False Claims Act

The False Claims Act has been called the single most important tool that American taxpayers have to recover funds when false claims are made to the federal government, including health care fraud, mortgage fraud, and procurement fraud.  We here at the Financial Fraud Law Blog believe it is difficult to argue with that statement.

Almost exactly 25 years ago, in 1986, Senator Charles Grassley and Representative Howard Berman led efforts in Congress to amend the False Claims Act, including enhancements to the qui tam provisions to encourage whistleblowers to come forward with allegations of fraud.   (That almost certainly was not the last time there was bipartisan agreement in Congress on a major issue, though we cannot vouch for this with complete certainty.)

Oracle Corp. and Oracle America Inc.

Science Applications International Inc. (SAIC); its subcontractor, Applied Enterprise Solutions LLC (AES); AES CEO Dale Galloway; and former government employees Stephen Adamec and Robert Knesel will pay the United States $22,676,000 to resolve allegations of false claims in a whistleblower suit.   SAIC will pay $20,400,000 and AES and Dale Galloway will pay $2,166,000. Adamec and Knesel are paying $110,000. 

Guidant LLC, a wholly owned subsidiary of Boston Scientific Corp.

The agreement by Maxim Healthcare Services, Inc., one of the country’s largest providers of home health care services, to pay $130 million to settle civil and criminal allegations relating to what the government characterizes as a “nationwide scheme to defraud Medicaid programs and the Veterans Affairs program” is the DOJ’s largest civil recovery in a home health care fraud case ever. 

Maxim Healthcare Services Inc., one of the nation’s leading providers of home healthcare services, has entered into a settlement to resolve criminal and civil charges relating to what federal prosecutors say was a nationwide scheme to defraud Medicaid programs and the Veterans Affairs program of more than $61 million.   

TriWest Healthcare Alliance Corporation, a contractor to TRICARE Management Activity, has agreed to pay $10 million to resolve civil false claims allegations, the Justice Department announced today.  TRICARE is the U.S. medical benefit plan which covers uniformed personnel, retirees, their dependents and reserve components. 

The U.S. has partially intervened in a lawsuit under the False Claims Act against Halifax Hospital Medical Center and Halifax Staffing Inc. in the U.S. District Court for the Middle District of Florida.   

The United States has intervened in a lawsuit against Nurses’ Registry and Home Health Corporation in the U.S. District Court for the Eastern District of Kentucky.  The lawsuit was filed in March 2008 by two former Nurses’ Registry employees, Alicia Robinson-Hill and David Price, and alleges among other things that Nurses’ Registry made false claims to Medicare for medically unnecessary home health services.