Health care fraud 

Here is a list of articles about some of the qui tam cases involving Medicare fraud and other kinds of health care fraud brought by John R. Phillips, Mary Louise Cohen and the firm. The qui tam lawsuits discussed below include those brought against:

Sharp Healthcare: San Diego Hospital Association — the parent of Sharp Healthcare and San Diego’s largest health care provider — paid $825,000 in November 1999 to settle a qui tam lawsuit that alleged Sharp improperly increased its revenues from Medicare by billing the government for services provided by attending physicians when those services actually were provided by physicians in training, or residents. The lawsuit also charged that Sharp regularly "upcoded" it bills to Medicare, charging the government for a higher level of service than was actually provided.

  • "Sharp settles suit alleging fraud at Grossmont Hospital," Cheryl Clark, San Diego Union-Tribune, 11/23/99.

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HealthCare One and World: The Justice Department joined in July 1999 a qui tam lawsuit alleging widespread fraud and falsification of medical records by two related southern California companies — HealthCare One and World — that manufactured and sold medical devices known as lymphedema pumps to cancer patients.

  • "DOJ joins unsealed lawsuit charging two California firms with Medicare fraud," Health Care Fraud Report, 8/11/99.

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KPMG LLP: A qui tam lawsuit against KPMG LLP was unsealed in May 1999 in federal court in Tampa, Fla. It charged that the accounting firm knew Medicare cost reports filed by Basic American Medical Inc. (BAMI) and later Columbia — which acquired BAMI in 1992 — contained false information, yet KPMG assisted in preparing them anyway.

  • "KPMG named in whistleblower suit involving Columbia/HCA," Federal Contracts Report, 6/7/99.
  • "KPMG is accused by whistleblower of aiding Columbia/HCA in fraud," Lucette Lagnado, The Wall Street Journal, 6/1/99.
  • "Accounting firm is named in Medicare fraud lawsuit," Kurt Eichenwald, The New York Times, 5/29/99.

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HCA-The Healthcare Co. (formerly Columbia/HCA Healthcare Corp.): Two whistleblowers brought separate lawsuits against HCA alleging that the for-profit hospital company systematically defrauded Medicare by filing fraudulent "cost reports." The Justice Department has joined both cases. The government’s analysis of HCA’s cost reports found that the company set aside reserves totaling more than $400 million from 1987 to 1997 to cover claims that it knew were not allowed under Medicare reimbursement regulations. Nearly 400 past and present HCA facilities made thousands of false claims, the government found. In December 2000, a former HCA management subsidiary pleaded guilty to criminal charges related to many of the schemes alleged in the whistleblowers’ complaints. HCA paid $95.3 million to settle the criminal charges, but has not yet resolved its civil liability for cost report and kickback issues. At the same time, it paid $745 million to settle other whistleblower and government claims. Included in those claims was a qui tam lawsuit brought by two Utah doctors who alleged HCA hospitals routinely billed Medicare for blood tests that were not requested by doctors and were not medically necessary. 

