#Scott J. Lampert

[mystlnewsonline]

New York News: Manhattan U.S. Attorney Announces $2 Million Settlement Of Health Care Fraud Claims Against Metropolitan Retina Associates, Inc., And Dr. Kenneth Felder

New York News: Manhattan U.S. Attorney Announces $2 Million Settlement Of Health Care Fraud Claims Against Metropolitan Retina Associates, Inc., And Dr. Kenneth Felder

Metropolitan Retina Associates and Dr. Felder Admit to Billing Medicare and Medicaid for Worthless and Unsubstantiated Imaging Studies of the Eye

New York – Geoffrey S. Berman,the United States Attorney for the Southern District of New York, and Scott J. Lampert, Special Agent in Charge for the New York Office of Inspector General of the U.S. Department of Health and Human Services (“HHS-OIG”),…

[356mission]

List of individuals and groups who have participated in an event at 356 Mission

LeanThe New Dreamz (Rose Luardo and Andrew Jeffrey Wright)

Andre Hyland

Whitmer Thomas

Jessica Ciocci

Michael Webster

Asha Schechter

Gabu Heindl & Drehli Robnik (screening)

Rachel Kushner (with parts read by Barry Johnston, Gale Harold, Karen Adelman, Paul Gellman, Stuart Krimko, Stanya Kahn, Alex Israel, Milena Muzquiz)

Mina Stone

Ken Ehrlich & Emily Joyce

Flora Wiegmann with Alexa Wier

James Lee Byars (screening)

Trisha Brown (screening)

Ei Arakawa (screening)

Jennifer Phiffer

Euan MacDonald and Henri Lucas

Fundación Alumnos47

ForYourArt

Derek Boshier

Alex Kitnick

Cherry Pop

De Porres

Aaron Dilloway

Jason Lescalleet

John Wiese

Final Party (Barry Johnston)

Crazy Band

Aram Moshayedi

Bruce Hainley

Gary Dauphin

Kathryn Garcia

Leland de la Durantaye

Sohrab Mohebbi

Tala Madani

Tiffany Malakooti

Negar Azimi

Barbara T. Smith

LeRoy Stevens

Joe Sola and Michael Webster

Math Bass and Lauren Davis Fisher

Angel Diez Alvarez (screening)

Hedi El Kholti

K8 Hardy

Anna Sew Hoy

L.A. Fog

Trinie Dalton

Rita Gonzalez

Alex Klein

Mark Owens

Tanya Rubbak

AL Steiner

C.R.A.S.H.

Lao

Mexican Jihad

Zak-Matic

Laura Poitras (screening)

Parker Higgins

Domenick Ammirati

John Seal

John Tain

Bruce Hainley

Lisa Lapinski

Kate Stewart

Sarah Lehrer-Graiwer

Ian Svenonius

Entrance Band

Allison Wolfe

Geneva Jacuzzi

Chain & the Gang

Shivas

Hunx

Jimi Hey

69

Tim Lokiec

Scott & Tyson Reeder

Total Freedom

Prince William

Kingdom

SFV Acid

Jesse Fleming

William Leavitt

Lucas Blalock

Oliver Payne

Meredith Monk

Jessica Espeleta

Rollo Jackson (screening)

Jack Smith (screening)

Noura Wedell

Sylvère Lotringer

Jesse Benson

Zoe Crosher

Alex Cecchetti

Patricia Fernandez

Jeff Khonsary

Ben Lord

Shana Lutker

Joseph Mosconi

Suzy Newbury

Scott Oshima

Kim Schoen

Clarissa Tossin

Mark Verabioff

Brica Wilcox

Michael Clark

Ben Brunnemer

Ted Byrnes / Corey Fogel

Kirsty Bell

Johnston Marklee

Emily Sundblad & Matt Sweeney

Kevin Salatino

Wooster Group (screening)

Shannon Ebner

East of Borneo

Sue Tompkins

Alexis Taylor

Leslie Buchbinder (screening)

Odwalla88

Dean Spunt

Bebe Whypz

Saman Moghadam (screening)

J Cush

Hive Dwellers

Bouquet

Dream Boys

Jen Smith

Thee Oh Sees

Jack Name

Alex Waterman and Will Holder

Jonathan Horowitz

Ali Subotnick

Brian Calvin

Dean Wareham

Gracie DeVito

Indah Datau

Jake DeVito

Sara Gomez

Luke Harris

Sarah Johnson

Julia Leonard

Jillian Risigari-Gai

Joseph Tran

George Kuchar (screening)

Andrew Lampert

Reach LA

Oscar Tuazon

Black Dice

Danny Perez

Avey Tare

Shinzen Young

Jesse Fleming and Lewis Pesacov

Mecca Vazie Andrews

Mira Billotte

Julian Ceccaldi

Oldest (Brooks Headley & Mick Barr)

DJ Andy Coronado

François Ceysson

Amanda Ross-Ho

Raphael Rubinstein

Wallace Whitney

Bradford Nordeen

Chris Kraus

Samuel Dunscombe & Curt Miller

Jay Chung

Lev Kalman & Whitney Horn (screening)

Maricón Collective

The Shhh 

Alice Bag 

Martin Sorrondeguy

Sex Stains

Kevin Hegge (screening)

Rhonda Lieberman

Lisa Anne Auerbach

David Benjamin Sherry

Eric Wesley

Tamara Shopsin, Jason Fulford, and Brooks Headley

Deborah Hay

Becky Edmunds (screening)

Kath Bloom

Erin Durant

Ben Vida

Charles Atlas

Laurie Weeks

Kerry Tribe

Renée Green

Fred Moten

The Office of Culture and Design / Hardworking Goodlooking

YUK, MNDSGN, and AHNUU

PATAO

Michael Biel

Mark Von Schlegell

Graham Lambkin

Lex Brown

Jibade-Khalil Huffman

Dan Levenson

Sarah Mattes

Carmen Winant

Gloria Sutton

John Musilli (screening)

Pieter Schoolwerth and Alexandra Lerman (screening)

Nate Young

Safe Crackers

Frances Stark

Liliana Porter (screening)

Adam Linder

Corazon del Sol

Gary Cannone

Ben Caldwell

Jacqueline Frazier

Jan-Christopher Horak

Haile Gerima (screening)

