Latest news with #Anti-KickbackStatute
Yahoo
10-06-2025
- Business
- Yahoo
Six Baron & Budd Shareholders Named to Lawdragon 500 Leading Plaintiff Financial Lawyers
DALLAS, June 10, 2025--(BUSINESS WIRE)--Six attorneys from the nationally recognized law firm Baron & Budd have been singled out again for their willingness to take on the largest corporations in the world on behalf of their clients. Baron & Budd shareholders Steve Baron, Russell Budd, Andrew Miller, William G. Powers, Scott Simmer and Roland Tellis are ranked among the Lawdragon 500 Leading Plaintiff Financial Lawyers in the United States. The Lawdragon list is compiled through nominations, independent research and vetting with other lawyers. Russell Budd and Steve Baron made the list for their work in consumer protection and class action cases. Russell Budd has been the firm's president and managing shareholder since 2002. For more than 40 years, he has successfully fought for the victims of corporate wrongdoing and individuals affected by asbestos. Currently, Budd serves as Co-Lead Counsel for the Attorney General litigation track in the Insulin Pricing MDL. Steve Baron heads the firm's mesothelioma and asbestos practice, which has secured large verdicts and settlements to cement Baron & Budd's reputation as a watchdog for consumer protection. Andrew Miller, William Powers and Scott Simmer, who work in the firm's Washington, D.C. office, were recognized for their work in whistleblower cases. Andrew Miller also made the list for his work on SEC, IRS and fraud litigation. His practice focuses on fraud and abuse litigation under federal and state False Claims Acts and represents clients with claims filed with the Whistleblower Offices of the Securities and Exchange Commission and the Internal Revenue Service. William Powers, who also was recognized for his expertise in consumer protection cases, is part of the firm's qui tam practice, specializing in litigation to combat civil fraud under the False Claims Act, Anti-Kickback Statute, and the Stark Law. Powers represents clients with claims filed with the Whistleblower Offices of the Securities and Exchange Commission and the Internal Revenue Service. Scott Simmer is a veteran litigator who specializes in rooting out deceit and fraud in hidden corners of government programs, education and healthcare industries. Simmer represents whistleblowers bringing qui tam cases of fraud under federal and state False Claims Acts as well as IRS, Securities and Exchange Commission (SEC) and Foreign Corrupt Practices Act (FCPA) whistleblowers. He also made the Lawdragon list for his work in investigations and SEC trials. Roland Tellis leads the firm's Los Angeles-based class action practice group. He specializes in consumer class actions, financial fraud, business torts, corporate misconduct, and automobile defects. About Baron & Budd, P.C. With more than 40 years of experience, Baron & Budd has the expertise and resources to handle complex litigation throughout the United States. As a law firm that takes pride in remaining at the forefront of litigation, Baron & Budd has spearheaded many significant cases for hundreds of public entities and tens of thousands of individuals. Since the firm was founded in 1977, Baron & Budd has achieved substantial national acclaim for its work on cutting-edge litigation, trying hundreds of cases to verdict and settling tens of thousands of cases in areas of litigation as diverse and significant as dangerous and highly addictive pharmaceuticals, defective medical devices, asbestos and mesothelioma, wildfires, environmental contamination, fraudulent banking practices, e-cigarettes, motor vehicles, federal whistleblower cases and other consumer fraud issues. View source version on Contacts Debra CollierMarketing ManagerSteven T. BaronShareholderBaron & Budd,
Business Wire
10-06-2025
- Business
- Business Wire
Six Baron & Budd Shareholders Named to Lawdragon 500 Leading Plaintiff Financial Lawyers
DALLAS--(BUSINESS WIRE)--Six attorneys from the nationally recognized law firm Baron & Budd have been singled out again for their willingness to take on the largest corporations in the world on behalf of their clients. Baron & Budd shareholders Steve Baron, Russell Budd, Andrew Miller, William G. Powers, Scott Simmer and Roland Tellis are ranked among the Lawdragon 500 Leading Plaintiff Financial Lawyers in the United States. The Lawdragon list is compiled through nominations, independent research and vetting with other lawyers. Russell Budd and Steve Baron made the list for their work in consumer protection and class action cases. Russell Budd has been the firm's president and managing shareholder since 2002. For more than 40 years, he has successfully fought for the victims of corporate wrongdoing and individuals affected by asbestos. Currently, Budd serves as Co-Lead Counsel for the Attorney General litigation track in the Insulin Pricing MDL. Steve Baron heads the firm's mesothelioma and asbestos practice, which has secured large verdicts and settlements to cement Baron & Budd's reputation as a watchdog for consumer protection. Andrew Miller, William Powers and Scott Simmer, who work in the firm's Washington, D.C. office, were recognized for their work in whistleblower cases. Andrew Miller also made the list for his work on SEC, IRS and fraud litigation. His practice focuses on fraud and abuse litigation under federal and state False Claims Acts and represents clients with claims filed with the Whistleblower Offices of the Securities and Exchange Commission and the Internal Revenue Service. William Powers, who also was recognized for his expertise in consumer protection cases, is part of the firm's