NJ Doctor Convicted Of Taking Bribes In Test-Referral Scheme With New Jersey Clinical Lab

LNEWARK, N.J. – A family doctor practicing in Bergen County, New Jersey, was convicted today of all 10 counts of an indictment charging him with accepting bribes in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.
Bernard Greenspan, 79, of River Edge, New Jersey, was convicted of one count of conspiring to commit violations of the Anti-Kickback Statute, the Federal Travel Act and wire fraud; three substantive violations of the Anti-Kickback Statute; three substantive violations of the Federal Travel Act; and three substantive violations of wire fraud. Greenspan was convicted following a 11-day trial before U.S. District Judge William H. Walls in Newark federal court. The jury deliberated just over four hours before returning the guilty verdict.

“We rightfully expect doctors to make their medical decisions based solely on what’s in the best interest of a patient,” U.S. Attorney Fishman said. “Whether they are dealing with a routine procedure or grappling with a potentially serious condition, patients should never have to worry that a doctor has violated that trust for personal greed. As we showed at trial – and the jury agreed – Greenspan abused his position and broke a wide range of federal laws when he accepted cash bribes and other illicit services in return for blood test referrals to BLS.”

“Patients have every right to insist that their physician is making medical referrals based on what is best for the patient—not what’s best for the doctor’s bank account,” said Special Agent in Charge Timothy Gallagher of the Newark FBI Field Office. “Bernard Greenspan decided to accept bribes in exchange for referrals and deprived patients of their right to honest services. These types of kickback arrangements cripple the healthcare industry and severely impact patient care. The FBI remains committed to investing its resources to combat these types of schemes.”

According to the indictment and testimony at trial, between March 2006 and April 2013, Greenspan received bribes totaling approximately $200,000 from BLS employees and associates. Greenspan periodically solicited and received monthly bribe payments in the form of sham rental, service agreement, and consultant payments.

In addition, Greenspan solicited and received other bribes, including payment for holiday parties for Greenspan and his office staff and additional cash bribes for ordering specific blood tests. In addition, BLS hired – at Greenspan’s specific request –a patient of Greenspan’s with whom he was having a sexual relationship. Greenspan’s referrals generated approximately $3 million in lab business for BLS.

The investigation has thus far resulted in 43 convictions – 29 of them of doctors – in connection with the bribery scheme, which its organizers have admitted involved millions of dollars in bribes and resulted in more than $100 million in payments to BLS from Medicare and various private insurance companies. It is believed to be the largest number of medical professionals ever prosecuted in a bribery case.

“This verdict should serve as a warning to any health care provider that dares to put personal profit ahead of proper patient care,” said Scott J. Lampert, Special Agent in Charge, Office of Inspector General, U.S. Department of Health and Human Services. “HHS-OIG, along with our law enforcement partners, will continue to aggressively pursue those who seek to undermine the federally funded health care programs intended for our most vulnerable Americans.”

“Dr. Greenspan violated the Hippocratic Oath taken by medical professionals when he pledged to ‘come for the benefit of the sick, remaining free of all intentional injustice,” said Inspector in Charge James V. Buthorn of U.S. Postal Inspection Service, Newark Division. “The culture of kickbacks and bribery have no place in our healthcare system, and the U.S. Postal Inspection Service was proud to do our part, working with our law enforcement partners to ensure justice was served today. Congratulations on the successful outcome to the agents and prosecutors who untiringly worked on investigating this case and preparing for trial.”

The investigation has recovered more than $12 million through forfeiture. On June 28, 2016, BLS, which is no longer operational, pleaded guilty and was required to forfeit all of its assets.

The conspiracy, Anti-Kickback, and Federal Travel Act counts are each punishable by a maximum potential penalty of five years in prison. The wire fraud charges are punishable by a maximum potential penalty of 20 years in prison per count. Each count also carries a maximum $250,000 fine, or twice the gross gain or loss from the offense. Greenspan’s sentencing is scheduled for June 20, 2017.

U.S. Attorney Fishman credited special agents of the FBI, under the direction of Special Agent in Charge Gallagher; inspectors of the U.S. Postal Inspection Service, under the direction of Inspector in Charge Buthorn; IRS–Criminal Investigation, under the direction of Special Agent in Charge Jonathan D. Larsen; and the U.S. Department of Health and Human Services, Office of Inspector General, under the direction of Special Agent in Charge Lampert with the ongoing investigation.

The government was represented at trial by Assistant U.S. Attorneys Joseph N. Minish and Danielle Alfonzo Walsman of the U.S. Attorney’s Office Health Care and Government Fraud Unit in Newark.

U.S. Attorney Paul J. Fishman reorganized the health care fraud practice at the New Jersey U.S. Attorney’s Office shortly after taking office, including creating a stand-alone Health Care and Government Fraud Unit to handle both criminal and civil investigations and prosecutions of health care fraud offenses. Since 2010, the office has recovered more than $1.32 billion in health care fraud and government fraud settlements, judgments, fines, restitution and forfeiture under the False Claims Act, the Food, Drug and Cosmetic Act and other statutes.

