Patients at the Rose Cancer Center in Mississippi thought they were receiving the treatment they desperately needed to fight their devastating disease. Unbeknownst to them, however, the clinic physician, Dr. Meera Sachdeva, was diluting their medicine, billing for services not provided, and forcing unqualified staff to perform critical medical procedures. Moreover, in order to conceal her fraud, Dr. Sachdeva instructed staff to falsify medical records.
In addition to the obvious adverse effects on the health of patients, Dr. Sachdeva’s conduct also defrauded the federal government of millions of dollars in Medicare funds, as well as private insurers who provided insurance coverage for the cancer center’s unfortunate patients.
Dr. Sachdeva might still be getting away with this reprehensible conduct if not for a brave employee named Kristi Beeson. Shortly after being hired as a laboratory technician at Rose Cancer Center, Kristi began to suspect that Dr. Sachdeva was involved in something very sinister. Her suspicions were confirmed when she herself was bluntly told to “correct”irregularities in patient medical records.
Refusing to participate in Dr. Sachdeva’s horrific scheme, Kristi contacted the authorities and exposed Dr. Sachdeva’s criminal conduct. The United States District Attorney for the Southern District of Mississippi initiated a criminal prosecution of Dr. Sachdeva, and Kristi provided crucial assistance that ultimately led to Dr. Sachdeva’s conviction. In addition to receiving a twenty year prison sentence, Dr. Sachdeva forfeited approximately $5.7 million in assets she obtained by defrauding Medicare.
In addition to assisting the federal criminal prosecution, Kristi also filed a whistleblower lawsuit under the qui tam provisions of the False Claims Act. We are proud to have served as her counsel in this case along with Marlene Koury and Gordon Schnell of the Constantine Cannon firm, and Jonathan Barrett of Barrett Law, PLLC in Mississippi.
For more information on this case, follow the links below:
Law360, Washington (August 18, 2014, 5:36 PM ET) — The former owner of a chemotherapy clinic sentenced to two decades in prison for defrauding Medicare, Medicaid and private insurers will pay $5.7 million to end a related whistleblower False Claims Act suit in Mississippi federal court, counsel for the relator announced Monday.
Meera Sachdeva, a doctor and the former owner of the Rose Cancer Center in Summit, Mississippi, will pay the $5.7 million out of the more than $8.4 million in fines and restitution she had earlier agreed to pay in her related criminal case, according to an announcement from Constantine Cannon LLP, one of the firms representing relator Kristi Beeson.
Marlene Koury, a member of the firm’s whistleblower practice, said in a statement Monday that Beeson’s role in the case had demonstrated the “critical” role whistleblowers play in helping root out health care fraud, praising her for coming forward with her complaint.
“But for the courage of Ms. Beeson stepping forward, this outrageous conduct likely would have gone on for years, with Dr. Sachdeva taking advantage of people during the most vulnerable time of their lives,” Koury said.
Beeson, a former laboratory technician at the cancer center, had filed her complaint after witnessing a number of fraudulent practices at the clinic that were charged to government and private payers, including unqualified staff performing bone marrow biopsies, the use of single doses of drugs for multiple patients, and the falsification of patient records to charge for services that were not performed at all, according to the announcement.
After this misconduct was brought to the attention of the federal government, it launched a criminal probe, raided the clinic and eventually shut it down, charging Sachdeva, Rose office manager Brittany McCoskey and outside medical biller Monica Weeks — accused of helping to cover up claims due for an audit — with health care fraud in September 2011.
In the criminal case, which also saw Sachdeva charged with money laundering, prosecutors claimed that the clinic had billed payers for reimbursement of higher quantities of drugs than it had actually purchased, as well as reusing syringes and drawing multiple patients’ chemotherapy drugs from the same bag, meaning they did not receive the full dosage they should have, among other allegations. Medicare and Medicaid were billed for more than $15.1 million by the clinic across the relevant period, according to the indictment.