  • "HCA faces new U.S. filings on Medicare," Lucette Lagnado, The Wall Street Journal, 3/19/01.
  • "Government joins suits against hospital giant," Kurt Eichenwald, The New York Times, 3/17/01.
  • "HCA faces new fraud charges," Bill Brubaker, The Washington Post, 3/17/01.
  • "Justice Department says HCA owes ‘hundreds of millions’ in fraud case," Keith Russell, Tennessean, 3/17/01.
  • "U.S. accuses HCA of Medicare fraud," Glenn Singer, Sun-Sentinel, 3/17/01.
  • "U.S. to seek $400 million more at HCA," The New York Times, 3/16/01.
  • "HCA lawsuit raises issues dating back to 1987," Keith Russell, Tennessean, 3/16/01.
  • "HCA faces civil fraud allegations," Kris Hundley, St. Petersburg Times, 3/16/01.
  • "HCA-Healthcare may be facing another charge," Los Angeles Times, 3/16/01.
  • "HCA agrees to pay U.S. $840 million to settle criminal, civil allegations," Health Care Fraud Report, 1/10/01.
  • "HCA to pay record $840 million to settle criminal, civil charges of Medicare fraud," Federal Contracts Report, 1/2/01.
  • "HCA to pay $95 million in fraud case," Kurt Eichenwald, The New York Times, 12/15/00.
  • "HCA units’ guilty pleas resolve largest Medicare criminal probe," Lucette Lagnado, The Wall Street Journal, 12/15/00.
  • "Payout to end HCA criminal charges," Kris Hundley, St. Petersburg Times, 12/15/00.
  • "HCA to pay $95 million in fines," Bill Brubaker, The Washington Post, 12/15/00.
  • "$745 million and far to go," Barbara Kirchheimer and Mark Taylor, Modern Healthcare, May 23, 2000.
  • "Two Utah doctors were whistleblowers in Columbia/HCA fraud investigation," Phil Sahm, The Salt Lake Tribune, May 20, 2000.
  • "Hospital company agrees to pay $745 million in U.S. fraud case," Kurt Eichenwald, The New York Times, May 19, 2000.
  • "Columbia/HCA to pay the U.S. $745 million," Lucette Lagnado, The Wall Street Journal, May 19, 2000.
  • "Hospital chain to settle case," Bill Brubaker, The Washington Post, May 19, 2000.
  • "Columbia agrees to pay $745m penalty," Julie Appleby, USA Today, May 19, 2000.
  • "Columbia/HCA to pay $745 million in Medicare fraud," Michael A. Hiltzik and Alissa J. Rubin, Los Angeles Times, May 19, 2000.
  • "Columbia set to pay $745 million," Kris Hundley, St. Petersburg Times, May 19, 2000.
  • "Columbia/HCA offers $745 million settlement," Keith Snider, The Tennessean, May 19, 2000.
  • "Settlement likely to cut into Columbia/HCA earnings," Keith Russell, The Tennessean, May 19, 2000.
  • "Columbia faces more legal pressure," Kris Hundley, St. Petersburg Times, 7/20/99.
  • "Columbia/HCA execs found guilty of fraud; fuels federal investigation of company," Health Care Fraud Report, 7/14/99.
  • "More charges appear likely," Keith Snider, The Tennessean, 7/7/99.
  • "Columbia/HCA healthcare convictions may bolster case for civil settlement," Lucette Lagnado, The Wall Street Journal, 7/6/99.
  • "Two found guilty of hospital fraud charges," Kurt Eichenwald, The New York Times, 7/3/99.
  • "Jury finds two Columbia execs guilty of fraud," Kris Hundley, St. Petersburg Times, 7/3/99.
  • "Defense’s turn nears in Columbia trial," Mark Taylor, Modern Healthcare, 6/7/99.
  • "KPMG named in whistleblower suit involving Columbia/HCA," Federal Contracts Report, 6/7/99.
  • "KPMG is accused by whistleblower of aiding Columbia/HCA in fraud," Lucette Lagnado, The Wall Street Journal, 6/1/99.
  • "Accounting firm is named in Medicare fraud lawsuit," Kurt Eichenwald, The New York Times, 5/29/99.
  • "Columbia fraud case heads to trial," Kris Hundley, St. Petersburg Times, 5/1/99.
  • "Federal case’s scope clouding Columbia/HCA negotiations," Keith Snider, The Tennessean, 3/7/99.
  • "U.S. agency files motion to consolidate fraud cases against Columbia/HCA," Lucette Lagnado, The Wall Street Journal, 2/16/99.
  • "U.S. amends suit against Columbia and Quorum, alleging pattern of fraud," Lucette Lagnado, The Wall Street Journal, 2/3/99.
  • "A lawyer for whistle-blowers: ‘part therapist,’" Lucette Lagnado, The Wall Street Journal, 1/7/99.
  • "Justice Department intervenes in second Columbia/HCA whistleblower case," Federal Contracts Report, 1/4/99.
  • "Whistle while you work," Sara Selis, Healthcare Business, 1/99.
  • "U.S. is joining 2d suit against hospital chain," Kurt Eichenwald, The New York Times, 12/31/98.
  • "U.S. joins second suit alleging fraud by Columbia Healthcare," Lucette Lagnado, The Wall Street Journal, 12/31/98.
  • "Justice Dept. joins suit against Columbia/HCA; whistleblower alleges Medicare fraud," David S. Hilzenrath, The Washington Post, 12/31/98.
  • "Justice on board in HCA fraud suit," J. Josef Hebert, The Washington Times, 12/31/98.
  • "Columbia faces second suit," Sarah Huntley, The Tampa Tribune, 12/31/98.
  • "Feds join second suit against Columbia," Kris Hundley, St. Petersburg Times, 12/31/98.
  • "Water-system gear suit draws attention," Andy Pasztor, The Wall Street Journal, 12/22/98.
  • "Feds join second suit against Columbia," Kris Hundley, St. Petersburg Times, 12/31/98.
  • "No end in sight: Five-year probe of Columbia, Quorum keeps growing," Kristen Hallam, Modern Healthcare, 11/9/98.
  • "Patiently, and now with help, whistleblower waits," Kris Hundley, St. Petersburg Times, 11/5/98.
  • "Columbia probe has deep roots," Kristen Hallam and Deanna Bellandi, Modern Healthcare, 10/26/98.
  • "U.S. joins, unseals whistleblower lawsuit alleging Columbia/HCA, Quorum fraud," Drew Douglas, Health Care Fraud Report, 10/21/98.
  • "He blew the whistle, and health giants quaked," Kurt Eichenwald, The New York Times, Oct. 18, 1998.
  • "Making it a federal case; suit alleges widespread fraud by Columbia, Quorum," Deanna Bellandi and Kristen Hallam, Modern Healthcare, 10/12/98.
  • "U.S. suit charges fraud by two big hospital chains," Kurt Eichenwald, The New York Times, 10/6/98.
  • "Justice Department joins lawsuit against Columbia/HCA, Quorum," Lucette Lagnado, The Wall Street Journal, 10/6/98.
  • "Justice joins Columbia/HCA lawsuit," Tom Lowry, USA Today, 10/6/98.
  • "U.S. in suit against Columbia/HCA," Robert A. Rosenblatt, Los Angeles Times, 10/6/98.
  • "Justice Department joins civil lawsuit against Columbia, Quorum," Miami Herald, 10/6/98.
  • "Government joins Columbia civil lawsuit," Kris Hundley, St. Petersburg Times, 10/6/98.
  • "Government joins civil suit against Columbia/HCA, Quorum," Julie Bell, The Tennessean, 10/6/98.
  • "Government joins in whistleblower lawsuit charging Columbia/HCA with Medicare fraud," Federal Contracts Report, 10/5/98.