Owner and Operator of Miami-Based Mental Health Centers Pleads Guilty in $70 Million Health Care Fraud Scheme

An owner, a clinical director, and a therapist pleaded guilty today for their roles in a health care fraud scheme involving three Miami-based mental health centers.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Division and Special Agent in Charge Shimon Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office made the announcement.

Santiago Borges, 51, Erik Alonso, 45, and Cristina Alonso, 43, all of Miami, pleaded guilty before U.S. District Judge Ursula Ungaro of the Southern District of Florida.  Borges pleaded guilty to conspiracy to commit health care fraud and conspiracy to defraud the United States and pay health care kickbacks.  Erik Alonso pleaded guilty to conspiracy to commit health care fraud and conspiracy to make false statements relating to health care matters.  Cristina Alonso pleaded guilty to conspiracy to commit health care fraud and conspiracy to make false statements relating to health care matters.

Borges owned the now-defunct mental health centers R&S Community Mental Health Inc. (R&S) and St. Theresa Community Mental Health Center Inc. (St. Theresa), and was an investor in New Day Community Mental Health Center LLC (New Day).  Erik Alonso was the clinical director of all three centers.  Cristina Alonso was a therapist at R&S.

R&S, St. Theresa and New Day were community mental health clinics that purported to provide intensive mental health services to Medicare beneficiaries in Miami.  In connection with their guilty pleas, the defendants admitted that, from 2008 through 2010, the clinics billed Medicare for costly partial hospitalization program (PHP) services that were not medically necessary or not provided to patients.  Borges admitted that he paid kickbacks to patient recruiters who, in exchange, referred beneficiaries to the centers.  Erik Alonso admitted that he oversaw the preparation of false patient records.  Cristina Alonso admitted that she fabricated patient records, including group therapy session notes that were used to support claims for reimbursement from Medicare.

According Borges’ plea agreement, between January 2008 and December 2010, the centers submitted more than $70 million in false and fraudulent claims to Medicare.  Medicare paid approximately $28 million on those claims.

The case is being investigated by the FBI and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Southern District of Florida.  This case is being prosecuted by Trial Attorney A. Brendan Stewart of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged over 2,300 defendants who collectively have billed the Medicare program for over $7 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.

Medical Biller Sentenced to 45 Months in Prison for Role in $4 Million Health Care Fraud Scheme

The medical biller of a Chicago-area visiting physician practice was sentenced today to 45 months in prison for her role in a $4 million health care fraud scheme.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Zachary T. Fardon of the Northern District of Illinois, Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services-Office of Inspector General (HHS-OIG) in Chicago and Acting Special Agent in Charge John A. Brown of the FBI’s Chicago Division made the announcement.

Mary Talaga, 54, of Elmwood Park, Illinois, was convicted in May 2015 following a jury trial of one count of conspiracy to commit health care fraud, six counts of health care fraud and three counts of false statements relating to a health care matter.  In addition to imposing the prison term, U.S. District Judge Gary Feinerman of the Northern District of Illinois ordered Talaga to pay approximately $1 million in restitution.

From 2007 to 2011, Talaga was the primary medical biller at Medicall Physicians Group Ltd., a physician practice that visited patients in their homes and prescribed home health care.  The evidence at trial showed that Talaga and her co-conspirators routinely billed Medicare for overseeing patient care plans (a service known as “care plan oversight” or CPO) when, in fact, the doctors at Medicall rarely provided the service.  The evidence at trial also showed that Talaga and her co-conspirators billed Medicare for other services that were never provided, including services rendered to patients who were deceased, services purportedly provided by medical professionals no longer employed by Medicall, and services purportedly provided by medical professionals who, based on billing records, worked over 24 hours per day.

According to the evidence presented at trial, during the five-year conspiracy, Medicall submitted bills to Medicare for more than $4 million in services that were never provided.  Medicare paid more than $1 million on those claims.

Rick Brown, 58, of Rockford, Illinois, and Roger A. Lucero, 64, of Elmhurst, Illinois, were also convicted of offenses based on their roles in the scheme.  Brown was convicted along with Talaga at trial and was previously sentenced to serve more than seven years in prison.  Lucero, Medicall’s Medical Director, pleaded guilty and will be sentenced at a later date.