qui tam practice, specializing in litigation to combat civil fraud under the False Claims Act, Anti-Kickback Statute, and the Stark Law. Powers represents clients with claims filed with the Whistleblower Offices of the Securities and Exchange Commission and the Internal Revenue Service. Scott Simmer is a veteran litigator who specializes in rooting out deceit and fraud in hidden corners of government programs, education and healthcare industries. Simmer represents whistleblowers bringing qui tam cases of fraud under federal and state False Claims Acts as well as IRS, Securities and Exchange Commission (SEC) and Foreign Corrupt Practices Act (FCPA) whistleblowers. He also made the Lawdragon list for his work in investigations and SEC trials. Roland Tellis leads the firm's Los Angeles-based class action practice group. He specializes in consumer class actions, financial fraud, business torts, corporate misconduct, and automobile defects. About Baron & Budd, P.C. With more than 40 years of experience, Baron & Budd has the expertise and resources to handle complex litigation throughout the United States. As a law firm that takes pride in remaining at the forefront of litigation, Baron & Budd has spearheaded many significant cases for hundreds of public entities and tens of thousands of individuals. Since the firm was founded in 1977, Baron & Budd has achieved substantial national acclaim for its work on cutting-edge litigation, trying hundreds of cases to verdict and settling tens of thousands of cases in areas of litigation as diverse and significant as dangerous and highly addictive pharmaceuticals, defective medical devices, asbestos and mesothelioma, wildfires, environmental contamination, fraudulent banking practices, e-cigarettes, motor vehicles, federal whistleblower cases and other consumer fraud issues.
Yahoo
17-05-2025
- Business
- Yahoo
Fresno hospital kickback scheme was fueled by wine, cigars and Vegas strip clubs
In the Spotlight is a Fresno Bee series that digs into the high-profile local issues that readers care most about. Story idea? Email tips@ One of the most brazen — and costliest — hospital kickback schemes involving the region's largest hospital group took place inside a nondescript, palm tree-lined medical plaza in north Fresno. That's where a healthcare technology company founded with money from Community Regional Medical Center built an exclusive wine and cigar lounge, complete with private humidor lockers for cigar storage, a state-of-the-art smoke ventilation system, and luxury wines and liquors valued at about $1 million. Only a select few executives and physicians had access to the office-turned-lounge near First Street and Alluvial Avenue, known as 'HQ2.' It was a place where doctors, healthcare executives and physician group leaders were generously rewarded for using the company's electronic health record system and fraudulently referring patients in violation of several federal laws, according to a 2019 unsealed federal whistleblower lawsuit. The alleged conspirators planned to build a grander 'ranch' luxury retreat using funds generated from the kickback scheme, according to the complaint, which was unsealed Wednesday. The scheme came to light only after a 2017 building fire at the medical plaza revealed a cache of a thousand bottles of wine,arousing suspicions from the whistleblower, an accountant, of improper spending. The U.S. Attorney's Office announced Wednesday that Community Health System and healthcare technology affiliate Physician Network Advantage Inc. (PNA) have agreed to pay $31 million to the federal government to settle allegations that it violated the False Claim Act. Community Health System (CHS), Fresno's largest healthcare group, owns downtown Fresno's Community Regional Medical Center and the Clovis Community Medical Center, as well as a health plan and physician network. Community Medical Centers (CMC) is the name of the group that includes the hospitals and clinics under the CHS umbrella. PNA is a health care technology business founded and funded by CMC to support Fresno-area physicians' adoption of the electronic health records platform used by Community, according to federal prosecutors. PNA's CEO Chris Roggenstein is a 'longtime friend' of former CHS CEO Craig Castro, according to the lawsuit. At the heart of the complaint is a scheme that PNA provided lavish benefits to doctors and physician group executives in exchange for enrolling in CMC's electronic health record technology known as 'Epic EHR.' The lawsuit also alleges physicians and medical groups who joined the network made fraudulent referrals to CMC facilities in violation of the Anti-Kickback Statute. The kickback scheme involves several major players in Fresno's medical system, from hospital executives to medical records companies to some of the largest physician groups in the Central Valley. Some of the 17 luxury gifts, trips and donations listed in the lawsuit included: A trip to Paris, France for Castro and his family totaling approximately $63,000. A private plane for Timothy Joslin, former CEO of CRMC, to go to Las Vegas. Strip clubs and meals for CMC executives and physicians during a Las Vegas medical conference in January 2016. A $9,400 trip to Spain for Scott Wells, president of Santé Health and Santé Foundation, as well as Joyce Fields-Keene CEO of Central California Faculty Medical Group, or CCFMG (now known as Inspire Health Medical Group). 