William Schoff and Dianne
Castano.
After
health care, the largest category of
fraud recoveries involved the production
of oil and other minerals from public
lands. The Department recovered more than
$243 million from companies alleged to
have underpaid royalties on such
production, including $95 million from
Chevron, $56 million from Shell, $43
million from Texaco, $32 million from BP
Amoco, $26 million from Conoco and $11.9
million from Devon Energy. These
settlements were all the result of a qui
tam lawsuit against 14 oil companies
filed in 1996 by J. Benjamin Johnson and
John Martinek, former employees of
Atlantic Richfield Co.
The
Department's recoveries also included
over $140 million in settlements with
twenty-five brokerage firms. These
companies allegedly sold open market
securities with artificially low yields
to municipalities refunding tax-exempt
bonds, thereby reducing the
municipalities' purchase of special
low-interest Treasury bonds. The most
significant "yield burning"
settlement came from Solomon Smith
Barney, which agreed to pay $38.8 million
to resolve these allegations.
Defense
procurement fraud accounted for another
$100 million in recoveries, including $54
million from the Boeing Corporation to
resolve allegations that it placed
defective transmission gears in army
Chinook helicopters. There is significant
evidence that the defective gears caused
numerous accidents including a 1988 crash
of a Chinook in Honduras in which five
American soldiers were killed. The
settlement resolved two related qui
tam actions filed by Brett Roby, a
former Quality Assurance Engineer for
Boeing subcontractor SPECO Corp.
Also
in fiscal year 2000, Government
contractor Jacobs Engineering Group, Inc.
agreed to pay $35 million to settle
allegations that the company inflated
lease payments under its contracts with
various government agencies. The
settlement resolves a qui tam
action filed in 1997 by former Jacobs
employee Edwin Bond. Bond was
subsequently dismissed from the action,
but he has appealed.
Civil
recoveries for fiscal year 2001 began on
a strong note with the largest FCA
recovery ever, a $745 million settlement
with HCA-The Health Company (formerly Columbia/HCA);
a $30.6 million settlement with LifeScan,
Inc., and a $27 million settlement with
National Health Care Corp. The LifeScan
settlement resolved a qui tam suit
filed in 1997 by two former employees,
alleging that the company failed to file
medical device reports with the FDA
advising it of the illnesses and injuries
resulting from defective blood glucose
monitoring devices. According to DOJ, the
reports the company did file contained
false, incomplete or misleading
information. The relators were Robert
Konrad and John Pumphrey.
National
Health Care paid $27 million to settle
allegations that it submitted inflate
costs reports to Medicare. The
allegations came to light as a result of
a qui tam lawsuit filed by a
former nursing home administrator for
National Health Care's Orlando facility,
Philip Charles Braeuning.
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