This collection contains health care-related fraud settlements between states and/or the federal government and private companies that generally result from complaints filed under the False Claims Act. Many of the settlements are accompanied by Corporate Integrity Agreements (CIA). Some settlements have the compliance terms included within their text. In some cases PLUS does have original or amended complaints. The cost for each settlement with any available CIA, if requested, is $27 plus shipping, handling and any applicable state tax.
| Parties | Court | Amount |
| Fraud/Topic | Date | CIA? | |
|
| U.S. v. Lankenau Hosp. |
E.D. Pa. |
$303,684 |
 |
| Billing codes |
12/23/99 |
N |
|
| U.S. v. Methodist Hospital (Pa.) |
E.D. Pa. |
$103,432 |
|
| Misuse of pneumonia diagnosis code |
12/22/99 |
Y |
|
| U.S. v. Ronald Landefeld |
N.D. Ohio |
$100,000 |
|
| Medicare fraud |
12/22/99 |
N |
|
| U.S. v. Hamilton Med. Cntr |
N.D. Ga. |
$1.2 mill. |
|
| Medicare/Medicaid upcoding |
12/17/99 |
N |
|
| U.S. v. Anthem BCBS of Connecticut |
D. Conn. |
$74 mill. |
|
| Fraudulent conduct |
12/6/99 |
Y |
|
| U.S. ex rel. Todarello v. Beverly Enterprises |
N.D. Cal. |
$175 mill. |
|
| Medicare billing |
12/3/99 |
Y |
|
| U.S. v. Medical Pathology Laboratory Ltd. |
S.D. Miss. |
$1.2 mill. |
|
| Medicare billing |
12/1/99 |
N |
|
| U.S. v. Mercy Health Srvcs (Farmington, Mich) |
W.D. Mich. |
$220,000 |
|
| Medicare false claims |
11/29/99 |
N |
|
| U.S. v. St. Charles Mercy Hospital |
N.D. Ohio |
$62,000 |
|
| Medicare billing |
11/26/99 |
Y |
|
| U.S. ex rel. Lance v. Ventura County (Calif.) |
C.D. Calif. |
$15.3 mill. |
|
| Medicare billing |
11/18/99 |
Y |
|
| U.S. v. Edgewater Med. Center (d/b/a Northside Operating Co.) |
N.D. Ill. |
$1 million |
|
| Medicare/Medicaid upcoding |
11/16/99 |
Y |
|
| U.S. v. Bon Secours Home Health/Hospice (BSH) Hospital |
D. Md. |
$20,250 |
|
| Medicare billing |
11/9/99 |
N |
|
| U.S. v. St. Vincent Mercy Medical Center |
N.D. Ohio |
$220,000 |
|
| Medicare billing |
11/8/99 |
Y |
|
| U.S. ex rel. Southeast Med. Consultants v. Coral Gables Hospital |
S.D. Fla. |
$3.6 mill. |
|
| Medicaid fraud |
11/4/99 |
N |
|
| U.S. v. Zander |
E.D. Calif. |
$169,023 |
|
| Medicare billing |
11/3/99 |
N |
|
| U.S. v. Atlantic General Hospital |
NA |
$64,290 |
|
| Patient dumping |
10/19/99 |
N |
|
| U.S. v. Aultman Hospital Hospital |
N.D. Ohio |
$385,000 |
|
| Medicare/Medicaid billing |
10/19/99 |
N |
|
| U.S. v. Community Health Partners of Ohio |
N.D. Ohio |
$91,000 |
|
| Medicare billing |
10/13/99 |
Y |
|
| U.S. ex rel. Health Outcomes Technologies v. E. Jefferson Gen. Hosp. |
E.D. Pa. |
$724,000 |
|
