Tampa – United States Attorney Maria Chapa Lopez announced today that the Middle District of Florida (MDFL) collected $276,324,126.35 in criminal and civil actions in the fiscal year ending September 30, 2020 (FY 2020). Of this amount, $99,349,069.35 represents collections from locally handled criminal and civil actions, including $65,223,665.55 in civil actions and $34,125,403.80 in criminal actions.
The MDFL’s Civil Division, led by Civil Chief Randy Harwell, recovered a total of $222,965,488 on behalf of federal agencies and programs in affirmative civil enforcement cases during the last fiscal year. This amount has two components. In addition to its efforts in local civil cases noted above, the district’s Civil Division also joins forces with other U.S. Attorney’s Offices and with the Department of Justice Civil Frauds Section to address fraud schemes and illegal practices extending beyond district boundaries. The MDFL’s Civil Division recovered an additional $157,741,823 in these jointly handled cases.
Additionally, the district’s Asset Recovery and Victims’ Rights Division, led by Chief Anita Cream, recovered $19,233,234 in asset forfeiture actions last fiscal year. Forfeited assets deposited into the Department of Justice Assets Forfeiture Fund are used to restore funds to crime victims and for a variety of law enforcement purposes. For instance, in FY 2019, nearly $21 million forfeited in the MDFL in this and prior years was returned to victims of the criminal offenses upon which the forfeitures were based, and more than $4.5 million was shared with federal, state, and local law enforcement agencies.
“Through our collaborative work with our federal, state, and local law enforcement partners, our collection efforts have resulted in the recovery of millions of dollars from convicted criminals and others who have benefitted from fraud and other illegal activities,” said U.S. Attorney Chapa Lopez. “These collected funds will assist victims in their recovery and assist law enforcement as they continue to hold criminals accountable for their crimes.”
U.S. Attorneys’ Offices, along with the department’s litigating divisions, are responsible for enforcing and collecting civil and criminal debts owed to the U.S. and criminal debts owed to federal crime victims. The law requires defendants to pay restitution to victims of certain federal crimes who have suffered a physical injury or financial loss. While restitution is paid to the victim, criminal fines and felony assessments are paid to the department’s Crime Victims’ Fund, which distributes the funds to state victim compensation and victim assistance programs.
The largest civil collections were from affirmative civil enforcement cases, in which the United States recovered government money lost to fraud or other misconduct or collected fines imposed on individuals and/or corporations for violations of federal health, safety, civil rights, or environmental laws. In addition, civil debts were collected on behalf of several federal agencies, including the U.S. Department of Housing and Urban Development, the U.S. Department of Health and Human Services, the Defense Health Agency, the Internal Revenue Service, the Small Business Administration, and the Department of Education. See below for MDFL significant civil case highlights.
CIVIL HEALTHCARE ENFORCEMENT CASE SUMMARIES
United States ex rel. Gardner v. Universal Health Services, Inc., et al., case no. 3:12-civ-608 (M.D. Fla.)
A whistleblower filed a complaint under the qui tam provisions of the False Claims Act, alleging that a nationwide provider of behavioral health services, Universal Health Services, Inc., had defrauded federal health programs in a variety of ways, notably by submitting bills for behavioral health services provided to ineligible patients, failing to discharge patients when they no longer needed inpatient or residential treatment, and improper use of physical and chemical restraints and seclusion. While the investigation was underway, seventeen other qui tam cases were filed against the defendants that made overlapping allegations. These cases were transferred to the Eastern District of Pennsylvania where Universal Health maintains its corporate headquarters, and, on July 20, 2020, the cases were globally settled for $122,000,000. Of this amount, $88,124,761 was paid to the United States, with the balance paid to participating state Medicaid plans. In terms of total settlement amount, this is the fifth largest civil health care settlement in the history of the Middle District of Florida. Press release: www.justice.gov/opa/pr/universal-health-services-inc-and-related-entities-pay-122-million-settle-false-claims-act
United States ex rel. Cho v. Surgery Partners, Inc., et al., case no. 8:17-civ-918 (M.D. Fla.)
Within a span of only a few days, two separate whistleblowers filed two qui tam complaints (one in the Eastern District of Pennsylvania and one in the Middle District of Florida) that alleged a large Tampa pain management practice, Tampa Pain Relief Centers, conspired with a local laboratory, Logan Laboratories, and their corporate owner, Surgery Partners, Inc., to defraud federal health programs through claims for medically unnecessary urine drug testing services. The United States intervened in order to settle these claims, and recovered $41,000,000, of which $40,741,823 was paid to the federal government. The balance was paid to state Medicaid plans. Press release: www.justice.gov/opa/pr/reference-laboratory-pain-clinic-and-two-individuals-agree-pay-41-million-resolve-allegations
Opthalmic Consultants, P.A.