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Quorum Health Group Inc.: Quorum, the nation’s largest hospital management company, paid the federal government $82.5 million in April 2001 to settle a whistleblower lawsuit that charged the company systematically defrauded Medicare for years by filing fraudulent "cost reports."

  • "Big hospital manager settles two fraud suits," Kurt Eichenwald, The New York Times, 10/3/00.
  • "Quorum to pay $95.5 million to settle two outstanding Medicare-fraud suits," Lucette Lagnado, The Wall Street Journal, 10/3/00.
  • "Quorum will settle fraud lawsuits for $95.5 million," Keith Russell, The Tennessean, 10/3/00.
  • "Quorum settles Medicare dispute," Kris Hundley, St. Petersburg Times, 10/3/00.
  • "Quorum settles Whitefish whistleblower case," Lynnette Hintze, The Daily Inter Lake, 10/3/00.
  • "Hospital subpoenas part of Quorum probe," Barbara Kirchheimer, Modern Healthcare, 4/5/99.
  • "Subpoenas issued in Quorum suit," The New York Times, 4/1/99.
  • "Subpoenas reignite Quorum civil probe," The Tennessean, 4/1/99.
  • "U.S. amends suit against Columbia and Quorum, alleging pattern of fraud," Lucette Lagnado, The Wall Street Journal, 2/3/99.
  • "Hospitals owned by Quorum said to overbill by $50 million," The New York Times, 2/3/99.
  • "No end in sight: Five-year probe of Columbia, Quorum keeps growing," Kristen Hallam, Modern Healthcare, 11/9/98.
  • "Patiently, and now with help, whistleblower waits," Kris Hundley, St. Petersburg Times, 11/5/98.
  • "Columbia probe has deep roots," Kristen Hallam and Deanna Bellandi, Modern Healthcare, 10/26/98.
  • "U.S. joins, unseals whistleblower lawsuit alleging Columbia/HCA, Quorum fraud," Drew Douglas, Health Care Fraud Report, 10/21/98.
  • "He blew the whistle, and health giants quaked," Kurt Eichenwald, The New York Times, Oct. 18, 1998.
  • "Making it a federal case; suit alleges widespread fraud by Columbia, Quorum," Deanna Bellandi and Kristen Hallam, Modern Healthcare, 10/12/98.
  • "U.S. suit charges fraud by two big hospital chains," Kurt Eichenwald, The New York Times, 10/6/98.
  • "Justice Department joins lawsuit against Columbia/HCA, Quorum," Lucette Lagnado, The Wall Street Journal, 10/6/98.
  • "Justice joins Columbia/HCA lawsuit," Tom Lowry, USA Today, 10/6/98.
  • "U.S. in suit against Columbia/HCA," Robert A. Rosenblatt, Los Angeles Times, 10/6/98.
  • "Justice Department joins civil lawsuit against Columbia, Quorum," Miami Herald, 10/6/98.
  • "Government joins Columbia civil lawsuit," Kris Hundley, St. Petersburg Times, 10/6/98.
  • "Government joins civil suit against Columbia/HCA, Quorum," Julie Bell, The Tennessean, 10/6/98.
  • "Government joins in whistleblower lawsuit charging Columbia/HCA with Medicare fraud," Federal Contracts Report, 10/5/98.