| Pneumonia miscoding |
10/8/99 |
Y |
|
| U.S. v. Western Reserve Care System |
N.D. Ohio |
$157,000 |
|
| Medicare billing |
10/6/99 |
Y |
|
| U.S. ex rel. Payne v. PennMed Consultants Inc. |
E.D. Pa. |
$2.1 mill. |
|
| Fraudulent cost reports |
10/4/99 |
Y |
|
| U.S. v. Dr's Hosp. of Wentzville |
NA |
$20,000 |
|
| Patient dumping |
10/99 |
N |
|
| U.S. v. San Joaquin Comm. Hospital |
NA |
$67,000 |
|
| Patient dumping |
10/99 |
N |
|
| U.S. v. Charter South Bend Behavioral Health Sys. |
NA |
$30,000 |
|
| Patient dumping |
10/99 |
N |
|
| U.S. v. Iowa Lutheran Hospital |
NA |
$12,500 |
|
| Patient dumping |
10/99 |
N |
|
| U.S. v. St. Joseph Health Center |
W.D. Mo. |
$172,228 |
|
| Medicare billing |
9/24/99 |
N |
|
| U.S. ex rel. SEAL v. SEAL (UCSD & UWMC) |
W.D. Wash. |
$8.3 mill. |
|
| Medicare billing |
9/15/99 |
N |
|
| U.S. v. Abram Kaplan Mem. Hospital |
M.D. Pa. |
$1,609.51 |
|
| False Medicare claims |
9/3/99 |
N |
|
| U.S. v. Holzer Med. Center |
S.D. Ohio |
$25,000 |
|
| Medicare/Medicaid billing |
9/2/99 |
N |
|
| U.S. v. Haig Gourdikian |
E.D. Calif. |
$145,000 |
|
| Medicaid fraud |
9/2/99 |
N |
|
| U.S. v. St. John's Episcopal Hospital |
NA |
$25,000 |
|
| Patient dumping |
9/99 |
N |
|
| U.S. v. Olean Gen hosp. |
NA |
$15,000 |
|
| Patient dumping |
9/99 |
N |
|
| U.S. v. Kaiser Found.. Hosp. |
NA |
$14,000 |
|
| Patient dumping |
9/99 |
N |
|
| U.S. v. Parkview Hosp. of Fort Wayne, Ind. |
N.D. Ind. |
$135,544 |
|
| Medicare billing |
9/1/99 |
N |
|
| U.S. v. Martin Luther Hospital Med. Center |
NA |
$7,500 |
|
| Patient dumping |
9/99 |
N |
|
| U.S. v. Community Hospital of Munster, In. |
N.D. In. |
$138,556 |
|
| Patient dumping |
9/1/99 |
N |
|
| U.S. ex rel. Mueller v. Walgreen |
M.D. Fla. |
$7.6 mill. |
|
| Prescription fraud |
9/99 |
N |
|
| New York v. Staten Island Univ. Hosp. |
|
$45 mill. |
|
| Medicaid overbilling |
9/99 |
N |
|
| U.S. v. Munster Medical Research Foundation d/b/a Community Hosp |
N.D.Ind. |
$138,556 |
|
| False claims for outpatient lab srvc |
9/1/99 |
N |
|
| U.S. ex rel. Cohen v. Mt. Sinai School of Medicine |
S.D. N.Y. |
$2.3 mill. |
|
| Improper receipt of excess funds |
9/99 |
Y |
|
| U.S. ex rel. Health Outcomes Technologies v. Chinese Hosp. |
E.D. Pa. |
$2.8 mill. |
|
| Pneumonia miscoding |
8/30/99 |
Y |
|
| U.S. and Ohio v. David M. Brown (Citywide Ambulance) |
S.D. Ohio |
$133,000 |
|
| Medicare upcoding |
8/26/99 |
N |
|
| U.S. v. Daleview Nursing Home (Paul DioGuardi) |
E.D. NY. |
$11,921 |
|
| Medicare billing |
8/25/99 |
N |
|
| U.S. v. Native American Health Services |
D.S.D. |
$101,000 |
|
| Medicare/Medicaid billing |
8/24/99 |
N |
|
