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Hudson Valley Hematology Oncology Associates, $5.3 million

U.S. ex rel. Abrahamsen v. Hudson Valley,
Southern District of New York.

Firm attorneys brought a qui tam suit against Hudson Valley Hematology Oncology Associates (Hudson Valley), a New York based treatment center for patients with blood disorders and cancer. The complaint alleges that Hudson Valley illegally billed Medicare and Medicaid for services that were improperly documented and/or were not rendered. Hudson Valley was also accused of violating the Anti-Kickback Statute by waiving copayments and adding the waived fees to claims for Medicare reimbursement. The relator, a former billing department employee at Hudson Valley, recieved between 10-25% of the funds recovered for the government. Hudson Valley also entered into a corporate integrity agreement as part of the settlement. 

Read more: https://www.poughkeepsiejournal.com/story/news/local/2016/10/21/medicare-hudson-valley-hematology-oncology/92510938/

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Oral Roberts University, $300,000

United States ex rel. Shoe v. Oral Roberts University,
District of South Carolina.

GBB attorney’s brought this False Claims Act case against Oklahoma based ORU alleging that the university had fraudulently billed the Department of Education after violating the federal ban on incentive-based compensation. The whistleblower contended that ORU hired Shoe Inc., a student recruiting firm, then paid them with a portion of the tuitions of recruited students. Title IV of the higher education act prohibits any university receiving federal student aid from compensating recruiters based on the number of students successfully recruited. Maurice Shoe, the whistleblower and co-owner of Shoe, was awarded $45,000. 

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North Greenville University, $2.5 million

United States ex rel. Shoe v. North Greenville University,
District of South Carolina.

Firm attorneys pursued a False Claims Act suit against North Greenville University, alleging NGU illegally submitted student aid claims to the government after providing incentive compensation to student recruiters. Title IV of the Higher Education Act makes it a crime for higher education institutions which receive federal student aid money to provide recruiters with commissions, bonuses, or other forms of incentive compensation for recruiting new students. The complaint against NGU accusing of paying a recruitment company which it partially owned, Joined Inc., based on the number of new students their recruiters enrolled.

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Northwell Health, $12 million

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.

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Humana Inc., $7 million

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.

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