Barbara McCullough (screening)

Jon Pestoni

Andrew Cannon

David Fenster

Dick Pics

Seth Bogart

Lonnie Holley

Rudy Garcia

Dynasty Handbag

Christine Stormberg

Anthony Valdez

Kate Mosher Hall

JJ Stratford

Diana Adzhaketov

DJs Cole MGN and Nite Jewel

Casey Jane Ellison

Gary Indiana + Walter Steding

Kate Durbin

Michael Silverblatt

Hamza Walker

Wynne Greenwood

Robert Morris

Maggie Lee (screening)

Brendan Fowler

Susan Cianciolo

Aaron Rose

John Boskovich (screening)

Michel Auder (screening)

Lauren Campedelli, Leo Marks, and Jan Munroe

Klang Association feat. Anna Homler (Breadwoman), Jorge Martin, Jeff Schwartz

sodapop

Hoseh

Miles Cooper Seaton & Heather McIntosh

Drip City

Geologist

Deaken

Brian Degraw

$3.33

Angela Seo

George Jensen

Carole Kim & Jesse Gilbert & Friends

Aledandra Pelly

dublab

Mariko Munro

Emily Jane Rosen

Lana Rosen

Max Syron

Mark Morrisroe (screening)

Ramsey McPhillips

Stuart Comer

Jordan Wolfson

Kiva Motnyk

Samara Golden

Sam Ashley

John Krausbauer

Kate Valk

Elizabeth LeCompte

Lewis Klahr

Barbara Kasten

Martine Syms

Margo Victor

Studioo Manueel Raaeder

Mary Farley

Wayne Koestenbaum

Jibz Cameron

Sean Daly

Kendra Sullivan

Trinh T. Minh-ha

Johanna Breiding + Jennifer Moon

Tisa Bryant

Cog•nate Collective (Misael G Diaz + Amy Y Sanchez-Arteaga)

Bridget Cooks

Michelle Dizon

Anne Ellegood

Shoghig Halajian

Katherine Hubbard

Simon Leung

Amanda McGough + Tyler Matthew Oyer

Dylan Mira

Litia Perta

Eden’s Herbals

Matt Connors

Flat Worms

Susan

Lucky Dragons

Dos Mega

David Korty

Monica Majoli

Forrest Nash

Sophie von Olfers

Rudolf Eb.er

dave phillips

Joke Lanz

The Dog Star Orchestra

The Edge of Forever (Elizabeth Cline + Lewis Pesacov)

Lutz Bacher (screening)

Agnes Martin (screening)

Marisa Takal

Moyra Davey (screening)

Suzanna Zak

Wu Tsang, boychild and Patrick Belaga

Snake Jé

VIP

Fictitious Business DBA The Geminis

DJ M.Suarez

Asmara

Weirdo Dave

Mission Chinese

Veronica Gonzalez Peña

Thomas Bayrle

Bernhard Schreiner

Bob Nickas

The Cactus Store / Christian Herman Cummings

Atelier E.B

Iman Issa

Diana Nawi

Sqirl

Downtown Women’s Center

Earthjustice

Juvenile Justice Clinic at Loyola Law School

Loyola Immigrant Justice Clinic

N.eed O.rganize W.ork

Planned Parenthood

SoCal 350 Climate Action

St. Athanasius

WriteGirl

Sean/Milan

John Santos

Thomas Davis

Twisted Mindz

Adrienne Adams

Evan Kent 

Jasmine McCloud 

Gia Banks

Ace Farren Ford

Dennis Mehaffey

Fredrik Nilsen

Paul McCarthy

Joe Potts

Rick Potts

Tom Recchion

Vetza

Oliver Hall

Rigo 23

Gil Kenan & Vice Cooler (screening)

Cassie Griffin

Clara Cakes

Clay Tatum + Whitmer Thomas (Power Violence)

DJ AshTreJinkins

DJs Protectme

Crush

Sara Knox Hunter

Dodie Bellamy

Miranda July

Alexander Keefe

Thomas Keenan

Kevin Killian

Silke Otto-Knapp

Calypso Jete, Essence Jete Monroe, Virginia X, Leandra Rose, Naomi Befierce, Tori Perfection, Foxie Adjuis

Brontez Purnell

Kate Wolf

Adam Soch (screening)

Dar A Luz

ADSL Camels

Cold Beat

Tropic Green

No Sesso

Michelle Carrillo

Ruth Root

Timothy Ochoa

[allisonlegal]

Walgreens Settles Whistleblower Suit for $269M

$269M Recovery From Walgreens In Two Civil Healthcare Fraud Settlements Geoffrey S. Berman, the United States Attorney for the Southern District of New York, Gregory E. Demske, Chief Counsel to the Inspector General of the U.S. Department of Health and Human Services (“HHS-OIG”), Scott J. Lampert, Special Agent in Charge of HHS-OIG’s New York Regional…

Walgreens Settles Whistleblower Suit for $269M was originally published on Allison Legal Law Firm

[scamandfraud]

Health Care Fraud: WALGREENS BOOTS ALLIANCE Pay For Two Civil Healthcare Fraud Settlements

Health Care Fraud: WALGREENS BOOTS ALLIANCE Pay For Two Civil Healthcare Fraud Settlements

Manhattan U.S. Attorney Announces $269.2 Million Recovery From Walgreens In Two Civil Healthcare Fraud Settlements

Geoffrey S. Berman, the United States Attorney for the Southern District of New York, Gregory E. Demske, Chief Counsel to the Inspector General of the U.S. Department of Health and Human Services (“HHS-OIG”), Scott J. Lampert, Special Agent in Charge of HHS-OIG’s New York Regional…

[investmart007]

Five Former Salesmen For Morris County Clinical Lab Sentenced For Bribing Doctors In $100 Million Test Referral Scheme

New Post has been published on https://is.gd/u051uh

Five Former Salesmen For Morris County Clinical Lab Sentenced For Bribing Doctors In $100 Million Test Referral Scheme

NEWARK, N.J. – Five individuals were sentenced yesterday for bribing doctors in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Craig Carpenito announced.