| U.S. ex rel. Kent v. Nova Southeastern Univ. |
S.D. Fla. |
$4.2 mill. |
|
| Medicare/Medicaid billing |
8/19/99 |
Y |
|
| U.S. ex rel. Nieber v. Kap"olani Home Health |
D. Haw. |
$3.4 mill. |
|
| Medicare/Medicaid overbilling |
8/18/99 |
Y |
|
| U.S. v. James T. Jenkins |
S.D. Ill. |
$55,000 |
|
| Medicaid overpayments |
8/17/99 |
N |
|
| U.S. v. Eastern Shore Gastroentorology P.A. |
D. Del. |
$124,000 |
|
| False Medicare claims |
8/13/99 |
N |
|
| U.S. v. Lee County |
E.D. Va. |
$38,350 |
|
| False Medicare/Medicaid |
8/9/99 |
N |
|
| U.S. v. Baton Rouge General Medical Center |
M.D. Pa. |
$46,175 |
|
| False Medicare claims |
8/8/99 |
N |
|
| U.S. v. John Fletcher |
D.S.C. |
$90,000 |
|
| Medicare billing |
8/3/99 |
N |
|
| U.S. ex rel. Casey v. BC/BS of Colorado |
D.N.M. |
$13.5 mill. |
|
| Obstruct/fed. audit |
7/28/99 |
N |
|
| U.S. ex rel. Lent v. Berman (N.Y.) |
S.D.N.Y. |
$1.3 mill. |
|
| Fraudulent Medicare |
7/19/99 |
Y |
|
| U.S. ex rel. McLendon v. Olsten |
N.D. Ga., E.D. NY |
$51 mill. |
|
| Medicare fraud |
7/19/99 |
Y |
|
| U.S. v. Hemstead Park Nursing Home |
E.D. N.Y. |
$63,832 |
|
| Medicare billing |
7/19/99 |
N |
|
| U.S. ex rel. Health Outcomes Technologies v. Sharp Mem. Hosp. |
E.D. Pa. |
$863,000 |
|
| Pneumonia miscoding |
7/19/99 |
Y |
|
| U.S. ex rel. Hoffman v. William B. Kessler Mem. Hosp. |
D.N.J. |
$128,000 |
|
| Medicare billing Unnecessary med. equip. |
7/15/99 |
N |
|
| U.S. v. Mark Cicero |
E.D. Tex. |
$10,000 |
|
| Medicare billing |
7/14//99 |
N |
|
| U.S. v. Wilson Memorial Hospital |
S.D. Ohio |
$90,000 |
|
| Medicare billing/outpatient lab services |
7/1/99 |
N |
|
| U.S. v. Brigham & Women's Pathology Foundation |
D. Mass. |
$476,167 |
|
| Medicare billing |
6/30/99 |
N |
|
| U.S. v. Midlands Medical & Cristopher Gill |
D.S.C. |
$250,000 |
|
| Medicare false claims |
6/24/99 |
N |
|
| U.S. v. PHC-Mississippi, LLC and Jack Hilton, MD. |
S.D. MS. |
$963,736 |
|
| Medicare billing |
6/23/99 |
Y |
|
| U.S. v. Dearborn Regional Clinical Labs |
E.D. Mich. |
$500,000 |
|
| Medicare billing |
6/15/99 |
N |
|
| U.S. v. St. Joseph's Medical Center |
S.D. N.Y. |
$270,000 |
|
| Medicare billing |
6/4/99 |
Y |
|
| U.S. v. Trumbull Mem. Hospital (Ohio) |
N.D. Ohio |
$640,000 |
|
| Health insurance program overbilling |
6/2/99 |
Y |
|
| U.S. v. Bradford Regional Medical Center |
E.D. Pa. |
$495,000 |
|
| Federal health program billing |
6/1/99 |
N |
|
| U.S. ex rel. Robinson v. Medaphis Inc. |
W.D. Mich. |
$15 mill. |
|
| Medicare billing |
6/99 |
Y |
|
| U.S. v. Psych Systems Of Long Island |
E.D. N.Y. |
$144,000 |
|
| False Medicare claims |
6/1/99 |
N |
|
| U.S. ex rel. Health Outcomes Technologies v. Eaton Hospital (Doctors Hospital of Hyde Park) |