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Omnicare Inc.: The geriatric pharmaceutical care company paid $5.3 million in April 1998 to settle a qui tam lawsuit and civil charges of Medicaid fraud. The lawsuit and government charged that an Omnicare subsidiary in Illinois routinely recycled the unused drugs of dead nursing home patients and re-sold them to Medicaid for other nursing home patients.

  • "Omnicare pays $5.3 million to settle Medicaid whistleblower case," Health Care Fraud Report, 5/6/98.
  • "Omnicare pays $5.3 million to settle Medicaid whistleblower case alleging drug recycling," Federal Contracts Report, 4/27/98.
  • "Omnicare unit settles case for $5.3m," Tom Lowry, USA Today, 4/22/98.
  • "Whistleblowers get $217,000 in pharmacy firm’s fraud settlement," Roy Malone, St. Louis Post-Dispatch, 4/22/98.
  • "Omnicare pays $5.3m settlement," Ursula Miller, Cincinnati Enquirer, 4/22/98.
  • "Omnicare pays $5.3m to end drug complaint," Nick Miller, The Cincinnati Post, 4/22/98.

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Dr. Badrudin Kurwa: The California ophthalmologist agreed in December 1997 to pay $375,000 to settle a whistleblower lawsuit that charged he billed Medicare for services he never performed.

  • "California doctor settles fraud lawsuit for 10 times his Medicare payments," Federal Contracts Report, 12/17/97.
  • "Arcadia doctor to pay medicare fraud damages," David R. Olmos, Los Angeles Times, 12/10/97.
  • "California doctor to pay $375k to settle allegations of overcharging Medicare," Federal Contracts Report, 12/15/97.
  • "Doctor settles charges," Frank C. Giradet, Pasadena Star-News, 12/10/97.

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SmithKline Beecham Clinical Laboratories: SmithKline agreed in February 1997 to pay $325 million to settle three whistleblower lawsuits. It was the second largest settlement ever made in a health care fraud case. The whistleblowers and federal government claimed that the company performed unnecessary tests, billed for tests that weren’t performed and gave physicians inducements to use SmithKline. Phillips & Cohen represented whistleblowers in one of the three qui tam lawsuits that were brought against SmithKline.

  • "Anatomy of biggest whistleblower recovery yet," Anne Paxton, Laboratory Industry Report, March-April 1997.
  • "SmithKline to pay $325 million to settle federal claims of lab-billing fraud," Elyse Tanouye, The Wall Street Journal, 2/25/97.
  • "Drug firm to pay $325 million for overbilling," The New York Times, 2/25/97.
  • "Lab pays U.S. $325 million for overbilling," Roberto Suro, The Washington Post, 2/25/97.
  • "Laboratory firm settles fraud case," Mark Johnson, The Richmond Times Dispatch, 2/25/97.
  • "Drug firm pays $325m in fraud case; settlement for overbilling is second largest of its kind," Steven Findlay, USA Today, 2/25/97.
  • "SmithKline to pay $325 million in whistleblower suit," Shannon P. Duffy, The Legal Intelligencer, 2/25/97.
  • "Laboratory firm settles fraud case," Mark Johnson, The Richmond Times Dispatch, 2/25/97.
  • "Drug firm pays $325M in fraud case," Steven Findlay, USA Today, 2/25/97.