Doug Hurley, 38, of Hillsborough, New Jersey, and Kevin Kerekes, 52, of Florham Park, New Jersey, were both sentenced to 24 months in prison. Luke Chicco, 45, of Garden City, New York, was sentenced to 21 months in prison. Kristina Hamdan, 40, of Paterson was sentenced to 41 months in prison. David McCann, 45, of Lyndhurst, New Jersey, was sentenced to three years of probation. U.S. District Judge Stanley R. Chesler imposed all five sentences today in Newark federal court.

Hurley, Kerekes, and Chicco previously pleaded guilty in June 2013 to separate informations charging them with one count of conspiracy to violate the Anti-Kickback Statute and the Federal Travel Act and one count of money laundering.

Hamdan pleaded guilty to Counts One and Thirteen of an indictment charging her with conspiracy to violate the Anti-Kickback Statute, the Federal Travel Act and the honest services wire fraud statute, and conspiracy to commit money laundering.  McCann pleaded guilty to an information charging him with conspiring to violate the Anti-Kickback Statute and the Travel Act.

According to documents filed in this and related cases and statements made in court:

Hurley, Kerekes, and Chicco each admitted that from the fall of 2010 through April 2013, they conspired with BLS president and part owner, David Nicoll and his brother, Scott Nicoll, to pay bribes to doctors in the forms of cash, checks and other means in order to induce them to refer patient blood specimens to BLS. Hurley, Kerekes, and Chicco also admitted that in some instances, they paid bribes to doctors through sham consulting companies, which they created and controlled, in order to hide the fact that BLS was the true source of the bribes.

Hamdan admitted that from November 2009 through April 2013, she paid doctors illegal bribes in exchange for blood specimen referrals to BLS.  For example, Hamdan bribed Yousef Zibdie, an internal medicine doctor with a practice in Woodland Park, in exchange for generating more than $900,000 in lab business for BLS.  The bribes were funded by BLS and, in an effort to obscure that BLS was the true source of the payments paid to the doctors by Hamdan, she made the payments through a sham consulting company that she created and controlled.

McCann paid thousands of dollars in cash on a monthly basis between December 2011 and April 2013 to numerous physicians on behalf of BLS in exchange for the doctors’ referral of blood specimens to BLS.

In addition to the prison term, Judge Chesler sentenced Hurley, Chicco, Kerekes, and Hamdan a year of supervised release. Hurley, Chicco, and Kerekes must also pay forfeiture of $800,000, $850,000, and $1.2 million, respectively. Hamdan must pay forfeiture of $1,209,890.36.

The investigation has thus far resulted in 53 convictions – 38 of them doctors – in connection with the bribery scheme, which its organizers have admitted involved millions of dollars in bribes and resulted in more than $100 million in payments to BLS from Medicare and various private insurance companies.  It is believed to be the largest number of medical professionals ever prosecuted in a bribery case.

The investigation has to date recovered more than $13 million through forfeiture.  On June 28, 2016, BLS, which is no longer operational, pleaded guilty and was required to forfeit all of its assets.

U.S. Attorney Carpenito credited special agents of the FBI, under the direction of Special Agent in Charge Gregory W. Ehrie in Newark; inspectors of the U.S. Postal Inspection Service, under the direction of Acting Inspector in Charge Ruth M. Mendonca; IRS–Criminal Investigation, under the direction of Acting Special Agent in Charge Bryant Jackson in Newark; and the U.S. Department of Health and Human Services, Office of Inspector General, under the direction of Special Agent in Charge Scott J. Lampert, with the ongoing investigation.

The government is represented by Senior Litigation Counsel Joseph N. Minish, Assistant U.S. Attorneys Danielle Alfonzo Walsman, Chief of the U.S. Attorney’s Office Public Protection Unit and Jacob T. Elberg, Chief of the Health Care and Government Fraud Unit, as well as Assistant U.S. Attorney Barbara Ward of the Asset Forfeiture and Money Laundering Unit.

Defense counsel: Luke Chicco: Robert J. Anello Esq., New York Doug Hurley: Michael Baldassare Esq., Newark Kevin Kerekes: Nace Naumoski Esq., Roseland and Alan Bowman Esq., Newark McCann: Benjamin Choi Esq. and Joseph Horn, Esq., Rutherford, New Jersey Kristina Hamdan: Edward J. Bilinkas Esq., Randolph, New Jersey

Source; U.S. Attorney’s Office District of New Jersey

[venitisblr-blog]

PHARMACIES DEFRAUDING MEDICARE AND MEDICAID PROGRAMS

PHARMACIES DEFRAUDING MEDICARE AND MEDICAID PROGRAMS

  Joon H. Kim, the Acting United States Attorney for the Southern District of New York, William F. Sweeney Jr., the Assistant Director-in-Charge of the New York Office of the New York Office of the Federal Bureau of Investigation (“FBI”), Scott J. Lampert, Special Agent in Charge of the New York Regional Office for the Department of Health and Human Services, Office of Inspector General…

[cassandradodds]

Another False Claims Act Lawsuit Filed Against UnitedHealth Group

UnitedHealth Group Named in 2 False Claims Act Lawsuits

United Health Group is facing two False Claims Act lawsuits filed within two weeks of one another. According to a May 16th press release issued by the Department of Justice, the federal government is joining a whistleblower lawsuit alleging that UHG mischarged Medicare Advantage and prescription drug programs, subsequently violating the False Claims Act. The government joined another False Claims Act lawsuit earlier this month which also named UHG as a defendant.

The whistleblower attorneys at Parker Waichman LLP keep up-to-date with lawsuits and settlements regarding alleged False Claims Act violations. The firm continues to offer free legal consultations to individuals with questions about filing a whistleblower lawsuit. Earlier this month, the government intervened in a lawsuit alleging that UHG submitted false claims for payment to Medicare.

According to the DOJ release, the recent lawsuit alleges that UHG committed healthcare fraud by increasing “risk adjustment” payments for Medicare beneficiaries. UHG is the largest Medicare Advantage Organization in the country. It has over 50 Medicare Advantage and Drug Prescription plans. Each month, the Medicare program makes a risk adjustment payment for each enrolled beneficiary. The payments depend on the beneficiary’s health status. UHG allegedly manipulated data regarding their status to increase payments, the government claims.