E.D. Pa. |
$4.5 mill. |
|
| Misuse of Medicare Codes |
5/27/99 |
Y |
|
| U.S. v. Integrated Health Services at Penn. Inc. |
E.D. Pa. |
$195,000 |
|
| Medicare/Medicaid billing for inadequate care |
5/17/99 |
N |
|
| U.S. v. Georgetown Univ. |
|
$5.3 mill. |
|
| Medicare Part B billing |
5/7/99 |
Y |
|
| U.S. v. Pacificare of Oklahoma |
D.D.C. |
$9 mill. |
|
| Overcharging FEHBP |
5/99 |
N |
|
| U.S. v. Fresenius Med. Care Holdings; NMC Diag. Svcs(DSI); BioTrax; SRC Hldng Co.; Clinical Diagn. Syst.; & NMC |
E.D. Pa. |
$16.5 mill. |
|
| Medicare billing |
5/99 |
Y |
|
| U.S. v. The Good Samaritan Medical Center (Zanesville) |
S.D. Ohio |
$437,000 |
|
| Medicare billing |
4/6/99 |
N |
|
| U.S. ex rel. Pijut v. Rich. J. Morgan & Assoc. |
E.D. Pa. |
$225,000 |
|
| Medicare upcoding |
4/6/99 |
N |
|
| U.S. v. Community Innovations Inc. |
E.D.N.C. |
$240,000 |
|
| Medicaid fraud |
4/1/99 |
Y |
|
| U.S. ex rel. Moore v. VillaView Community H. |
S.D. Cal. |
$51,000 |
|
| Illegal kickbacks |
3/19/99 |
Y |
|
| U.S. v. Infusion Mgmt. Services Inc. (HomeCare for IV therapy Concepts of America) |
N.D. Tex. |
$10 mill. |
|
| Fraudulent Medicare billing |
3/15/99 |
Y |
|
| U.S. v. DRs. Meera and Pravin Ghandy |
S.D. Ill. |
$137,000 |
|
| Medicaid billing |
3/15/99 |
N |
|
| U.S. v. New Age Pulmonary Diagnostics |
|
$400,000 |
|
| Medicare billing |
3/99 |
Y |
|
| Connecticut v. SunRise HealthCare Corp. |
|
$1.4 mill. |
|
| Improper billing |
2/17/99 |
N |
|
| U.S. v. Horizon West Inc. |
E.D. Ca. |
$4 mill. |
|
| Medicare fraud |
2/10/99 |
Y |
|
| U.S. v. Kings County Hosp. |
|
$82,000 |
|
| Patient dumping |
2/99 |
N |
|
| U.S. v. Catholic Healthcare West Central Calif. D/b/a Mercy Hospital |
|
$12,500 |
|
| Patient dumping |
2/99 |
N |
|
| U.S. v. East Orange General Hospital |
|
$85,000 |
|
| Patient dumping |
2/99 |
N |
|
| U.S. v. Santa Clara Valley Medical Center |
|
$10,000 |
|
| Patient dumping |
2/99 |
N |
|
| U.S. v. Torrance Memorial Medical Center |
|
$67,500 |
|
| Patient dumping |
2/99 |
N |
|
| U.S. v. Hanford Community Medical Center |
|
$10,000 |
|
| Patient dumping |
2/99 |
N |
|
| U.S. ex rel. Tossell v. Orlando Reg. Health Sys. |
M.D. Fla. |
$469,000 |
|
| Medicaid upcoding |
1/20/99 |
Y |
|
| U.S. v. BC/BS of Mass. |
NA |
$4.75 mill. |
|
| Secondary payer law violations |
1/20/99 |
N |
|
| U.S. v. Kaiser Found. Hosp. Santa Clara, Ca. |
|
$25,000 |
|
| Patient dumping |
1/99 |
N |
|
| U.S. v. DuBois Regional Medical Center |
W.D. Pa. |
$50,000 |
|
| Medicare ESRD billing |
1/99 |
N |
|
| U.S. v. Cedars-Sinai Medical Center |
|
$40,000 |
|
| Patient dumping |
1/99 |
N |
|
