News & Cases


$11M Whistleblower Award on TeamHealth $60M Overbilling Medicare & Medicaid at IPC Healthcare

$11M Whistleblower Award on TeamHealth $60M Overbilling Medicare & Medicaid at IPC Healthcare

Tennessee-based TeamHealth Holdings has agreed to pay $60 million plus interest to resolve allegations that IPC Healthcare, a company it recently acquired, is guilty of overbilling Medicare, Medicaid, the Defense Health Agency, and the Federal Employees Health Benefits Program.  

North Hollywood, CA-based IPC Healthcare Inc. provides hospitals with physicians and other professionals. Its employees work in more than 1,300 facilities across 28 states. Allegedly, the TeamHealth-controlled company had a practice of “upcoding” when billing government programs. Upcoding refers to billing for more expensive medical services by changing service codes in relevant documentation.

Whistleblower Dr. Bijan Oughatiyan Exposes Alleged Upcoding Scam

The False Claims Act lawsuit against IPC Healthcare was filed by Dr. Bijan Oughatiyan, MD, who worked as a hospitalist (a physician who focuses on hospital services) at IPC between 2003 and 2008. The suit was filed shortly after he left the company, in 2009. The 49-year-old doctor alleges that IPC "trained" and "encouraged" hospitalists in the practice of overbilling....


Advanced C4 Solutions Pays $4.535M in SPAWAR Defense Contractor Fraud Settlement

Advanced C4 Solutions Pays $4.535M in SPAWAR Defense Contractor Fraud Settlement

Florida-based Advanced C4 Solutions, Inc. agreed pay $4.535 million to resolve claims that it violated the federal False Claims Act by knowingly overbilling the government for work performed under an Air Force technology contract at Maryland’s Joint Base Andrews.

Defendants Andrew Bennett and James Shank pleaded guilty to conspiracy to commit wire fraud, according to Department of Justice information.

Feds Say Contractors Charge U.S. For Nonexistent Labor Hours, Ineligible Job Rates

The settlement agreement stems from alleged activities beginning in June 2010, when the U.S. Navy’s Space and Warfare Systems Command (SPAWAR) granted Advanced C4 Solutions a contract titled “DO 27” to perform labor and project management services for an Air Force technology project....


Top 10 FCPA Enforcement Actions in 2016: Record Year Fuels FCPA Whistleblower Opportunity

Top 10 FCPA Enforcement Actions in 2016: Record Year Fuels FCPA Whistleblower Opportunity

Last year set new records for Foreign Corrupt Practices Act (FCPA) enforcement, with 27 companies paying over $2.48 billion in FCPA settlements. In 2016, the Department of Justice (DOJ) reached four of the largest FCPA settlements in history: Teva Pharmaceuticals Industries ($519 million), Odebrecht and Braskem ($419.8 million), Och-Ziff Capital Management Group ($412 million) and VimpelCom Limited ($397.6 million).
These precedent-setting resolutions speak volumes regarding the...

United Shore Shoddy Underwriting, QC Practices Cost $48M in FHA Lending Violations Case

United Shore Shoddy Underwriting, QC Practices Cost $48M in FHA Lending Violations Case

Troy, Michigan-based United Shore Financial Services LLC (USFS) has agreed to pay the U.S. $48 million to resolve allegations it violated the False Claims Act by underwriting Federal Housing Administration (FHA)-insured mortgage loans that did not meet FHA requirements.

As part of the settlement agreement, United Shore admitted to pressuring underwriters to approve FHA mortgages, using a compensation plan formula tying underwriter compensation to percentage of loans approved and closed, and falsely certifying that direct endorsement underwriters reviewed appraisal reports before USFS approval and FHA-insured mortgage endorsement, the Justice Department announced Wednesday.

U.S. Investigation Finds USFS Approved Hundreds of Ineligible FHA-Insured Loans

Allegations stem from a January 10, 2014-initiated joint investigation into United Shore Financial Services’ underwriting and quality control practices by the U.S. Department of Housing and Urban Development (HUD), HUD’s Office of Inspector General, the Civil Division’s Commercial Litigation Branch and the Western District of Wisconsin and Eastern District of Michigan U.S. Attorneys’ Offices....


California Bay Sleep Clinic Technician Gets $545K Whistleblower Award In $2.6M FCA Settlement

California Bay Sleep Clinic Technician Gets $545K Whistleblower Award In $2.6M FCA Settlement

Whistleblower Elma F. Dresser will receive a $545,000 whistleblower award for aiding the United States in reaching a $2.6 million settlement with northern California’s Bay Sleep Clinic, affiliates Qualium Corporation and Amerimed Corporation, and owners and operators, Anooshiravan Mostowfipour and Tara Nader, the Department of Justice announced Wednesday.

The $2.6 million settlement resolves allegations that Bay Sleep Clinic and other defendants violated the False Claims Act by submitting false claims to the Medicare program for diagnostics and medical devices.