'The whistleblower lawsuit makes claims regarding personal choices that don't reflect our high standards as a non-profit health system, or the values of our current leadership team and board. And a number of elements in the 2019 lawsuit reflect either inaccurate or incomplete information,' said Michelle Von Tersch, senior vice president and chief of staff for CHS. In a statement, PNA said it cooperated with the Civil Division of the U.S. Attorney's Office in Sacramento in its review of Community Health System's electronic medical records program that began nearly 15 years ago. 'The settlement brings this matter to a conclusion without any determination or admission of legal liability for PNA,' the statement said. Thirty-five doctors were known to have received payment from CHS, according to the settlement agreement. According to the complaint, CMC embarked on the seven-year, $75 million quality improvement initiative in or around 2010 to replace their business and clinical data system with new technology — the Epic EHR system. CHS Board Chair Roger Sturdevant said that, in 2009, the federal government directed the healthcare industry to transition to electronic health records, which CHS did to provide patients with a 'robust, consistent, and secure electronic health records system.' 'However, it is clear we needed stronger oversight measures to assure that both Community and our vendor partner maintained appropriate compliance at all times.' Sturdevant told The Bee in a statement. 'While we are confident that physician referrals were driven by Community Health System's position as a leading provider of hospital-based and specialty services, we recognize that even the appearance of inappropriate incentives must be addressed.' In 2010, Physician Network Alliance, Inc. was formed with the sole purpose and business function of expanding defendant CMC's Epic EHR network of Fresno area medical practices — and to shelter the illegal kickback payments and elaborate gifts, the lawsuit says. According to the complaint, as early as 2011 CMC and PNA started giving kickbacks to Fresno-area physicians in the form of cash, expensive wine, strip-clubs, trips with private planes, and free or heavily discounted access to the Epic EHR software. PNA would bring in physicians and doctors groups into the network, all of which were subject to approval by CMC. In or around 2014 and 2015, CMC and PNA changed their building model so that PNA could retain some of the money received from the physician group, licensing fees and other monthly fees for maintenance and support of the Epic EHR system. Defendant PNA was able to retain a cash surplus from the Epic EHR client fees, so PNA began to use the excess cash for extra gifts and travel for CMC executives and CMC network physicians, such as the European and Vegas trips. PNA allegedly provided jobs to family members of CMC executives at the request of CMC. The HQ2 cigar lounge was constructed sometime after 2014 with an estimated $1.1 million of CMC funds, the complaint said. Michael Terpening, the former controller for PNA, discovered the 'illegal activity' after a fire at PNA's headquarters in 2017, in which 40 to 50 boxes of wine — totaling 1,000 bottles — were found in a storage room. When Terpening approached his boss Roggenstein about the wine, he was told it was 'leftover from the holiday party.' Terpening and his attorney could not be reached for comment. Discovery of the wine surplus led Terpening to become suspicious of other large expenditures submitted as deductible 'business expenses' for PNA, the complaint said. But, according to the complaint, Roggenstein ignored Terpening's advice to cease the illegal activity, and instead 'redoubled his criminal efforts.' Roggenstein and CMC had plans to build out the 'HQ Ranch,' a luxury retreat for CMC executives and physician practices that would include a cigar and wine lounge 'large and grander in scale than HQ2,' a skeet shooting range and a small off-road vehicle course. 'Once he realized that neither Defendant Mr. Roggenstein, Defendant PNA, nor Defendant CMC had any intention of remedying the above conduct, and in an effort to quit the illegal conspiracy, Mr. Terpening resigned from his position as a Controller for Defendant PNA,' the complaint said. The lawsuit alleged the defendants violated three federal laws through its kickback scheme: the Anti-Kickback Statute, the False Claims Act and the Stark Law. The Anti-Kickback Statute makes it a crime to knowingly and willingly offer, pay, solicit or receive any remuneration to induce a person to refer to an individual for the furnishing of any item or service covered under federal healthcare program. Claims submitted knowingly and in violation of the Anti-Kickback Statute constitute a 'false or fraudulent' claim under the False Claims Act, according to the lawsuit. The Stark Law prohibits a physician or medical provider from referring Medicare patients for certain services to an entity with which a physician's immediate family has a financial relationship. The 2019 complaint lists several defendants, including: Fresno Community Hospital and Medical Center; Physician Network Advantage, Inc.; Santé Health System; Santé Health Foundation; Berj Apkarian; Craig Castro; Central California Faculty Medical Group; Timothy Joslin; Michael Muruyama; Grant Nakamura; Patrick Rafferty; Christopher Roggenstein; and Michael Synn. On Tuesday, summons were issued to the defendants. In court filings, the U.S. The Attorney's Office said it chose not to intervene at this time given the settlement with defendants Santé Health System, Inc., Santé Health Foundation, Central California Faculty Medical Group, Grant Nakamura and Michael Synn. But it has left open the possibility that it may take action pending further investigation. A scheduling conference is set for Aug. 21 at 11:30 am in the Yosemite Federal Courthouse with Magistrate Judge Helena M. Barch-Kuchta.
