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Oglethorpe Inc. Agrees to Pay $10.25 Million to Resolve False Claims Act Lawsuit

Florida based Oglethorpe Inc. and it’s three Ohio treatment facilities will pay $10.25 million to settle allegations of illegal patient kickback provisions, unnecessary inpatient admission, and the resulting submission of false claims to Medicare. The suit alleged that Oglethorpe’s treatment centers, which include two inpatient psychiatric hospitals and one substance abuse treatment facility, provided free long-distance transportation to induce patients to seek treatment at the facilities. Claims submitted to Medicare or Medicaid for services provided to these patients violate the Anti-Kickback Statute and therefore constitute false claims. The government also accused Oglethorpe of submitting claims for medically unnecessary inpatient admissions and associated services, which are also false claims.

The civil settlement resolves claims that were brought under the qui tam or whistleblower provision of the False Claims Act. The whistleblower in this case, a former client advocate at one of Oglethorpe’s facilities, will receive a percentage share of the total funds recovered.

Read the DOJ press release here: https://www.justice.gov/opa/pr/ohio-treatment-facilities-and-corporate-parent-agree-pay-1025-million-resolve-false-claims

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With Biden Team Focused On Other Crises, Experts Say Drug Epidemic Is Exploding

“It’s a front-burner issue on any day of the week but not on this day… And that’s a real problem,” says firm Partner Reuben Guttman of the Biden administration’s current handle on the nations uncontrolled drug overdose rates. Read the full article, from NPR and WAMU 88.5, here: https://wamu.org/story/21/01/29/with-biden-team-focused-on-other-crises-experts-say-drug-epidemic-is-exploding/

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Insitu Inc. to Settle False Claims Allegations for $25 million

Washington State company Insitu Inc., an unmanned aerial vehicle contractor, has agreed to pay $25 million to settle allegations that it submitted false cost and pricing data for determination of contract value with the U.S. Special Operations Command and Navy. The lawsuit was built upon evidence that between 2009 and 2017 Insitu entered into multiple federal contracts that were based on pricing data for new parts and materials while the company fully intended to, and in fact did, purchase and use less expensive recycled or refurbished parts. The settlement was the result of a whistleblower complaint filed by a whistleblower and former executive of Insitu. The whistleblower will receive over $4.6 million from the recovery.

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Texas Heart Hospital to Pay $48 million to Resolve Allegations of False Claims

The DOJ has announced that Texas Heart Hospital of the Southwest LLP and its subsidiary THHBP Management Company, LLC have agreed to pay the US $48 million to settle allegations that the hospital submitted claims to Medicare that were in violation of the Physician Self-Referral Law and the Anti-kickback Statute of the False Claims Act. The allegations of misconduct rest on the hospitals requirement that it’s owners, who are physicians, satisfy a yearly quota of 48 patient contacts in order to maintain ownership. Under the Physician Self-Referral Law, commonly known as the Stark Law, hospitals may not bill Medicare for services furnished by a doctor with which the hospital has a financial relationship, barring certain regulatory exceptions. The law is intended to ensure physicians operate in the best interest of their patients and not under the influence of improper financial inducements.

The settlement is the result of a qui tam complaint brought by two former Texas Heart Hospital physician owners. They will collectively receive almost $14 million as their share in the recovery.

Read the DOJ press release here: https://www.justice.gov/opa/pr/texas-heart-hospital-and-wholly-owned-subsidiary-thhbp-management-company-llc-pay-48-million

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