The case was investigated jointly by HHS-OIG and the FBI, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Northern District of Illinois.  This case was prosecuted by Trial Attorney Brooke Harper and Senior Trial Attorney Jon Juenger of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged over 2,300 defendants who collectively have billed the Medicare program for over $7 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

Detroit-Area Physician Pleads Guilty for Role in $5.7 Million Fraud Scheme

A Detroit-area medical doctor who prescribed unnecessary controlled substances and billed for unperformed office visits and diagnostic testing pleaded guilty today for his role in a $5.7 million health care fraud scheme.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge Paul M. Abbate of the FBI’s Detroit Field Office, Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Chicago Regional Office and Special Agent in Charge Jarod J. Koopman of Internal Revenue Service-Criminal Investigation (IRS-CI) made the announcement.

Laran Lerner, 59, of Northville, Michigan, pleaded guilty before U.S. District Judge Victoria A. Roberts of the Eastern District of Michigan to one count of health care fraud and one count of structuring cash transactions to avoid bank reporting requirements, as charged in a two-count information filed on Aug. 21, 2015.  Sentencing is set for Jan. 24, 2015.

According to admissions made as part of his plea agreement, Lerner lured patients into his clinic with prescriptions for unnecessary controlled substances.  Lerner admitted that he billed and caused Medicare to be billed for a variety of unnecessary prescriptions, tests and office visits to make it appear as though he was providing legitimate medical services instead of medically unnecessary controlled substances.  According to admissions made as part of his plea agreement, Medicare was billed $5,748,237.31, as a result of Lerner’s unnecessary prescriptions, office visits and diagnostic testing.

As part of the plea agreement, Lerner agreed to permanently surrender his Drug Enforcement Administration controlled substance registration and agreed not to re-apply in the future.

Lerner also pleaded guilty to structuring cash deposits he received as a result of his scheme to avoid triggering the requirement under federal law that domestic banks file a report – called a Currency Transaction Report – with the Secretary of Treasury for all transactions in currency over $10,000.  Lerner admitted that he knew about this requirement and caused his cash deposits to be structured in $5,000 increments on consecutive days at various branch locations in the Detroit area to avoid detection.  According to court documents, Lerner deposited $70,000 in cash in April 2013 alone by making deposits of $5,000 on fourteen different days.

The case was investigated by the FBI, HHS-OIG and IRS-CI, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Eastern District of Michigan.  The case is being prosecuted by Trial Attorney Elizabeth Young of the Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged over 2,300 defendants who collectively have billed the Medicare program for over $7 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

Medical Director and Three Therapists Convicted in $63 Million Health Care Fraud Scheme

A federal jury in Miami late yesterday convicted the former medical director of, and three therapists employed by, a now-defunct health care provider of conspiracy to commit health care fraud and related charges for their roles in a scheme to fraudulently bill Medicare and Florida Medicaid more than $63 million.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office and Special Agent in Charge Shimon Richmond of the U.S. Department of Health and Human Services-Office of Inspector General’s (HHS-OIG) Miami Regional Office made the announcement.

Roger Rousseau, 73, of Miami; Doris Crabtree, 62, of Miami; Angela Salafia, 68, of Miami Beach, Florida; and Liliana Marks, 48, of Homestead, Florida, were found guilty of conspiracy to commit health care fraud.  In addition, Rousseau was convicted of two counts of health care fraud.  Sentencing is scheduled for Nov. 6, 2015, before U.S. District Judge Robert N. Scola Jr. of the Southern District of Florida.

Rousseau was the former medical director of Health Care Solutions Network Inc. (HCSN), a now-defunct partial hospitalization program (PHP) that purported to provide intensive treatment for mental illness.  Crabtree, Salafia and Marks were therapists who worked for HCSN.

According to the evidence presented at trial, from approximately 2004 through 2011, HCSN billed Medicare and Medicaid for mental health services that were not medically necessary or never provided, and that HCSN paid kickbacks to assisted living facility owners and operators in Miami who, in exchange, referred beneficiaries to HCSN.

The trial evidence showed that Rousseau routinely signed what he knew to be fabricated and altered medical records without reviewing the substance of the records and, in most instances, without ever meeting with the patients.  The evidence at trial also demonstrated that Crabtree, Salafia and Marks fabricated medical records to support HCSN’s false and fraudulent claims for reimbursement for PHP services.

In total, HCSN submitted approximately $63.7 million in false and fraudulent claims to Medicare and Medicaid.  Medicare and Medicaid paid approximately $28 million on those claims.

In November 2014, following a jury trial, co-defendants Blanca Ruiz and Alina Fonts were convicted of conspiracy to commit health care fraud, and Fonts also was convicted of health care fraud.  In February 2015, both Ruiz and Fonts were sentenced to serve six years in prison.

The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Southern District of Florida.  The case was prosecuted by Trial Attorneys Allan J. Medina, Lisa H. Miller and Bryan D. Fields of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged over 2,300 defendants who collectively have billed the Medicare program for over $7 billion.  In addition, HHS’s Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

Assistant Administrator of Riverside General Hospital Sentenced to 40 Years in Prison for $116 Million Medicare Fraud Scheme

The former assistant administrator of Riverside General Hospital was sentenced today to 40 years in prison for his role in a $116 million Medicare fraud scheme.  To date, 10 individuals have pleaded guilty or been convicted for their involvement in the scheme.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division and U.S. Attorney Kenneth Magidson of the Southern District of Texas made the announcement.