A civil investigation was opened into the practices of this Sarasota ophthalmology practice and its co-owners, Robert Snyder, M.D. and Paul Runge, M.D., based upon a referral from the local Medicare integrity contractor. The investigation concluded that from 2013 through 2017, the practice and the two physicians had submitted false claims to Medicare, Tricare, and federal employee health benefit plans arising from treatment of eye conditions. Specifically, the investigation concluded that they had improperly engaged in a practice known as “multi-dosing” (using a single vial of medication to provide doses to multiple patients) in order to receive reimbursement to which they were not entitled. On June 20, 2020, the practice and Dr. Snyder agreed to pay $4.8 million to resolve these civil claims. Press release: https://www.justice.gov/usao-mdfl/pr/sarasota-based-ophthalmic-consultants-agrees-pay-48-million-resolve-claims-multi-dosing
United States ex rel. Parker v. Florida Cancer Research Institute, et al., case no. 2:17-civ-428 (M.D. Fla.)
An employee of the Florida Cancer Research Institute filed a qui tam complaint after she contacted the VA Office of Inspector General’s hotline to report that the institute was being overpaid by the VA for physician-administered drugs. An agency audit following the hotline complaint determined that a mistake in the Fee Basis Claims System had led the Florida Claims Processing Centers to pay the full amount billed by the provider rather than the appropriate Medicare rate. Subsequently, the VA fixed the issue and the institute worked cooperatively with the United States to determine the amount of an overpayment, ultimately returning $2,341,508. Press release: https://www.justice.gov/usao-mdfl/pr/cancer-treatment-center-repays-more-234-million-resolve-civil-claims-pertaining
United States and State of Florida ex rel. Peters v. Hope Hospice and Community Services, et al., case no. 2:16-civ-6 (M.D. Fla.)
A former director of hospice care at a southwest Florida provider of hospice filed a qui tam lawsuit alleging that her former employer, Hope Hospice and Community Services, had defrauded Medicare through claims for reimbursement of medically unnecessary hospice care. The ensuing civil investigation concluded that from July 1, 2012 through June 30, 2016, the provider had submitted claims for services provided to hospice patients who were not terminally ill, in certain instances to patients for a period of over four years. On July 8, 2020, the United States announced a settlement of these civil claims in return for $3,200,000. Press release: https://www.justice.gov/usao-mdfl/pr/hope-hospice-agrees-pay-32-million-settle-false-claims-act-liability
United States ex rel. Silva et al. v. Vici Marketing, Inc., et al., case no. 8:15-civ-444 (M.D. Fla.)
In 2015, two former employees of Oldsmar Pharmacy filed a qui tam complaint alleging that the Tampa Bay area compounding pharmacy submitted claims for millions of dollars in reimbursement to the Tricare health program that were tainted by kickbacks. Among their allegations was that a marketing company owned by Scott Roix – Vici Marketing – was sending patient information to doctors, who certified the patients’ need for compounded pain creams. The compounding pharmacy defendants then billed Tricare for millions of dollars in reimbursement for these medically unnecessary creams. In August, 2018, the United States intervened in the qui tam lawsuit and filed its own complaint, alleging that Roix and his marketing companies fraudulently obtained insurance coverage information from consumers across the country, used that information to arrange for medically unnecessary prescriptions of pain creams, and sold the prescriptions to pharmacies under the guise of marketing services. The United States further alleged that the payments solicited from the pharmacies were based on the volume and value of the prescriptions. On August 1, 2019, the United States announced an ability to pay settlement with Mr. Roix and his marketing companies (HealthRight, LLC; Health Savings Solutions, LLC; Vici Marketing, LLC; and Vici Marketing Group, LLC) that resolved the allegations of the United States in its civil complaint for $2,500,000. The civil settlement also resolved claims that HealthRight, at the direction of Roix, received payments from Synergy Pharmacy that were based on the value and volume of prescriptions solicited by HealthRight on behalf of Synergy Pharmacy. These allegations were also the subject of a criminal case captioned United States v. Roix, et al., case No. 2:18-cr-133 (E.D. Tenn.), in which Roix and HealthRight pleaded guilty in September 2018. Press release: https://www.justice.gov/usao-mdfl/pr/telemarketer-and-his-companies-agree-pay-25-million-settle-allegations-they-operated
United States ex rel. Green et al. v. Tran, et al., case no. 5:15-civ-60 (M.D. Fla.)
In 2015, two relators filed a qui tam complaint alleging that a Villages dermatologist, Thi Thien Nguyen Tran, and his practice, Village Dermatology and Cosmetic Surgery, had defrauded Medicare through a variety of schemes. After a lengthy investigation, we substantiated that Dr. Tran had upcoded claims for complex wound repairs following Mohs surgery procedures, and billed them as adjacent tissue transfers in order to obtain Medicare reimbursement that he was not entitled to receive. On March 13, 2020, we intervened in order to settle these claims in return for $1,744,000. Press release: https://www.justice.gov/usao-mdfl/pr/villages-dermatologist-agrees-pay-more-17-million-settle-false-claims-act-liability