“As the nation’s largest Medicare Advantage Organization, UHG received substantial overpayments based upon untruthful and inaccurate information about the health status of those enrolled in its plans,” said Acting U.S. Attorney James P. Kennedy Jr. for the Western District of New York, according to the release. “Such fraudulent spending of taxpayer’s dollars will not be tolerated.”

According to the release, the government alleged that “UHG knowingly disregarded information about beneficiaries’ medical conditions, which increased the risk adjustment payments UHG received from Medicare. In particular, the lawsuit contends that, for many years, UHG conducted a national Chart Review Program designed to identify additional diagnoses not reported by treating physicians that would increase UHG’s risk adjustment payments.”

“However, UHG allegedly ignored information from these chart reviews showing that hundreds of thousands of diagnoses provided by treating physicians and submitted by it to Medicare were invalid and did not support the Medicare payments it had previously requested and obtained. By ignoring this information, UHG avoided repaying Medicare monies to which it was not entitled.”

The False Claims Act lawsuit alleges that UHG gave healthcare providers an incentive to give an incorrect diagnosis. Additionally, the government alleges that UHG failed to remedy the situation when identifying the invalid diagnoses.

The government states that “UHG’s own reviews of these providers’ medical records confirmed that the providers were reporting invalid diagnoses. But upon obtaining such evidence, UHG knowingly avoided further efforts to identify invalid diagnoses from these providers and repay Medicare monies to which neither it nor these providers were entitled.”

“To ensure that the program remains viable for all beneficiaries, the Justice Department remains tireless in its pursuit of Medicare fraud perpetrated by healthcare providers and insurers,” said Acting U.S. Attorney Sandra R. Brown for the Central District of California, according to the release. “The primary goal of publicly funded healthcare programs like Medicare is to provide high-quality medical services to those in need – not to line the pockets of participants willing to abuse the system.”

Special Agent in Charge Scott J. Lampert of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), said “With approximately one third of Medicare beneficiaries enrolled in Medicare Advantage plans, careful investigation of charges is more important than ever,” the release states.

“People receiving health care through these programs and taxpayers deserve nothing less.”

The government learned of these allegations through a whistleblower, or qui tam lawsuit. The whistleblower is a former finance director for the UHG that managed Medicare Advantage Plans. As with other whistleblower claims, the suit was filed under the qui tam provision of the False Claims Act.

False Claims Act and Whistleblower Lawsuits

Whistleblowers can play a crucial role in helping the government identify fraud. Under the False Claims Act, private citizens can bring a lawsuit on behalf of the government when they have knowledge of fraud. This includes false claims being submitted through federal programs, such as Medicare or Medicaid.

As the government reviews the whistleblower lawsuit, documents are kept “under seal” to keep the case confidential. Afterwards, the government can choose to join, or “intervene” with the lawsuit.

The whistleblower can continue to pursue litigation privately if the government does not join, although chances of success are usually lower.

The law also offers protections for individuals filing a whistleblower lawsuit, since these actions almost always come with professional risks. For example, it is illegal to demote, fire, harass or otherwise retaliate against employees for their whistleblower activities. Retaliation for whistleblowing activities can lead to litigation.

If a False Claims Act lawsuit leads to financial recovery, then the whistleblower is entitled to a portion of the damages, between 15 and 30 percent of the total recovery.

Parker Waichman notes that whistleblowers have received substantial awards for helping the government identify fraud. One whistleblower is receiving $5.4 million in a $34 million False Claims Act settlement with two Missouri hospitals.

Another whistleblower will receive $430,000 as part of an $18 million settlement with Baxter Healthcare. The lawsuit alleged that it violated the False Claims Act as well as the Federal Food, Drug and Cosmetic Act (FDCA) by repeatedly ignoring reports of moldy air filters at its facility in Marion, North Carolina.

Filing a Whistleblower (Qui Tam) Lawsuit

Whistleblowers play a crucial role in identifying corporate healthcare fraud and other actions that cause false claims to be submitted to federal programs such as Medicare and Medicaid. Whistleblowers are protected from retaliation, and can recover compensation for their efforts. If you or someone you know is interested in filing a whistleblower lawsuit, contact Parker Waichman today. Our experienced attorneys offer free, no-obligation case evaluations. For more information, fill out our online form or call 1-800-YOURLAWYER (1-800-968-7529).

from Parker Waichman http://www.yourlawyer.com/blog/another-false-claims-act-lawsuit-filed-unitedhealth-group/

from WordPress https://parkerwaichman.wordpress.com/2017/06/05/another-false-claims-act-lawsuit-filed-against-unitedhealth-group/

[mystlnewsonline]

New York News: Daycare Owner, Tariq Butt Sentenced For Stealing Government Funds

New York News: Daycare Owner, Tariq Butt Sentenced For Stealing Government Funds

BUFFALO, N.Y. -U.S. Attorney James P. Kennedy, Jr. announced today that Tariq Butt, 42, of Buffalo, NY, who was convicted of theft of government funds, was sentenced to serve 12 months in prison by U.S. District Judge Lawrence J. Vilardo. The defendant was also ordered to pay restitution totaling $305,000 to the Department of Health and Human Services.

Assistant U.S. Attorney Maura K. O’Donnell,…

[parkerwaichmanlaw]

Another False Claims Act Lawsuit Filed Against UnitedHealth Group

UnitedHealth Group Named in 2 False Claims Act Lawsuits

United Health Group is facing two False Claims Act lawsuits filed within two weeks of one another. According to a May 16th press release issued by the Department of Justice, the federal government is joining a whistleblower lawsuit alleging that UHG mischarged Medicare Advantage and prescription drug programs, subsequently violating the False Claims Act. The government joined another False Claims Act lawsuit earlier this month which also named UHG as a defendant.

The whistleblower attorneys at Parker Waichman LLP keep up-to-date with lawsuits and settlements regarding alleged False Claims Act violations. The firm continues to offer free legal consultations to individuals with questions about filing a whistleblower lawsuit. Earlier this month, the government intervened in a lawsuit alleging that UHG submitted false claims for payment to Medicare.

