Northwell Health, $12 million

Elizabeth Shofner, Justin Brooks Articles, Nancy Gertner Articles, Reuben Guttman Articles, Successes, Traci Buschner Articles

United States of America ex rel. George Markelson, et. al. v. David B. Samadi, M.D. and Northwell Health, Inc. et al.,
Southern District of Florida.

GBB attorneys represented one of three whistleblowers in a False Claims Act suit against NY health network Northwell Health, Inc. and it’s subsidiary Lenox Hill Hospital. Whistleblowers alleged that Northwell and hospital Urologist David B. Samadi billed Federal Medicare programs in violation of multiple laws or regulations. Among the accusations were that Samadi and Northwell billed for medically unnecessary procedures, billed for overlapping surgeries, and over-compensated Samadi as an illegal reward for hospital referrals. Whistleblowers also claimed that Samadi left endoscopic procedures to be completed or attended by unsupervised medical students so that he could complete or supervise another patient’s procedure. Defendant’s behavior led to the submission of false claims to Medicare and ultimately millions of dollars in fraudulent government payments.

Humana Inc., $7 million

Dr. Caroline Poplin Articles, Elizabeth Shofner, Justin Brooks Articles, Reuben Guttman Articles, Successes, Traci Buschner Articles

U.S., ex rel. Graves v. Plaza Med. Centers Corp., Humana Inc., and Michael Cavanaugh,
Southern District of Florida.

Our attorneys contributed to a qui tam action alleging that defendant Michael Cavanaugh, a doctor at Plaza Medical Centers Corporation (PMC), over-diagnosed patients with illness or complications then fraudulently billed Medicare for services. Cavanaugh’s false Medicare claims led Medicare to increase monthly payments to Humana, Inc., a plan administrator, which would then distribute the funds to Cavanaugh and other defendants.

Bank of America, $95 million

Elizabeth Shofner, Reuben Guttman Articles, Successes, Traci Buschner Articles

U.S. ex rel. Szymoniak v. Bank of America, et al.,
District of South Carolina / Western District of North Carolina.

Firm attorneys played a role in a False Claims Act recovery from mortgage servicer Bank of America on behalf of the government. Bank of America and several other major banks paid a total of $95 million to resolve allegations that they had regularly submitted fraudulent mortgage assignments when filing for Federal Housing Administration mortgage insurance. Our lawyers and the whistleblower collaborated with almost half a dozen U.S. Attorney’s Offices to reach the windfall recovery for the government.

Pfizer (Rapamune), $257.4 million

Dr. Caroline Poplin Articles, Elizabeth Shofner, Reuben Guttman Articles, Successes, Traci Buschner Articles

U.S. ex rel. Sandler and Paris v. Wyeth Pharmaceuticals and Pfizer, Inc.,
Eastern District of Pennsylvania.

The firm’s attorneys served as lead counsel for two whistleblowers who alleged marketing abuses of Pfizer subsidiary Wyeth Pharmaceutical’s immunosuppressant drug Rapamune. After initially declining to participate in the case, the Justice Department ultimately intervened after being presented with the strength of the evidence uncovered by the Firm’s attorneys and their clients. The case culminated in a $257.4 million settlement, one of the largest False Claims Act recoveries for a single drug. The settlement agreement noted the broad scope of Wyeth’s alleged unlawful marketing of Rapamune, including the knowing promotion of Rapamune for uses that were not approved by U.S. Food and Drug Administration. The company also pled guilty to a violation of the Food Drug and Cosmetics Act and entered into a Corporate Integrity Agreement with the U.S. Department of Health and Human Services.

Community Health Systems, $97 million

Dr. Caroline Poplin Articles, Elizabeth Shofner, Reuben Guttman Articles, Successes, Traci Buschner Articles

U.S. ex rel. Doghramji, et al. v. Community Health Systems Inc., et al.,
Middle District of Tennessee.

Firm attorneys represented three relators in a case alleging healthcare fraud by Tennessee-based company Community Health Systems, Inc. (“CHS”). The scheme to defraud the Medicare system jeopardized patients safety by unnecessarily hospitalizing patients and  preventing patients suffering from true emergencies from receiving  adequate care. CHS paid $97 million to resolve accusations that CHS emergency rooms in 120 hospitals systematically admitted patients not suffering from any emergency who should have been treated in an out-patient setting to capitalize on increased cost of reimbursement for emergency services and cheat federal and state insurance plans out of millions.

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