OTHER
DA TE
ENTITY
FCA ALLEGATIONS
AMOUNT
A university agreed to pay $22 million to settle FCA allegations that it: (1) improperly billed at certain hospital facilities that were converted from physician offices because it failed to provide proper notice to beneficiaries of the conversion, even after a Medicare Administrative Contractor informed the university that its notice practices were deficient; (2) billed for laboratory tests that were not medically necessary; and (3) caused a hospital to submit inflated claims for laboratory testing performed at a related institute in violation of related party regulations, by controlling the hospital’s decision to purchase the tests at inflated rates in exchange for the university’s surgeons continuing to perform surgeries at the hospital. The hospital reached a separate settlement related to these last allegations. 163 Private equity owner of a mental health clinic operator agreed to pay $19.95 million, and two former executives of the clinic operator agreed to pay $5.05 million, to resolve FCA allegations that they: (1) knew the clinic operator employed individuals who were unlicensed or unqualified to perform the services they were providing, or who provided services in unsupervised settings, in violation of state Medicaid regulations; and (2) caused false claims to be submitted to the Massachusetts Medicaid agency by failing to adopt recommendations to bring the operator into compliance. The mental health services operator entered into a prior settlement relating to the allegations. 164
University of Miami
5/10/2021
$22 million
H.I.G. Growth Partners, LLC; H.I.G. Capital, LLC; Peter J. Scanlon; Kevin P. Sheehan
10/14/2021
$25 million
163 https://www.justice.gov/usao-sdfl/pr/university-miami-pay-22-million-settle-claims-involving-medically-unnecessary. 164 https://www.mass.gov/news/private-equity-firm-and-former-mental-health-center-executives-pay-25-million-over-alleged-false-claims-submitted-for-unlicensed-and-unsupervised-patient-care.
NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 78
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