According to the DOJ release, the recent lawsuit alleges that UHG committed healthcare fraud by increasing “risk adjustment” payments for Medicare beneficiaries. UHG is the largest Medicare Advantage Organization in the country. It has over 50 Medicare Advantage and Drug Prescription plans. Each month, the Medicare program makes a risk adjustment payment for each enrolled beneficiary. The payments depend on the beneficiary’s health status. UHG allegedly manipulated data regarding their status to increase payments, the government claims.

“As the nation’s largest Medicare Advantage Organization, UHG received substantial overpayments based upon untruthful and inaccurate information about the health status of those enrolled in its plans,” said Acting U.S. Attorney James P. Kennedy Jr. for the Western District of New York, according to the release. “Such fraudulent spending of taxpayer’s dollars will not be tolerated.”

According to the release, the government alleged that “UHG knowingly disregarded information about beneficiaries’ medical conditions, which increased the risk adjustment payments UHG received from Medicare. In particular, the lawsuit contends that, for many years, UHG conducted a national Chart Review Program designed to identify additional diagnoses not reported by treating physicians that would increase UHG’s risk adjustment payments.”

“However, UHG allegedly ignored information from these chart reviews showing that hundreds of thousands of diagnoses provided by treating physicians and submitted by it to Medicare were invalid and did not support the Medicare payments it had previously requested and obtained. By ignoring this information, UHG avoided repaying Medicare monies to which it was not entitled.”

The False Claims Act lawsuit alleges that UHG gave healthcare providers an incentive to give an incorrect diagnosis. Additionally, the government alleges that UHG failed to remedy the situation when identifying the invalid diagnoses.

The government states that “UHG’s own reviews of these providers’ medical records confirmed that the providers were reporting invalid diagnoses. But upon obtaining such evidence, UHG knowingly avoided further efforts to identify invalid diagnoses from these providers and repay Medicare monies to which neither it nor these providers were entitled.”

“To ensure that the program remains viable for all beneficiaries, the Justice Department remains tireless in its pursuit of Medicare fraud perpetrated by healthcare providers and insurers,” said Acting U.S. Attorney Sandra R. Brown for the Central District of California, according to the release. “The primary goal of publicly funded healthcare programs like Medicare is to provide high-quality medical services to those in need – not to line the pockets of participants willing to abuse the system.”

Special Agent in Charge Scott J. Lampert of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), said “With approximately one third of Medicare beneficiaries enrolled in Medicare Advantage plans, careful investigation of charges is more important than ever,” the release states.

“People receiving health care through these programs and taxpayers deserve nothing less.”

The government learned of these allegations through a whistleblower, or qui tam lawsuit. The whistleblower is a former finance director for the UHG that managed Medicare Advantage Plans. As with other whistleblower claims, the suit was filed under the qui tam provision of the False Claims Act.

False Claims Act and Whistleblower Lawsuits

Whistleblowers can play a crucial role in helping the government identify fraud. Under the False Claims Act, private citizens can bring a lawsuit on behalf of the government when they have knowledge of fraud. This includes false claims being submitted through federal programs, such as Medicare or Medicaid.

As the government reviews the whistleblower lawsuit, documents are kept “under seal” to keep the case confidential. Afterwards, the government can choose to join, or “intervene” with the lawsuit.

The whistleblower can continue to pursue litigation privately if the government does not join, although chances of success are usually lower.

The law also offers protections for individuals filing a whistleblower lawsuit, since these actions almost always come with professional risks. For example, it is illegal to demote, fire, harass or otherwise retaliate against employees for their whistleblower activities. Retaliation for whistleblowing activities can lead to litigation.

If a False Claims Act lawsuit leads to financial recovery, then the whistleblower is entitled to a portion of the damages, between 15 and 30 percent of the total recovery.

Parker Waichman notes that whistleblowers have received substantial awards for helping the government identify fraud. One whistleblower is receiving $5.4 million in a $34 million False Claims Act settlement with two Missouri hospitals.

Another whistleblower will receive $430,000 as part of an $18 million settlement with Baxter Healthcare. The lawsuit alleged that it violated the False Claims Act as well as the Federal Food, Drug and Cosmetic Act (FDCA) by repeatedly ignoring reports of moldy air filters at its facility in Marion, North Carolina.

Filing a Whistleblower (Qui Tam) Lawsuit

Whistleblowers play a crucial role in identifying corporate healthcare fraud and other actions that cause false claims to be submitted to federal programs such as Medicare and Medicaid. Whistleblowers are protected from retaliation, and can recover compensation for their efforts. If you or someone you know is interested in filing a whistleblower lawsuit, contact Parker Waichman today. Our experienced attorneys offer free, no-obligation case evaluations. For more information, fill out our online form or call 1-800-YOURLAWYER (1-800-968-7529).

from Parker Waichman http://www.yourlawyer.com/blog/another-false-claims-act-lawsuit-filed-unitedhealth-group/

[omcik-blog]

New Post has been published on OmCik

New Post has been published on http://omcik.com/hedge-fund-managers-dont-always-beat-the-market-but-they-still-make-billions/

Hedge fund managers don’t always beat the market, but they still make billions

Good performance, mediocre results or even downright ugly returns. When it comes to hedge funds, it scarcely matters. Even as some investors begin to sour on these high-priced stock pickers, the top fund managers still haul in enormous paychecks.

The 25 best-paid hedge fund managers earned a collective $11 billion in 2016, according to an annual ranking published on Tuesday by .

Even managers who had a tough year were able to cash in. Nearly half of the top-25 earners made single-digit returns for their investors, a lackluster sum in a year when the Standard & Poor’s 500-stock index was up 12 percent, accounting for reinvested dividends.

More from New York Times:

The top earner of 2016 was James Simons, the former code breaker for the National Security Agency and the founder of Renaissance Technologies, who made $1.6 billion. Ray Dalio, the founder of Bridgewater Associates who is best known for his philosophy of “,” came in a close second with $1.4 billion. Further down the list was Robert Mercer, the co-chief executive of Renaissance and one of the biggest backers of Donald J. Trump’s presidential campaign, who earned $125 million.

But some of the best-known names in the industry — including William A. Ackman, John A. Paulson and Edward S. Lampert — failed to make the list. Also missing from the list: women.

The list is based on estimates drawn from each individual’s share of their firm’s management and performance fees. It also takes into consideration each manager’s own capital invested in the funds.

