Category Archives: Whistleblower Articles

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

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.

Oakland, CA based Kaiser Foundation Health Plan has agreed to pay $6.3 million to settle allegations that it submitted false Medicare Advantage patient diagnoses in order to receive inflated payments from Medicare.

Under the Medicare Advantage program, Medicare pays private insurers based on the cost of providing care for all recipients enrolled in their plans. Generally, patients with worse or more numerous diagnoses result in larger payments while healthier patients result in smaller payments.

The suit was brought by a former employee of Kaiser Health foundation. She will receive $1.5 million for her role in the settlement.

Read the full press release here: https://www.justice.gov/opa/pr/medicare-advantage-provider-pay-63-million-settle-false-claims-act-allegations