Business Wire
05-05-2025
- Business
- Business Wire
Former Justice Department Litigator Aleza Remis Joins Hicks Thomas
HOUSTON--(BUSINESS WIRE)--Hicks Thomas LLP announced today that , former assistant deputy chief of the Department of Justice Health Care Fraud Unit, has joined the firm's Houston office as senior counsel. 'We are thrilled to welcome Aleza to the firm,' said Hicks Thomas partner John B. Thomas. 'She is an experienced and talented trial lawyer. Given her Department of Justice background, not only will she be a great resource to our managed care practice, but her standup trial experience will be in great demand given our firm's active civil trial docket.' During nearly 10 years at the Department of Justice, Ms. Remis investigated and prosecuted white-collar crime within the health care industry. In her role as assistant deputy chief of the Health Care Fraud Unit, she led the Texas Strike Force, which targets fraudulent providers and works to combat the opioid crisis. In addition to trying multiple federal criminal trials, her litigation experience includes countless investigations and securing trial convictions and guilty pleas against medical professionals, executives and company owners involved in fraud, Anti-Kickback Statute violations and pharmaceutical drug crimes. 'I am looking forward to this next stage of my career,' said Ms. Remis. 'Joining a firm with such an active trial docket will allow me to keep my trial skills sharp as I apply my litigation experience to the civil trial arena.' Before joining the Justice Department, Ms. Remis clerked for the Honorable Gregg J. Costa on the U.S. Court of Appeals for the Fifth Circuit. She also served as an adjunct professor at The University of Texas School of Law, her alma mater. Ms. Remis received her undergraduate degree from Vanderbilt University. Founded in 1997, Texas-based Hicks Thomas LLP is a premier litigation firm representing plaintiffs and defendants across the nation. With offices in Houston, Austin, Beaumont, Amarillo, and Sacramento, California, the firm provides in-depth experience in cases involving oil and gas (upstream, midstream and downstream), construction, environmental, complex commercial, toxic tort, products liability, corporate governance, securities, banking, insurance coverage, transportation, trade secrets and general business litigation. Learn more:
Yahoo
25-03-2025
- Yahoo
Wisconsin man ordered to pay $2.2 million in restitution to Medicaid/Medicare and 21 month prison sentence
(WFRV) – A Wisconsin man was sentenced on March 21 to 21 months in prison for paying healthcare kickbacks in violation of the Anti-Kickback Statute, as well as a restitution payment of over $2 million to Medicaid and Medicare with a $75,000 fine. According to a release from Richard G. Frohling, Acting United States Attorney for the Eastern District of Wisconsin, Justin Drew Hanson and his co-defendant, in prison on similar charges, owned a Milwaukee-area clinical labratory called 'Noah Associates.' Suspect arrested after fleeing and threatening Green Bay police with a knife In 2017, the two worked on a three-year scheme to pay kickpacks to a Milwaukee substance use treatment clinic owner in return for referrals of Medicaid and Medicare patients for urine drug testing. 'The Anti-Kickback Statute 'prohibits the knowing and willful payment of 'remuneration' to induce or reward patient referrals or the generation of business involving any item or service payable by the Federal health care programs.' United States Department of Health and Human Services The duo produced false agreements to conceal the fraud, paying about $400,000 in kickpacks for these tests, which weren't ordered by any physician and unnecessary for treatment. Medicaid and Medicare paid Noah Associates over $2.2 million for these tests. Hanson received several hundred thousand dollars during this scheme. United States District Judge J.P. Stadtmueller emphasized that Hanson manipulated and breached the trust of two important programs to receieve millions of dollars he didn't earn. Judge Stadtmueller specifically noted that he stole from 'every taxpayer in the country.' Allong with the prison sentence, fines and $2.2 million in restitution, Hanson will no longer be allowed to participate in either Medicaid and Medicare; in addition, Noah Associates has been shut down. Police in Wisconsin clear driveway of snow following welfare check 'Rather than bill the government for tests that patients truly needed, Hanson abused the Medicaid and Medicare programs for his own benefit,' Acting U.S. Attorney Frohling said via the release. 'The United States Attorney's Office is committed to working with its law enforcement partners to hold individuals who engage in these schemes accountable for their actions.' No additional details were provided. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