These outsize paydays come at a turning point for the industry. For eight consecutive years, hedge funds have disappointed, underperforming a roaring stock market. In addition, some managers have lost billions of dollars through wrong-footed bets, marking what one hedge fund billionaire, Daniel S. Loeb, called a “catastrophic period” for the industry.

Some frustrated investors headed for the exits in 2016, taking with them $70 billion from the $3 trillion industry. As a result, managers shut their doors and wound down their funds at the fastest rate since the financial crisis in 2008.

Things became so tough last year that big money managers found themselves sitting at the negotiating table with their investors, offering lower fees and better terms for sharing in the returns.

“It’s a moment in time where you’re going to see a cleansing of the hedge fund industry,” said Adam I. Taback, head of global alternative investments at Wells Fargo Investment Institute.

“The industry had a lot of money and a lot of growth all chasing the same investments,” Mr. Taback said, adding that a culling was much needed for the industry to return to its roots.

Despite hedge fund managers’ struggles to beat the market, their compensation has soared over the past decade. The $11 billion payday for the top-25 managers in 2016 is down from $13 billion the previous year, but still more than double what the top earners made in 2000, the first year that Institutional Investor compiled its list. It also dwarfs the sums earned by executives of public companies.

Even the lowest-ranking manager on Alpha magazine’s expanded top-50 list made more money in 2016 than any big United States bank executive, including Jamie Dimon of J. P. Morgan, Lloyd Blankfein of Goldman Sachs and James Gorman of Morgan Stanley, all of who have been criticized for their big paychecks.

The key to these large paydays is the fee system known as 2-and-20. Hedge funds typically charge investors 2 percent of their investment annually, regardless of performance. So even in a disappointing year, managers still are paid a handsome sum. In the event they make a profit, the funds take 20 percent of that as well.

Not all hedge funds underperformed in 2016. At the $42 billion Renaissance, where a team of cryptographers, physicists and astronomers parse large volumes of data, the firm’s two public funds, Renaissance Institutional Equities Fund and Renaissance Institutional Diversified Alpha Fund, gained 21.5 percent and 11 percent, respectively.

At Bridgewater, Mr. Dalio’s $165 billion firm, the flagship fund, Pure Alpha, gained just 2.4 percent. But its newest fund, Optimal, gained 7 percent, and its All Weather fund, which charges lower fees, gained 11.6 percent.

The original allure of a hedge fund was the promise of smoother returns during market upheavals along with risk-adjusted returns that would stand out. In recent years, investors have complained that some firms failed to uphold this pledge.

“When a manager collects a fee without adding value, it’s just not right,” said Scott M. Stringer, the New York City comptroller. Some of the New York City pension funds have pared back their investments in hedge funds, and the comptroller’s office has requested lower fees and better terms from those it continues to hold.

Mr. Paulson, who is best known for reaping a windfall by betting on a collapse of the housing market in 2008, has made $15.45 billion over the 16 years that Institutional Investor has been compiling its list. But he was bumped off the list after in 2016, a year that he called “the most challenging” since he founded Paulson & Company in 1994.

Mr. Lampert of ESL Investments was once heralded as a hedge fund wunderkind and has made $7.16 billion over the years. But these days his investment in the beleaguered Sears Holdings , and he is not on this year’s list.

And Mr. Ackman of Pershing Square Capital Management has had percentage losses in the double digits for two years in a row. Earlier this year, that a wager on Valeant Pharmaceuticals International — the biggest in his firm’s history — was a “huge mistake,” and he sold the position, resulting in a remarkable $4 billion loss. Mr. Ackman is not on the list this year but came in fourth in 2014 with $950 million.

Others made the list despite posting subpar returns. Kenneth C. Griffin, the billionaire founder of Citadel and a major Republican donor, took home $600 million despite what he called “a challenging year” in which he made investors in his main flagship funds just over 5 percent. Mr. Loeb of Third Point earned $260 million, after making investors in his offshore fund just over 6 percent.

Two of the most recent high-profile hedge fund closures underscore the pressures managers face, including market swings from surprise events such as Britain’s exit from the European Union and the election of President Trump.

Richard C. Perry, once among the most successful and earliest hedge fund investors, last year after steep losses, citing strong “market headwinds” that made “the timing for success in our positions too unpredictable.” He has made Institutional Investor’s top-50 earners list five times.

Earlier this year, Eric Mindich, the founder of Eton Park Capital Management, his firm because of “a combination of industry headwinds, a difficult market environment and, importantly, our own disappointing 2016 results.” Mr. Mindich made the list in 2007.

While some managers may have taken a pay cut to appease investors, they still earn more each year than the average American could ever dream of earning in a lifetime. During the presidential campaign, Mr. Trump accused hedge funds of “getting away with murder” and pledged that they would be “paying up” if he became president, by closing a loophole that allowed them to pay lower taxes.

But the Trump administration’s , released at the end of April, appears to be a boon for the industry. In its current form, Mr. Trump’s plan eliminates the special treatment called carried interest for hedge funds, but he replaces it with a new and lower rate.

[allisonlegal]

CEO of PT Center Settles Improper Medicare Billing

Geoffrey S. Berman, the United States Attorney for the Southern District of New York, and Scott J. Lampert, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General’s New York Region (“HHS-OIG”), announced today that the United States filed and settled a civil fraud lawsuit against FUSION PHYSICAL…

CEO of PT Center Settles Improper Medicare Billing was originally published on Allison Legal Law Firm

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DOCTORS IN ILLEGAL DISTRIBUTION OF PILLS

DOCTORS IN ILLEGAL DISTRIBUTION OF PILLS

Joon H. Kim, the Acting United States Attorney for the Southern District of New York, James J. Hunt, Special Agent in Charge of the U.S. Drug Enforcement Administration’s New York Division (“DEA”), James P. O’Neill, the Commissioner of the New York City Police Department (“NYPD”), and Scott J. Lampert, Special Agent in Charge of the New York Office of the U.S. Department of Health and Human…

[cassandradodds]

UnitedHealth Group Hit with 2 False Claims Act Lawsuits in 2 Weeks

Feds Allege UnitedHealth Group Committed Medicare Fraud

The federal government is joining a whistleblower lawsuit alleging that UnitedHealth Group violated the False Claims Act by mischarging Medicare Advantage and prescription drug programs. According to a press release issued by the Department of Justice, it is the second such lawsuit the government has intervened in this month against UHG.