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Damon Clinical Laboratories Inc. (Corning Clinical Laboratories Inc.): Damon paid a total of $119 million in October 1996 to settle a whistleblower lawsuit and criminal charges that it had defrauded Medicare by performing and billing for unnecessary medical tests. Phillips & Cohen represented whistleblowers in one of the two lawsuits that were brought against Damon.

  • "Corning to pay largest lab fraud probe penalty," Lisa Scott, Modern Healthcare, 10/14/96.
  • "Guilty plea OK’d in record $119m health-fraud case," Ralph Ranalli, The Boston Herald, 10/11/96.
  • "Whistleblowers were ‘disgusted’ by scam," Mark Muellert, The Boston Herald, 10/11/96.
  • "Corning to pay $119 million to settle a case of Medicare billing by Damon," Paulette Thomas, The Wall Street Journal, 10/10/96.
  • "Corning will plead guilty to Medicare fraud," Milt Freudenheim, The New York Times, 10/10/96.
  • "Needham lab fined $119m for fraud," Kimberly Blanton, The Boston Globe, 10/10/96.
  • "Blowing the whistle has big rewards," Tina Cassidy, The Boston Globe, 10/10/96.
  • "Lab fined a record $119m for med scam," Ralph Ranalli, The Boston Herald, 10/10/96.

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MetPath (Corning Clinical Laboratories Inc.) and Unilab Corp.: The two independent medical testing labs agreed in September 1996 to pay a total of $11 million to settle a whistleblower lawsuit charging that they had overbilled Medicare and other government health-insurance programs by performing blood tests that had not been ordered.

  • "Corning Labs deal halts suit," Jerry DeMarco, The Record, 9/20/96.
  • "Two labs will pay $11 million to settle overcharging case," The San Francisco Daily Journal, 9/30/96.
  • "Unilab, Corning settle with feds for $11 mil," The Dark Report, 9/23/96.

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Corning’s MetPath division and MetWest (Unilab Corp.): The two medical laboratories in September 1993 paid a total of $39.8 million to settle a whistleblower lawsuit that alleged MetPath and MetWest had billed Medicare for unnecessary blood tests.

  • "Blood-testing labs pay U.S. $39.8 million," Spencer Rich, The Washington Post, 9/14/93.
  • "Corning unit, Unilab pay $39.8 million to settle allegations of Medicare fraud," Rhonda L. Rundle, Wall Street Journal, 9/14/93

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National Health Laboratories Inc.: NHL paid $110 million in December 1992 to settle a whistleblower lawsuit that charged the company routinely billed Medicare for unnecessary blood tests.

  • "Lab firm to pay $110 million in blood test fraud," Dana Priest, The Washington Post, 12/19/92.
  • "$110 million payment set for fraud in health claims," Calvin Sims, The New York Times, 12/19/92.

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Scripps Clinic and Research Foundation: In the first settlement of a False Claims Act case since the law was amended in 1986, Scripps paid $355,000 in April 1988 to settle a whistleblower lawsuit that alleged the eye clinic had billed Medicare for unnecessary surgery and operations that were never performed. A doctor at the clinic paid $250,000 in August 1990 to settle his portion of the lawsuit.

  • "Medical whistleblowers," Frank Kuznik, Hippocrates, 10/98.
  • "Whistleblowers: No easy job, but more workers vie for the title," Deanna Bellandi, Modern Healthcare, 12/22/97.
  • "This doctor turned in a colleague for Medicare fraud," M. Carroll Thomas, Medical Economics, 1/7/91.
  • "Medical group to pay $355,000 to Medicare," Kathie Bozanich, Los Angeles Times, 4/29/88.
  • "Whistleblower's lawsuit accuses Scripps Clinic, eye doctor of fraud,"Claire Spiegel, Los Angeles Times, 8/9/87.

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