Mohammad Khan, 65, of Houston, the assistant administrator who oversaw many of the partial hospitalization programs (PHPs) at Riverside General Hospital, pleaded guilty in February 2012 to conspiracy to commit health care fraud, conspiracy to pay and receive kickbacks and paying illegal kickbacks.  He was sentenced by U.S. District Court Judge Sim Lake of the Southern District of Texas.  He was also ordered to pay restitution in the amount of $31,321,200.

According to admissions made in connection with his guilty plea, from January 2008 through February 2012, Khan and others at Riverside General Hospital operated a scheme to defraud Medicare by submitting claims for PHP services that were not medically necessary and, in some cases, never provided.  Prior to Khan’s arrest, Riverside submitted over $116 million in claims to Medicare for PHP services purportedly provided to the recruited beneficiaries, when in fact, the PHP services were medically unnecessary or never provided.  Khan also admitted that he and his co-conspirators paid kickbacks to patient recruiters and to owners and operators of group care homes in exchange for which those individuals delivered ineligible Medicare beneficiaries to the hospital’s PHPs.

Others involved in the fraudulent scheme already have pleaded guilty and are awaiting sentencing.  Earnest Gibson III, the former president of Riverside; his son, Earnest Gibson IV, who operated a Riverside PHP; Regina Askew, a patient file auditor and group home operator; and Robert Crane, a patient recruiter, were all convicted after jury trial in November 2014 and await sentencing.  William Bullock, an operator of a Riverside satellite location, as well as Leslie Clark, Robert Ferguson, Waddie McDuffie and Sharonda Holmes, who were involved in paying or receiving kickbacks, also have pleaded guilty to their roles in the scheme.

The case was investigated by the FBI, Internal Revenue Service Criminal Investigation and Texas Attorney General’s Medicaid Fraud Control Unit, with assistance from Health & Human Services’ Office of the Inspector General, Railroad Retirement Board’s Office of Inspector General and Office of Personnel Management’s Office of Inspector General.  The case was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Southern District of Texas.  The case is being prosecuted by Assistant Chief Laura M.K. Cordova of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,100 defendants who collectively have billed the Medicare program for more than $6.5 billion.  In addition, the HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to:www.stopmedicarefraud.gov.

MainJustice.Com: “Former Civil Division Fraud Leader Joins White Collar Firm”

MainJustice.Com: “Former Civil Division Fraud Leader Joins White Collar Firm”

Patricia Davis, former Assistant Director, Fraud Section, Civil Division, joins GeyerGorey LLP

Sweet Lime Portrait Design, Family Photography, Baby Photography, Maternity Photography
Patricia Davis, a twenty-year veteran of the Department of Justice, has joined GeyerGorey LLP as of counsel.  She previously served as Assistant Director, Fraud Section, Civil Division, U.S. Department of Justice, where she was responsible for investigating and prosecuting hundreds of cases involving fraud on government healthcare, procurement and grant/loan programs.  Prior to joining the Department, Ms. Davis was Deputy Counsel to the Inspector General at the General Services Administration.  She is the eleventh former DOJ prosecutor to join the boutique law firm in less than a year.

(See the firm’s Representative Matters by clicking here [this is not a comprehensive list and does not yet incorporate any of Ms. Davis’s experience])

 “The scope and breadth of Pat’s experience is unparalleled.  Much of the Civil Division’s enforcement program focusing on Defense Department contracts and pharmaceuticals rested squarely on her shoulders,” said Brad Geyer, one of the firm’s founding partners.  “We are delighted that Pat has decided to join us.”

Robert Zastrow, who was Verizon’s Assistant General Counsel for 15 years before co-founding the firm in October 2012, added,“ Pat Davis is an excellent addition to our corporate compliance and white collar practice.”

 “I believe that Pat brings our firm to a new level in terms of our ability to get cases placed appropriately and to enhance the chances that our qui tam (False Claims Act) cases will be adopted by the government,” said Hays Gorey, a firm co-founder.  “With Pat’s terrific background and deep legal knowledge, we are uniquely positioned to develop cases so that they are ready, when filed, to be transitioned immediately to the appropriate U.S. Attorney’s Office or the Civil Division of the Department of Justice.”

Headquartered in Washington, D.C., with offices in New York, Boston, Philadelphia and Dallas, GeyerGorey LLP specializes in white collar criminal defense, particularly investigations and cases involving allegations of economic crimes, including violations of the federal antitrust laws (price fixing, bid rigging, territorial and customer allocation agreements), the procurement and grant fraud statutes, the securities laws, the Foreign Corrupt Practices Act, the False Claims Act and other whistleblower actions.  The firm also conducts internal investigations of possible criminal conduct and provides advice regarding compliance with antitrust, anti-bribery and other laws and regulations, in addition to advising on voluntary and mandatory disclosure issues. For further information, please call Patricia Davis at (202) 559-1456 or email [email protected].