The whistleblower attorneys at Parker Waichman LLP keep up-to-date with lawsuits and settlements regarding alleged False Claims Act violations. The firm continues to offer free legal consultations to individuals with questions about filing a whistleblower lawsuit.

The previous complaint, filed earlier this month, alleged that UHG submitted false claims for payment to Medicare. The recent complaint alleges that

The release, dated May 16th, states that UHG committed healthcare fraud by increasing “risk adjustment” payments for Medicare beneficiaries. DOJ notes that UHG has over 50 Medicare Advantage and Drug Prescription plans; it is the largest Medicare Advantage Organization in the country. The Medicare program pays a risk adjustment payment every month for each enrolled beneficiary. The beneficiary’s health status influences these risk adjustment payments.

According to the release, the government alleged that “UHG knowingly disregarded information about beneficiaries’ medical conditions, which increased the risk adjustment payments UHG received from Medicare. In particular, the lawsuit contends that, for many years, UHG conducted a national Chart Review Program designed to identify additional diagnoses not reported by treating physicians that would increase UHG’s risk adjustment payments.”

“However, UHG allegedly ignored information from these chart reviews showing that hundreds of thousands of diagnoses provided by treating physicians and submitted by it to Medicare were invalid and did not support the Medicare payments it had previously requested and obtained. By ignoring this information, UHG avoided repaying Medicare monies to which it was not entitled.”

Additionally, the government alleged that UHG engaged in improper financial relationships with healthcare providers, giving them incentive to provide an invalid diagnosis. The complaint alleges that UHG discovered the invalid diagnoses, but failed to address the issue properly. The government points out that “UHG’s own reviews of these providers’ medical records confirmed that the providers were reporting invalid diagnoses. But upon obtaining such evidence, UHG knowingly avoided further efforts to identify invalid diagnoses from these providers and repay Medicare monies to which neither it nor these providers were entitled.”

“As the nation’s largest Medicare Advantage Organization, UHG received substantial overpayments based upon untruthful and inaccurate information about the health status of those enrolled in its plans,” said Acting U.S. Attorney James P. Kennedy Jr. for the Western District of New York, according to the release. “Such fraudulent spending of taxpayer’s dollars will not be tolerated.”

These allegations were brought to light through a whistleblower, or qui tam claim. The whistleblower is a former finance director for the UHG that managed Medicare Advantage Plans. The suit was filed under the qui tam provision of the False Claims Act. Whistleblowers can play a crucial role in helping the government identify fraud.

“To ensure that the program remains viable for all beneficiaries, the Justice Department remains tireless in its pursuit of Medicare fraud perpetrated by healthcare providers and insurers,” said Acting U.S. Attorney Sandra R. Brown for the Central District of California, according to the release. “The primary goal of publicly funded healthcare programs like Medicare is to provide high-quality medical services to those in need – not to line the pockets of participants willing to abuse the system.”

Special Agent in Charge Scott J. Lampert of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), said “With approximately one third of Medicare beneficiaries enrolled in Medicare Advantage plans, careful investigation of charges is more important than ever,” the release states.

“People receiving health care through these programs and taxpayers deserve nothing less.”

False Claims Act Background

Whistleblower claims are filed under the qui tam provision of the False Claims Act; these complaints are filed when private individuals have knowledge of fraud against the government. This includes false claims being submitted through federal programs, such as Medicare or Medicaid.

The whistleblower gathers information and files their qui tam lawsuit, which the government will review. The suit is kept “under seal” during this time to keep the allegations confidential. The government may choose to join, or “intervene” with the lawsuit, as it did with the two recent suits against UHG. If the government does not intervene, the individual can still pursue the claim on their own, although their chances of success are usually lower.

The law also offers protections for individuals filing a whistleblower lawsuit, since these actions almost always come with professional risk. For example, it is illegal to demote, fire, harass or otherwise retaliate against employees for their whistleblower activities. If a False Claims Act lawsuit leads to financial recovery, then the whistleblower is entitled to a portion of the damages, between 15 and 30 percent of the total recovery.

Parker Waichman notes that whistleblowers have received substantial awards for their efforts in identifying fraud. Recently, the government reached a $34 million settlement with two Missouri hospitals over alleged False Claims Act Violations. The whistleblower in that case is receiving $5.4 million. Earlier this year, Baxter Healthcare agreed to pay $18 million to settle allegations that it violated the False Claims Act as well as the Federal Food, Drug and Cosmetic Act (FDCA) by repeatedly ignoring reports of moldy air filters at its facility in Marion, North Carolina. The whistleblower, an employee at the Baxter facility, was awarded $430,000.

Filing a Whistleblower (Qui Tam) Lawsuit

Whistleblowers play a crucial role in identifying corporate healthcare fraud and other actions that cause false claims to be submitted to federal programs such as Medicare and Medicaid. Whistleblowers are protected from retaliation, and can recover compensation for their efforts. If you or someone you know is interested in filing a whistleblower lawsuit, contact Parker Waichman today. Our experienced attorneys offer free, no-obligation case evaluations. For more information, fill out our online form or call 1-800-YOURLAWYER (1-800-968-7529).

from Parker Waichman http://www.yourlawyer.com/blog/unitedhealth-group-hit-2-false-claims-act-lawsuits-2-weeks/

from WordPress https://parkerwaichman.wordpress.com/2017/05/25/unitedhealth-group-hit-with-2-false-claims-act-lawsuits-in-2-weeks/

[parkerwaichmanlaw]

UnitedHealth Group Hit with 2 False Claims Act Lawsuits in 2 Weeks

Feds Allege UnitedHealth Group Committed Medicare Fraud

The federal government is joining a whistleblower lawsuit alleging that UnitedHealth Group violated the False Claims Act by mischarging Medicare Advantage and prescription drug programs. According to a press release issued by the Department of Justice, it is the second such lawsuit the government has intervened in this month against UHG.

