Case Results

“The District of South Carolina continues to devote significant resources to pursuing claims under the False Claims Act and this is yet another example of how this commitment is benefiting the taxpayers by recovering funds for the government.” – Bill Nettles

Claims involved the submission for services provided by physician assistants as though they had been performed by physicians, claims for testing and radiology services that were not medically necessary and claims for admission of Tetanus Immunoglobulin when Tetanus Toxoid were given which is considerably less expensive.  The investigation began with the filing of whistleblower lawsuits by former employees of Nason Medical.

“Health care fraud is a very high priority in this office.  We have shifted our office resources by trebling the number of attorneys dedicated to address civil fraud cases.  This case is particularly egregious because it involves allegations of profiting by exposing patients to unnecessary radiation in the CT scans.” – Bill Nettles

The investigation was prompted by a whistleblower who filed a lawsuit under the qui tam provision of the False Claims Act.“Combatting fraud against the government is a priority in this office; and importantly, holding accountable health care providers who have improper financial relationships with referral sources has been a focus.  Financial relationships between physicians for referrals can alter a physicians’ judgment as to what’s necessary and appropriate for a patient.  Our goal in this settlement was not only to recover money for improper healthcare claims, but to deter similar conduct and, in turn, promote health care affordability.” – Bill Nettles

“Medicare fraud is stealing, and it is crippling America’s health care system.  We have doubled the number of attorneys working these cases in South Carolina.  Take notice, if you are bilking the Medicare system designed to support our elders, we are working to find you.” – Bill Nettles

Allegations included that HCA submitted laboratory claims for low density lipids (LDL) when the tests were not ordered and/or medically necessary at four Florida hospitals.  They also contended that claims were submitted for fetal biophysical profiles with non-stress codes, then additionally submitted another claim for a standalone non-stress test at one of the Florida hospitals during the period of January 1, 2007 through September 26, 2014.  – “This office has made a substantial commitment to combating fraud.  Our commitment has made this district one of the leaders on behalf of the whistleblowers.  We hope that those who commit fraud will recognize that it is our goal to make the consequences more than just the cost of doing business.” – Bill Nettles

“Public health insurance programs shouldn’t foot the bill for drug company schemes that manipulate doctors and patients to maximize profits.  This is an excellent example of how the government can work with private whistleblowers to recover money for taxpayers.” – Bill Nettles

Kickbacks took the form of performance-based rebates that were tied to market-share or volume thresholds, as well as grants, speaker fees, consulting services, data fees, dinners and travel.

“The District of South Carolina has devoted significant resources over the last three years pursuing claims under the False Claims Act, and this settlement is the latest example of this office’s successful efforts.  I am very proud of the work this office has done in this area.” – Bill Nettles

It was found the companies increased the weights of shipments and storage of servicemember’s and federal employee’s household goods and then submitted claims for payment to the government for the inflated weights.  The case was handled by Assistant United States Attorneys Fran Trapp, Jennifer Aldrich and Stan Ragsdale.

“Fraud on the government is high priority in this office.  Monies paid to Covan for inflated weights could have been used for the benefit of our servicemembers.  Our aggressive pursuit of this case is further proof of our commitment to combat fraudulent claims made against the Federal Government.”- Bill Nettles

Default judgment awarded by the United States District Court of South Carolina against Lacy School of Cosmetology and Earnest “Jay” Lacy for presenting false claims to the U.S. Department of Education for student loans and grants.

“This use of the False Claims Act shows we are on the leading edge of qui tam litigation across the country.  Through this type of litigation, we continue our efforts to stop fraud and protect federal funds.” – Bill Nettles