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False Claims Act Settlements

Since the time of our Landmark Victory, Goldberg Kohn’s False Claims Act practice has developed a nationwide track record of success for our clients. By carefully crafting complaints, working cooperatively with the government, and litigating effectively against the most powerful law firms in the country, Goldberg Kohn has repeatedly obtained successful settlements for whistleblower clients.

Community Health Systems, Inc.

  • Goldberg Kohn represented former employees of Community Health Systems, Inc. (CHS) in a qui tam lawsuit alleging that the company knowingly billed government health care programs for unnecessary ER admissions in 119 of its hospitals.
  • According to the Department of Justice (DOJ), CHS allegedly “engaged in a deliberate corporate-driven scheme to increase inpatient admissions of Medicare, Medicaid and the Department of Defense’s (DOD) TRICARE program beneficiaries” and admitted patients when it was not medically necessary.
  • CHS agreed to pay $98.15 million to resolve these allegations. Criminal charges and Medicare fraud allegations against subsidiary Health Management Associates, LLC resulting from this initial suit were resolved by a separate $260 million settlement.
  • The original Goldberg Kohn suit is captioned United States ex rel. Plantz v. Community Health Systems, Inc., et al., Case No. 10C-0959 (N.D. Ill.). The DOJ combined this case with seven other qui tam cases from various districts after intervening.
  • For more information on these settlements and the criminal proceedings see the Department of Justice (DOJ) press releases here and here or Goldberg Kohn's press releases here and here.

Allergan, Inc.

  • Allergan, Inc., a global pharmaceutical company, agreed to pay $13 million to the federal government and 19 States to resolve allegations that they provided illegal kickbacks to ophthalmologists to induce them to write prescriptions for Allergan eye care products.
  • This suit was jointly filed and litigated by Goldberg Kohn and Philadelphia law firm Pietragallo Gordon Alfano Bosick & Raspanti, and is captioned United States ex rel. Herbert J. Nevyas, M.D. and Anita Nevyas-Wallace, M.D. v. Allergan, Inc., Civil Action No. 09-CV-00432 (E.D. Pa.).
  • For more information, see Goldberg Kohn's press release.

 IPC The Hospitalist Company, Inc

  • Goldberg Kohn represented a physician formerly employed by IPC in a qui tam lawsuit alleging that IPC engaged in a long-running "upcoding" scheme—encouraging physicians to bill for their services at the highest possible levels without regard for the services actually rendered, and in many cases billing for more services in one day than could possibly have been provided in a 24-hour period.
  • Team Health Holdings, Inc. acquired IPC in 2015 and agreed to pay $60 million to resolve these allegations.
  • The case is captioned United States ex rel. Oughatiyan v. IPC The Hospitalist, Inc., et al., Civil Action No. 09 C 5418 (N.D. Ill.). Goldberg Kohn attorneys prosecuted the case alongside government attorneys from the DOJ and the United States Attorney's Office.
  • For more information, see the DOJ press release, Goldberg Kohn's press release, or this article by the Chicago Daily Law Bulletin.

Allen School of Health Sciences

  • Settlements totaled $4.29 million in a case brought by a Goldberg Kohn client against the Allen School of Health Sciences, a for-profit school, and its former Chief Operating Officer.
  • This case is captioned United States ex rel. Joshua Cage v. The Allen School and Jason Reich, Case No: 1:13-cv-04431 (S.D.N.Y.).
  • The government intervened and litigated this case. For more information, see the DOJ press release or this Goldberg Kohn whistleblower blog post on higher education incentive compensation fraud, which also briefly mentions this case.

Education Management Corp.

  • Education Management Corp. (EDMC), a for-profit college company, agreed to pay $95.5 million to resolve allegations that it falsely certified compliance with Title IV of the Higher Education Act and parallel state statutes in order to receive federal and state grant and loan monies.
  • The settlement amount reflected EDMC's financial situation and its ability to pay; the suit alleged billions in damages.
  • Goldberg Kohn was co-lead counsel to the whistleblowers who originated the case. The original case which Goldberg Kohn helped litigate is captioned United States ex rel. Washington et al. v. Education Management Corp., et al., Civ. No. 07-461 (WDPA). The DOJ and the states of California, Florida, Illinois, and Indiana joined the suit, and it was combined with three other cases filed in Pennsylvania and Tennessee.
  • For more information see the DOJ press release on the settlement or this New York Times article covering the government's intervention in the case.

Shire Pharmaceuticals LLC

  • Shire agreed to pay $56.5 million to resolve allegations that they illegally marketed and promoted several drugs including Adderall XR despite a lack of clinical supporting data.
  • This original Goldberg Kohn suit is captioned United States ex rel. Hsieh, Harris, and Clark v. Shire PLC, et al., No. 09-6994 (N.D. Ill.). 
  • For more information, see the DOJ press release or Goldberg Kohn’s press release. While Shire is a global pharmaceutical company, it is headquartered in the United Kingdom; thus, this lawsuit made waves in the London Times as well.

Omnicare, Inc.; Morris and Philip Esformes 

  • Goldberg Kohn represented a former employee of Total Pharmacy in a qui tam lawsuit alleging that Omnicare's $32 million purchase of Total Pharmacy included a multimillion-dollar kickback to secure long-term pharmacy contracts with more than two dozen nursing homes operated by Morris and Philip Esformes, who also owned Total Pharmacy.
  • Omnicare agreed to pay $17.2 million to the government to settle its part of the ongoing lawsuit, and the individuals later settled for $5 million.
  • This case received significant press coverage by the Chicago Tribune, which reported on the ruling denying summary judgment here, the settlement announcement here, Omnicare's previous $17.2 million separate settlement agreement here. The Tribune also reported on Philip Esformes' later federal indictment—this $1 billion Medicare indictment is the largest case ever brought against an individual by the DOJ.
  • For a brief description of the district court ruling, see our "Other False Claims Act Successes" webpage. The case is captioned United States ex rel. Nehls v. Omnicare Inc. et al., Case No. 1:07-cv-05777 (N.D. Ill.).

Rush University Medical Center

  • Goldberg Kohn represented two former employees in a qui tam lawsuit against Rush University Medical Center ("Rush"), which alleged in part that the hospital submitted false claims to Medicare from 2000 to 2007 by entering into certain leasing arrangements for office space with two individual physicians and three physician practice groups in violation of the Stark Law.
  • Rush agreed to settle these allegations for $1.5 million. For more information, see the DOJ’s press release.
  • Several matters remained unresolved by this first settlement, including allegations that the orthopedic practice at Rush was falsely billing Medicare for surgeries that residents performed unsupervised. Though the District Court for the Northern District of Illinois initially dismissed the case, Goldberg Kohn successfully appealed and was able to obtain a favorable settlement after the the U.S. Seventh Circuit Court of Appeals reversed the dismissal. For more information on the appeal, see our "Other False Claims Act Successes" webpage.

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