MRI Diagnostic Testing Company, Imagimed LLC, and Its Former Owners and Chief Radiologist to Pay $3.57 Million to Resolve False Claims Act Allegations

New York-based Imagimed LLC, the company’s former owners, William B. Wolf III and Dr. Timothy J. Greenan, and the company’s former chief radiologist, Dr. Steven Winter, will pay $3.57 million to resolve allegations that they submitted to federal healthcare programs false claims for magnetic resonance imaging (MRI) services, the Justice Department announced today.  Imagimed owns and operates fifteen MRI facilities, located primarily in New York state, under the name “Open MRI.”

 Allegedly, from July 1, 2001, through April 23, 2008, Imagimed, Greenan, Wolf and Winter submitted claims to Medicare, Medicaid and TRICARE for MRI scans performed with a contrast dye without the direct supervision of a qualified physician.  Since a potential adverse side effect of contrast dye is anaphylactic shock, federal regulations require that a physician supervise the administration of contrast dye when it is used for an MRI.  Also, allegedly, from July 1, 2005, to April 23, 2008, Imagimed, Greenan, Wolf and Winter submitted claims for services referred to Imagimed by physicians with whom Imagimed had improper financial relationships.  In exchange for these referrals, Imagimed entered into sham on-call arrangements, provided pre-authorization services without charge and provided various gifts to certain referring physicians, in violation of the Stark Law and the Anti-Kickback Statute.

“The Department of Justice is committed to guarding against abuse of federal healthcare programs,” said Stuart F. Delery, Assistant Attorney General for the Civil Division.  “We will help protect patients’ health by ensuring doctors who submit claims to federal healthcare programs follow proper safety precautions at all times.”

U.S. Attorney for the Northern District of New York, Richard S. Hartunian said: “This case is an example of our commitment to using all of the remedies available, including civil actions under the False Claims Act, to ensure patient safety and combat health care fraud.  Stripping away the profit motive for circumventing physician supervision requirements has both a remedial and a deterrent effect.  The settlement announced today advances our critical interest in both the integrity of our health care system and the safe delivery of medical services.”

The allegations resolved by the settlement were brought in a lawsuit filed under the False Claims Act’s whistleblower provisions, which permit private parties to sue for false claims on behalf of the government and to share in any recovery.  The whistleblower in this case, Dr. Patrick Lynch, was a local radiologist and will receive $565,500.

This settlement illustrates the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius.  The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.  One of the most powerful tools in this effort is the False Claims Act.  Since January 2009, the Justice Department has recovered a total of more than $14.8 billion through False Claims Act cases, with more than $10.8 billion of that amount recovered in cases involving fraud against federal health care programs.

The investigation and settlement were the result of a coordinated effort among the U.S. Attorney’s Office for the Northern District of New York; the Justice Department’s Civil Division, Commercial Litigation Branch and the Department of Health and Human Services’ Office of Inspector General.

The case is United States of America ex rel. Lynch v. Imagimed LLC, et al. (N.D. N.Y.).  The claims released by the settlement are allegations only, and there has been no determination of liability.

GeyerGorey LLP Issues Updated Representative Matters List; Experience is Wide and Deep

Representative Matters

Our attorneys have led and participated in some of the highest profile matters in the past decade, both while in the government and in private practice. We have been involved in the most significant criminal cartel cases, the most important mergers, the most notable civil antitrust investigations, the largest procurement fraud cases, and game-changing antitrust cases that reached the United States Supreme Court. Our collective experience stands as a testament to our work ethic, our drive for excellence, and the trust and responsibility we have been given by our clients and the government.

International Cartels:

  • Led investigation and prosecution of marine contractors engaged in conspiracy to suppress and eliminate competition to install deep sea oil platforms
  • Led investigation and prosecution of international freight forwarders engaged in conspiracy to fix prices on international air cargo shipments
  • Led investigation and prosecution of household-goods moving contractors engaged in conspiracy to fix prices for international moving services provided to Department of Defense
  • Investigation and prosecution of graphite electrodes manufacturers
  • Investigation and prosecution of ocean shipping companies
  • Investigation and prosecution of a FTSE 250 engineering company that resulted in the indictment, extradition and conviction of its former chief executive
  • Defended foreign construction company in investigation and prosecution of alleged billion-dollar bid rigging scheme, in related qui tam litigation, and in other related matters
  • Defended foreign vitamin manufacturers in investigations and prosecutions of alleged international price-fixing agreements
  • Defended foreign specialty chemical manufacturers in investigations and prosecutions of alleged international price-fixing agreements
  • Defended U.S.-based executive of foreign company in criminal and civil litigation related to his alleged role in an international cartel to fix prices in the marine supply industry
  • Defended foreign executive of foreign company in criminal and civil litigation related to his alleged role in the conspiracy to fix air cargo rates around the world
  • Defended international freight forwarder in criminal litigation related to its alleged role in an international conspiracy to rig bids on U.S. military shipping contracts
  • Investigation and subsequent prosecution of foreign vitamin manufacturers for price fixing conspiracy