All three defendants pled guilty after reaching plea agreements in 2012, with Sachdeva receiving a total of 240 months in prison and being ordered to pay $8.4 million in fines. Weeks received three years’ probation and was ordered to pay nearly $22,000, while McCoskey received 13 months in prison and a $55,000 restitution order.
Beeson said in a statement Monday that she was pleased to see Sachdeva receive a prison sentence for her “harmful acts,” saying that the patients who had been mistreated by the doctor are now “receiving the correct medical treatment they deserve.”
For bringing her qui tam suit — unsealed last week with the resolution of the case, according to her counsel, although the case is still unable to be publicly accessed as of Monday afternoon — she will share with three other whistleblowers about $500,000 in proceeds from the forfeiture, with additional proceeds to go both to the government and private insurers, according to the announcement.
Beeson is represented by Patrick M. Barrett III of Barrett Law Office PLLC, by Marlene Koury of Constantine Cannon LLP and by Jonathan Barrett.
Counsel information for the government, Sachdeva and the other three whistleblowers wasn’t immediately available.
The criminal case is U.S. v. Sachdeva, case number 3:11-cr-00068, in the U.S. District Court for the Southern District of Mississippi. The civil case is in the same court, with further details not yet available Monday.
America’s taxpayers are in a long-term battle against powerful and well-funded corporate cheats and thieves.
Fraud is a core part of some company business plans, and incentivized integrity programs are a threat to their bottom line.
Opposition to federal and state False Claims Acts is entrenched. The liars are cunning and powerful.
Above all, they are patient.
For more than 25 years TAF and the TAF Education Fund have successfully promoted whistleblower laws and outreach.
As a result, the False Claims Act has survived attacks in Congress and at the Supreme Court. We have worked to amend and strengthen the law. We have worked to expand the False Claims Act to the states, and we have sparked the creation of new incentivized whistleblower legislation targeting tax fraud, securities fraud, and commodities trading fraud.
But corporate lobbyists still prowl Capitol Hill.
Apologists for fraud push and probe for weaknesses.
They suggest capping whistleblower awards, knowing such a move will remove incentives to bring large cases.
Eager to cap integrity, they are little less eager to put a cap on fraud!
Exclude officers and managers in fraud cases when scores of millions, and even billions of dollars have been stolen from the American people? They are opposed to that!
Require a salary cap for the CEOs of fraudster corporations as a condition of settlement? Let’s not be too hasty!
Increase staffing within DoJ’s Civil Division so that cases can be moved forward more expeditiously? They will never suggest it.
And why would they? Fraud against America’s taxpayers is big business. In fact, stealing money from the U.S. Treasury is so profitable that some fraudster companies now have lawyers on permanent retainer in Washington with the sole mission of undermining incentivized integrity programs.
The good news is the TAF Education Fund need only tell stories of success to show the power of current law.
Or, as Attorney General Eric Holder put it when asked about the Chamber of Commerce’s attempts to cap whistleblower awards:
“The Act has presently constructed, is working extremely, extremely well.… In the past 25 years, we have had nearly 8,000 qui tam cases filed, and they have yielded more than $21 billion in recoveries for the United States, $3.4 billion in recoveries to relators. In Fiscal Year 2011 alone, the Department recovered more than $2.7 billion in qui tam cases, and relators received about $530 million dollars as their statutory share.
The statute as it is presently constructed works, and works quite well.
I would be reluctant to fool around with a formula that for the past 25 year has been shown to be an effective tool in getting at fraud and incentivizing people to stay involved in the process, and working with government as partners.”
Three years and $15 billion additional dollars later, we couldn’t say it better ourselves.
Operators of the Lymphedema & Wound Care Institute Inc. in Houston have agreed to pay $4.3 million to settle a whistleblower’s allegations that they improperly billed Medicare for physical therapy treatments provided by unqualified therapists.