Whistleblower Dresser Alleges Non-Licensed Sleep Clinic Staff, Non-Approved Testing Locations, Illegal Kickbacks

Former eight-year Bay Sleep Clinic marketer and sleep technician, Elma F. Dresser, filed the initial whistleblower lawsuit in April 2012, after obtaining inside information of the defendants’ improper Medicare billings....


2016: A Stellar Year for Whistleblowers, $4.7 Billion in False Claims Act Recoveries

2016: A Stellar Year for Whistleblowers, $4.7 Billion in False Claims Act Recoveries

America’s courageous whistleblowers filed over 700 qui tam suits in fiscal year 2016 and received $519 million in awards for their valuable tips and assistance in fighting various types of fraud.

Since the 2009 Fraud Enforcement and Recovery Act made groundbreaking improvements to the False Claims Act’s whistleblower provisions, the government has recovered close to $24 billion, paying a sizable $4 billion in whistleblower awards.

As legislation tries to catch up with the rampant reports of fraud across a variety of industries, the federal False Claims Act remains the star when it comes to facilitating the exposure of government-defrauding schemes across America....


JPMorgan: $264 Million Settles FCPA Bribery Charges on 200 China Friends & Family Hires

JPMorgan: $264 Million Settles FCPA Bribery Charges on 200 China Friends & Family Hires

A U.S. government investigation into a JPMorgan hiring program in Asia concluded with a multi-$264 million settlement. The SEC found substantial evidence that J.P. Morgan offered prestigious jobs to the children of Chinese government officials in exchange for the officials' influence to secure lucrative investment-banking assignments - a violation of the Foreign Corrupt Practices Act (FCPA).

In 2006, JPMorgan APAC created a referral program known internally as the “Sons & Daughters Program.” According to the SEC order, the initial goal of the program was to accommodate frequent requests “to hire the relatives and friends of senior executives or officials with its clients, prospective clients, and contacts within foreign government ministries” by offering targeted entry-level and short-term employment opportunities.

Compliance Officer Chris Charnock’s Concerns Dismissed by JPMorgan Management

While the program may have been created in good faith in the beginning, by 2011, JPMorgan employees in Asia were already trying to raise concerns with compliance executives in New York that the bank might be charged with bribery....


Whistleblower Didn’t Live to See Landmark Allied Mortgage Verdict, Taxpayers Recover $92 Million

Whistleblower Didn’t Live to See Landmark Allied Mortgage Verdict, Taxpayers Recover $92 Million

In May, 2011, Peter Belli filed a complaint in Boston. With guidance from whistleblower experts at Mahany Law, he accused Allied Home Mortgage Capital Corporation of massive mortgage fraud in a False Claims Act “qui tam” whistleblower lawsuit.

Over five years later, and after a trial that lasted five weeks, a jury found both the corporation and its CEO, Jim Hodge, guilty of knowingly representing to Housing and Urban Development (HUD) that certain loans were properly prepared and eligible for Federal Housing Administration (FHA) insurance, when in fact they were not.

Belli had managed several Allied branches in Massachusetts, Rhode Island, Arizona, and other states. He was thus in an ideal position to observe Allied Capital’s fraudulent practices, and he was determined to bring the scheme to light. Unfortunately, he passed away before the verdict came out only days ago in Texas. The move to a Texas court had been a choice of the defendants....


Breaking: $100 Million Verdict in Allied Capital False Claims Case

Breaking: $100 Million Verdict in Allied Capital False Claims Case

A Southern District of Texas federal court jury returned today a nearly $100 million verdict against Allied Capital and bank principal Jim Hodge for violating the U.S. False Claims Act and under FIRREA statutes.

The case has special significance as it is one of only 2 False Claims Act cases against a lender related to the mortgage meltdown that went to trial and verdict. The other was the well-chronicled HUSL - Bank of America case. All others were settled in some of the largest settlement amounts in U.S. history.

The False Claims aspects of the case relate to Allied’s “shadow branches”. HUD requires banks, mortgage companies, lenders…to have licensed offices, in effect something at risk themselves in the form of salaries, offices rents and other overhead as a government approved loan originator and therefore a motivator for good business practices....


Hudson Valley Oncology Medicare Fraud Exposed by Whistleblower Medical Coder: $5.31MM Settlement

Hudson Valley Oncology Medicare Fraud Exposed by Whistleblower Medical Coder: $5.31MM Settlement

Hudson Valley Hematology Oncology Associates will pay the government $5.31 million to resolve allegations in a whistleblower lawsuit that it systematically billed Medicare and Medicaid for ineligible and non-existent services.

Between 2010 and 2015, Hudson Valley was allegedly involved in two different fraudulent schemes. On the one hand, it waived Medicare beneficiaries’ copayments and billed Medicare instead. On the other hand, it routinely billed both Medicare and Medicaid for services that were either not performed or not medically necessary. 

Whistleblower Lucille Abrahamsen: Medical Coder Hudson Valley Employee

Hudson Valley’s wrongdoing was first brought to light by Lucille Abrahamsen, a resident of  Highland, New York,  who filed a lawsuit under the False Claims Act in April, 2014. Abrahamsen became aware of her employer’s improper billing practices while working for them as a medical coder....