Domestic Price Fixing and Bid Rigging:

  • Defended electrical products manufacturer in first felony prosecution under the Sherman Act and in civil treble damage litigation
  • Represented a class of nurses in litigation against a hospital association and a number of Arizona hospitals
  • Represented the State of Ohio against a number of dairies for allegedly rigging bids of school milk
  • Investigation and prosecution of highway paving contractors in multiple districts for bid rigging
  • Investigation and prosecution of military insignia providers supplying the Army Air Force Exchange System with over 4,000 items of insignia
  • Represented metal drum manufacturer in prosecution for price fixing
  • Investigation of polypropylene bag manufacturers and that resulted in the prosecution of a manufacturer for Buy American Act violations and conspiracy to defraud
  • Investigation and prosecution of nearly 40 cases against paving contractors for conspiring to rig bids in connection with federal and state highway and airport contracts
  • Investigation and prosecution of an auction rigging conspiracy involving auto parts to by the Department of Defense at Defense Reutilization Marketing Offices (DRMO)
  • Investigation and prosecution of multiple electrical construction contractors for conspiring to rig bids for major power wiring contracts associated with steel mills and waste water treatment plants
  • Investigation and prosecution of multiple wholesale grocery companies and bid managers for rigging bids to school districts, hospitals and jails in southern Texas
  • Investigation and prosecution of multiple dairies for rigging bids for school milk sold to districts in Louisiana
  • Investigation and prosecution of crawfish processors for fixing prices paid to crawfish farmers and fishermen
  • Investigation and prosecution of bribery conspiracy involving the reconstruction of the New Orleans levee system after Hurricane Katrina
  • Investigation and prosecution of fire protective services company and its president
  • Investigation and prosecution of an Iraq-based general construction bid rigging scheme
  • Investigation and prosecution of conspiracy to solicit kickback scheme involving security services on a US Agency for International Development contract
  • Investigation and prosecution of fuel theft from an overseas United States military facility
  • Investigation and prosecution of a Europe-based scheme to defraud the Iraqi government by facilitating the fraudulent claim for payment of armored vehicles that were never delivered
  • Represented individual accused of defrauding government defense agency out of hundreds of thousands of dollars of grant money
  • Represented company accused of defrauding government by failing to supply vitamin-enriched food products with the proper level of enrichment
  • Represented large computer software company in internal investigation of improper influence on government contracting process

General Criminal:

  • Defended CEO and three closely-held companies in a multi-state racketeering and tax fraud prosecution
  • Investigation and prosecution of multiple labor racketeering cases ranging from prosecutions of United Mine Worker Union officials for theft of union funds used to pay for the murder of a political opponent of the union president to the prosecution of two Boston-based racketeers for actions associated with their travel to California in connection with a union organizing effort at a San Rafael newspaper
  • Investigation and prosecution of the mayor of a New Jersey town for taking bribes in connection with the permitting of a tank farm at the terminus point of a major Gulf Coast to East Coast pipeline
  • Investigation and prosecution of the most prolific serial bank robber in United States history
  • Investigation and prosecution of the murder for hire of a government witness and one of the largest cocaine importation conspiracies East of the Mississippi River
  • Investigation and prosecution of numerous gun, drug and false identity cases
  • Investigation and prosecution of multiple obstructions of justice, contempt, false statement, witness tampering and perjury cases arising out of grand jury investigations
  • Investigation and prosecution of bank fraud cases
  • Represented individuals before the District of Columbia Court of Appeals in appeals from criminal convictions (more than a dozen cases)
  • Defended individual in intelligence community in investigation by DCIS for alleged violations of public corruption statutes (18 U.S.C §§ 207 & 208)
  • Defended individual in criminal investigation by Inspector General of NASA
  • Defended individual in federal bribery investigation
  • Defended government contractor in investigation by the Inspector General of the Department of Agriculture
  • Defended several regional hospitals in various unrelated federal investigations of allegedly fraudulent billing practices, Stark violations
  • Represented hospital CEO in investigation of alleged Stark violations
  • Represented pathology laboratory in healthcare fraud investigation
  • Represented national healthcare company in investigation of allegedly criminal off-label marketing
  • Represented various individuals in applications for presidential pardons

Mergers and Acquisitions:

  • Represented Warner Music in connection with the proposed acquisition of EMI by Universal Music
  • Represented DISH Network in opposition to the proposed acquisition of T-Mobile by AT&T
  • Represented Merck in connection with its acquisition of Schering Plough
  • Represented Simon Properties in connection with its acquisition of Prime Outlets
  • Obtained antitrust clearance in the acquisition of Liquid Container by Graham Packaging
  • Obtained consent decree against nuclear engineering firm which had acquired another firm with the same engineering specialty
  • Represented major home healthcare provider in acquisition valued in excess of $500 million
  • Represented pathology laboratory in merger valued in excess of $100 million
  • Represented foreign mining company in acquisition of US coal mines valued over $1 billion
  • Represented hospital management company in acquisition valued in excess of $500 million
  • Represented individual in several acquisitions of stock each valued in excess of $100 million
  • Represented major over-the-counter pharmaceutical company in four different acquisitions over several years whose values ranged from over $100 million to over $500 million
  • Represented national restaurant chain in acquisition valued at about $1 billion
  • Represented regional hospital chain in acquisition of a hospital valued above $50 million
  • Represented hospital valued in excess of $100 million in sale to state hospital system

Civil Antitrust Matters:.

  • Defended large telecommunications provider in three week trial for alleged exclusionary conduct directed towards telecom services resellers.
  • Represented large telecommunications provider as plaintiff in case alleging monopolization of market for telecom switch software.
  • Represented leading music copyright licensing organization in a decade-long investigation by the Department of Justice
  • Led the investigation of Ticketmaster at the Department of Justice
  • Led major, successful prosecution by United States Department of Justice of conspiracy among twenty-four leading market-makers in NASDAQ stocks, including Goldman, Sachs & Co. and J. P. Morgan Securities,  Inc. who had conspired to maintain spreads between buying and selling prices of NASDAQ stocks
  • Defended large telecommunications provider in multi-year litigation brought by competitive telecom carrier alleging monopolization of market for high speed data services
  • Led successful investigation and prosecution of Salomon Bros Inc. and two hedge funds, Caxton Corporation and Steinhardt Partners, LP, to limit the supply of two-year Treasury notes to the “repo,” or “repurchase agreement,” market
  • Successfully brought the Reagan Administrations ‘s first challenge to a merger (brewing industry)
  • Successfully represented the United States in a litigated matter challenging field of use restrictions in patent licensing agreement in specialty chemicals
  • Successfully represented the United States in challenge to professional rules of conduct limiting competition among accountants in Texas
  • Successfully represented the United States in challenge to acquisition by Texaco, Inc. of an independent oil refining company
  • Represented high-tech electronic service provider with respect to antitrust issues in a bet-the-company patent infringement case
  • Represented sporting goods manufacturer in vacating a consent decree
  • Represented leading music copyright pool in civil antitrust investigation leading to vacating of an earlier consent decree and modification of another consent decree
  • Represented hospital CEO in litigation arising from denial of physician staff privileges

Antitrust Compliance Counseling:

  • Advised large telecommunications provider on its price and product bundling
  • Advised large telecom provider in connection with a joint venture of three carriers to entire the mobile payments market with mobile phones
  • Advised major manufacturer of household appliances on antitrust compliance
  • Advised major manufacturer of high-end kitchen appliances on antitrust compliance
  • Advised major manufacturer of over-the-counter pharmaceutical on antitrust compliance
  • Advised regional airport on state action doctrine and compliance with antitrust laws
  • Advised national trade association on antitrust compliance and Noerr-Pennington doctrine
  • Advised international shipping company on compliance regarding competition, fraud, and foreign corrupt practices
  • Advised African government on contracting and anti-fraud and anti-corruption best practices

Other Civil Litigation:

  • Represented Haiti in multinational investigation and litigation leading to the recovery of money stolen by its former president Jean-Claude Duvalier
  • Represented developers in multiple appeals involving alleged illegal cooperative conversion terms
  • Defended law firm in $10 million professional malpractice action
  • Defended various healthcare providers in numerous different federal investigations of alleged fraud, related qui tam cases, and related whistleblower termination actions
  • Defended CMS contractor in qui tam case
  • Represented regional Medicare Advantage organization in suit against the U.S. Government
  • Defended book distributor and publisher in defamation case
  • Defended author in defamation case
  • Represented gaming company in civil rights action relating to state gaming regulations
  • Defended copyright and trademark owner in intellectual property litigation
  • Defended local retailer of gray market goods in trademark infringement litigation
  • Represented major multinational corporation in suit seeking refund of local corporate franchise tax
  • Represented government contractor in appeal of denial of security clearance
  • Defended employers in cases alleging violation of wage-and-hour statute
  • Represented developers in multiple appeals involving alleged illegal cooperative conversion terms
  • Defended employer in case alleging employment discrimination
  • Defended employer in case alleging sexual harassment
  • Defended employers in cases alleging unlawful discharge

Experience by Industry:

  • Air Cargo
  • Aircraft Parts (Domestic)
  • Airlines
  • Airport Contracts
  • Automobile Dealers (Domestic)
  • Airlines
  • Asset Forfeiture
  • Auction Rigging (Multiple Industries)
  • Banking (International)
  • Baked Goods (Domestic)
  • Baking Soda
  • Book Publishing
  • Bridge Construction
  • Carbon Products
  • Caustic Soda
  • Cell Towers (Domestic)
  • Chemicals (Multiple Products, Domestic and International)
  • Clothing and Textiles (Multiple Products, Domestic and International)
  • Computer Software
  • Construction (Domestic and International)
  • Copyright and Trademark
  • Dairy Products
  • Deep sea Oil Platforms
  • Democratization Programs
  • Electrical Products
  • Embassy Construction
  • Engineering
  • Export-Import Bank Clients (Multiple Industries, International)
  • Food Service Contracts (Multiple Industries, Domestic and International)
  • Financial Institutions (Domestic and International)
  • Fire Protection Services
  • Freight Forwarding (Domestic and International)
  • Fuel Supply (Domestic and International)
  • General Construction (Multiple Industries, Domestic and International)
  • Government Contracts (Multiple Industries, Domestic and International)
  • Graphite Electrodes
  • Highway Construction
  • Hospitals
  • Housing Foreclosure Auctions (Domestic)
  • Information Technology (Multiple Industries, Domestic and International)
  • Industrial Gases (Domestic and Multiple Products)
  • LIBOR
  • Marine Contractors
  • Medical Products (Multiple Products, Domestic and International)
  • Metal Drums
  • Military Insignia (International)
  • Military Moving and Storage
  • Mining and Related Products (Multiple Industries, Domestic)
  • Motor Vehicles (Domestic)
  • Municipal Bonds (Multiple Industries, Domestic and International)
  • Nursing
  • Ocean Shipping (International)
  • Oilfield Supplies
  • Pharmaceuticals (Multiple Products, Domestic and International)
  • Polypropylene bags
  • Rock Salt
  • Seafood
  • Security Contracts
  • School District Contracts (Multiple Industries)
  • Soda Ash
  • Shipping (Multiple Industries, Domestic and International)
  • Slag Removal
  • Telecommunications
  • Tobacco
  • Translation Services
  • Trucking
  • US Agency for International Development Contractors and Grant Recipients
  • Vitamins
  • Warzone
  • Waste Hauling
  • Wholesale Groceries
  • Wireless
  • World Bank Contractors and Grant Recipients (International)
  • Vitamins

 

Experience by Subject Matter:

  • Antitrust (Civil and Criminal)
  • Auction Rigging
  • Bank Robberies (Domestic)
  • Bank Fraud
  • Bid-Rigging
  • Bribery
  • Buy American Act Violations
  • Capital Crimes
  • Cartels (Multiple Products, Domestic and International)
  • Cash Smuggling (International, multiple procurements by multiple governments)
  • Civil Merger and Non-Merger Cases (Multiple Products, Multiple Industries Domestic and International)
  • Civil Rights Actions
  • Competition Advocacy
  • Contempt
  • Contracting Fraud
  • Corporate Defense (Multiple Industries, Domestic and International)
  • Criminal Conspiracies
  • Defamation
  • Disaster Fraud
  • Drug Cartels and Trafficking
  • Embezzlement
  • Employment Law
  • False Claims
  • False Statements
  • Federal Trade Commission Matters
  • Firearms and Weapons Offenses (Domestic and International)
  • Foreign Corrupt Practices Act (FCPA) (Multiple Industries)
  • Forgery
  • Fuel Theft
  • Grant Fraud (Multiple Industries, Multiple Agencies, Domestic and International)
  • Hart-Scott-Rodino Pre-Merger Notification
  • Health Care Fraud (Compliance, Organizational Defense, Whistleblowers)
  • Kickbacks
  • Identity Theft
  • Intellectual Property
  • Mail Fraud
  • Market Allocation
  • Mergers and Acquisitions
  • Money Laundering (Multiple Industries, Domestic and International)
  • Monopolies (Multiple Industries, Domestic and International)
  • Murder for Hire
  • Non-governmental Organizations (International)
  • Obstruction of Justice
  • Overseas Contingency Operations
  • Perjury
  • Presidential Pardons
  • Price Fixing
  • Procurement Fraud (Multiple Industries, Domestic and International)
  • Professional Malpractice Defense
  • Public Corruption
  • Qui Tam Matters
  • Racketeering
  • Securities Fraud
  • Stark Violations
  • Tax Fraud (International, Domestic and State)
  • Territorial Allocation
  • Webb-Pomerene Organizations (International)
  • Weapons Offenses (Domestic and International)
  • Whistleblowers (Multiple Industries, Domestic and International)
  • Wire Fraud
  • Witness Tampering