The whistleblower attorneys at Parker Waichman LLP keep up-to-date with lawsuits and settlements regarding alleged False Claims Act violations. The firm continues to offer free legal consultations to individuals with questions about filing a whistleblower lawsuit.

The previous complaint, filed earlier this month, alleged that UHG submitted false claims for payment to Medicare. The recent complaint alleges that

The release, dated May 16th, states that UHG committed healthcare fraud by increasing “risk adjustment” payments for Medicare beneficiaries. DOJ notes that UHG has over 50 Medicare Advantage and Drug Prescription plans; it is the largest Medicare Advantage Organization in the country. The Medicare program pays a risk adjustment payment every month for each enrolled beneficiary. The beneficiary’s health status influences these risk adjustment payments.

According to the release, the government alleged that “UHG knowingly disregarded information about beneficiaries’ medical conditions, which increased the risk adjustment payments UHG received from Medicare. In particular, the lawsuit contends that, for many years, UHG conducted a national Chart Review Program designed to identify additional diagnoses not reported by treating physicians that would increase UHG’s risk adjustment payments.”

“However, UHG allegedly ignored information from these chart reviews showing that hundreds of thousands of diagnoses provided by treating physicians and submitted by it to Medicare were invalid and did not support the Medicare payments it had previously requested and obtained. By ignoring this information, UHG avoided repaying Medicare monies to which it was not entitled.”

Additionally, the government alleged that UHG engaged in improper financial relationships with healthcare providers, giving them incentive to provide an invalid diagnosis. The complaint alleges that UHG discovered the invalid diagnoses, but failed to address the issue properly. The government points out that “UHG’s own reviews of these providers’ medical records confirmed that the providers were reporting invalid diagnoses. But upon obtaining such evidence, UHG knowingly avoided further efforts to identify invalid diagnoses from these providers and repay Medicare monies to which neither it nor these providers were entitled.”

“As the nation’s largest Medicare Advantage Organization, UHG received substantial overpayments based upon untruthful and inaccurate information about the health status of those enrolled in its plans,” said Acting U.S. Attorney James P. Kennedy Jr. for the Western District of New York, according to the release. “Such fraudulent spending of taxpayer’s dollars will not be tolerated.”

These allegations were brought to light through a whistleblower, or qui tam claim. The whistleblower is a former finance director for the UHG that managed Medicare Advantage Plans. The suit was filed under the qui tam provision of the False Claims Act. Whistleblowers can play a crucial role in helping the government identify fraud.

“To ensure that the program remains viable for all beneficiaries, the Justice Department remains tireless in its pursuit of Medicare fraud perpetrated by healthcare providers and insurers,” said Acting U.S. Attorney Sandra R. Brown for the Central District of California, according to the release. “The primary goal of publicly funded healthcare programs like Medicare is to provide high-quality medical services to those in need – not to line the pockets of participants willing to abuse the system.”

Special Agent in Charge Scott J. Lampert of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), said “With approximately one third of Medicare beneficiaries enrolled in Medicare Advantage plans, careful investigation of charges is more important than ever,” the release states.

“People receiving health care through these programs and taxpayers deserve nothing less.”

False Claims Act Background

Whistleblower claims are filed under the qui tam provision of the False Claims Act; these complaints are filed when private individuals have knowledge of fraud against the government. This includes false claims being submitted through federal programs, such as Medicare or Medicaid.

The whistleblower gathers information and files their qui tam lawsuit, which the government will review. The suit is kept “under seal” during this time to keep the allegations confidential. The government may choose to join, or “intervene” with the lawsuit, as it did with the two recent suits against UHG. If the government does not intervene, the individual can still pursue the claim on their own, although their chances of success are usually lower.

The law also offers protections for individuals filing a whistleblower lawsuit, since these actions almost always come with professional risk. For example, it is illegal to demote, fire, harass or otherwise retaliate against employees for their whistleblower activities. If a False Claims Act lawsuit leads to financial recovery, then the whistleblower is entitled to a portion of the damages, between 15 and 30 percent of the total recovery.

Parker Waichman notes that whistleblowers have received substantial awards for their efforts in identifying fraud. Recently, the government reached a $34 million settlement with two Missouri hospitals over alleged False Claims Act Violations. The whistleblower in that case is receiving $5.4 million. Earlier this year, Baxter Healthcare agreed to pay $18 million to settle allegations that it violated the False Claims Act as well as the Federal Food, Drug and Cosmetic Act (FDCA) by repeatedly ignoring reports of moldy air filters at its facility in Marion, North Carolina. The whistleblower, an employee at the Baxter facility, was awarded $430,000.

Filing a Whistleblower (Qui Tam) Lawsuit

Whistleblowers play a crucial role in identifying corporate healthcare fraud and other actions that cause false claims to be submitted to federal programs such as Medicare and Medicaid. Whistleblowers are protected from retaliation, and can recover compensation for their efforts. If you or someone you know is interested in filing a whistleblower lawsuit, contact Parker Waichman today. Our experienced attorneys offer free, no-obligation case evaluations. For more information, fill out our online form or call 1-800-YOURLAWYER (1-800-968-7529).

from Parker Waichman http://www.yourlawyer.com/blog/unitedhealth-group-hit-2-false-claims-act-lawsuits-2-weeks/

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HEALTH CARE FRAUD AND IDENTITY THEFT

HEALTH CARE FRAUD AND IDENTITY THEFT

Preet Bharara, the United States Attorney for the Southern District of New York, William F. Sweeney Jr., the Assistant Director-in-Charge of the New York Field Office of the Federal Bureau of Investigation (“FBI”), Scott J. Lampert, Special Agent-in-Charge of the New York Regional Office of the United States Department of Health and Human Services Office of the Inspector General (“HHS-OIG”), and…

[allisonlegal]

Walgreens Settles Kickback Lawsuit for $50M

$50 Million Settlement With Walgreens For Paying Kickbacks To Induce Beneficiaries Of Government Healthcare Programs To Fill Their Prescriptions At Walgreens’ Pharmacies Preet Bharara, the United States Attorney for the Southern District of New York, Scott J. Lampert, Special Agent in Charge of the New York Office of the U.S. Department of Health and Human…

Walgreens Settles Kickback Lawsuit for $50M was originally published on Allison Legal Law Firm