According to the whistleblower, a physician who treats patients with lymphedema, the defendants billed Medicare for lymphatic drainage therapy that was performed by massage therapists. Under Medicare rules, the subject therapy must be conducted by physical therapists in order to qualify for Medicare reimbursement.
As a reward for exposing this fraud by filing a False Claims Act lawsuit, the whistleblower will receive 19% of the settlement proceeds.
Caremark LLC (“Caremark”) agreed to pay $4.25 million to resolve a False Claims Act lawsuit alleging that it failed to reimburse Medicaid for prescription drug costs that should have been paid by private health insurance plans. Caremark is a pharmacy benefit management company operated by CVS Caremark Corp.
“Dual eligible” individuals are covered by Medicaid as well as private health insurance, but federal law requires that private insurers assume their health care costs. Medicaid is entitled to reimbursement of any prescription claims it pays for dual eligibles.
Using a computer claims processing program, Caremark allegedly cancelled claims for reimbursement submitted by Medicaid for dual eligibles, thereby shifting prescription drug costs to the government.
This False Claims Act lawsuit was filed by a former Caremark quality assurance representative, who will receive $505,680 from the federal government’s share of the settlement proceeds.
Vantage Oncology LLC, an owner and operator of radiation oncology centers, has agreed to pay more than $2.08 million to resolve a whistleblower’s allegations that it over-billed Medicare for radiation oncology services.
The government in this False Claims Act lawsuit accused Vantage of double billing for certain procedures, billing for services without proper supporting documentation, and billing for radiation treatment provided without required doctor supervision.
The whistleblower in this case, a former Vantage employee, will receive $354,450 as his share of the settlement proceeds pursuant to the qui tam provisions of the False Claims Act.
Basco Manufacturing Co. (“Basco”) has agreed to pay $1.1 million to resolve a whistleblower’s allegations that it made false customs declarations to avoid paying duties on products imported from China. The products involved were aluminum extrusions, which are used in the manufacture of shower enclosures.
As alleged by the whistleblower, Basco represented to the government that aluminum extrusions were imported from Malaysia, rather than China. By routing the products through Malaysia and misrepresenting their true origin, Basco avoided having to pay antidumping and countervailing duties applicable to Chinese products. The government claimed that Basco knew that the products were simply repackaged in Malaysia and were not substantially transformed to the extent that the country of origin could change from China to Malaysia.
By exposing this scheme through the filing of a False Claims Act lawsuit, the whistleblower is entitled to receive a share of the settlement proceeds. The amount of this share has not been determined.
Baptist Health Systems has agreed to pay $3,675,000 to resolve a whistleblower’s allegations that it violated the False Claims Act by failing to disclose insurance coverage applicable to treatment it provided to Medicare beneficiaries.
Under Medicare rules, providers are required to disclose the fact that a patient has other insurance when the provider submits claims to Medicare. In these instances, the claims are processed through the applicable insurance policy, with Medicare sometimes paying for the patient’s deductible or other out of pocket costs. By failing to disclose the existence of applicable insurance coverage, Baptist Health Systems caused the government to overpay Medicare claims from 2003 through 2007.
The whistleblower who exposed this practice through the filing of a False Claims Act lawsuit will receive $661,500 from the settlement proceeds.
Nursing home operator Ensign Group, Inc. has agreed to pay $48 million to resolve allegations that it billed Medicare for unnecessary rehabilitation therapy services.
These False Claims Act lawsuits involved billing for services provided at six skilled nursing facilities operated by Ensign in California. According to the whistleblowers’ allegations, Ensign provided medically unnecessary therapy to patients, and billed Medicare for services it had not provided. The government also contended that Ensign improperly incentivized its employees to increase the amount of therapy provided to Medicare patients regardless of the patients’ individual therapy needs.
The whistleblowers who filed these lawsuits, two therapists formerly employed with Ensign, will share in the settlement proceeds pursuant to the qui tam provisions of the False Claims Act. The amount of the whistleblowers’ share has not been announced.