Find Corporate Waste

Tag: Whistleblower

  • SSM Health Pays Nearly $1M After Pharmacy Copay Waiver Allegations

    SSM Health Pays Nearly $1M After Pharmacy Copay Waiver Allegations

    This case is an example of how the Trump Administration’s Department of Justice is clawing back billions of taxpayer dollars from fraud schemes throughout the country.

    The United States has reached a $939,290 civil settlement⁠ with SSM Health Care over allegations that the retail pharmacy at Saint Louis University Hospital routinely waived patient copays, causing Medicare and the Federal Employees Health Benefits Program to overpay for prescriptions.  

    DOJ says the conduct ran from September 2020 through February 2023, with pharmacy employees allegedly waiving or failing to collect copays. That is not a harmless discount. Routine copay waivers can steer patients to one pharmacy, hide the real prescription cost, and inflate what federal programs pay.

    The case began with a qui tam whistleblower suit filed under the False Claims Act. The whistleblower will receive $159,210, while SSM will also pay $150,000 in fees and costs. SSM did not admit liability and DOJ credited the company’s cooperation and remedial action.  

    For FCW, the takeaway is direct: when providers manipulate the economics behind federally reimbursed claims, the taxpayer is left holding the bill. Copays are not paperwork. They are part of the program-integrity firewall.

  • Aquatherm Pays $1.35M Over PPP Eligibility Allegations

    Aquatherm Pays $1.35M Over PPP Eligibility Allegations

    Aquatherm, L.P.⁠ agreed to pay $1,351,575.84 to resolve False Claims Act⁠ allegations that it improperly obtained a Paycheck Protection Program⁠ loan for which it was not eligible, according to the U.S. Attorney’s Office for the District of Delaware⁠.

    DOJ said Aquatherm received an $864,982 PPP loan in March 2021 after certifying that it and its affiliates had fewer than 300 employees. Under the applicable PPP rule, that employee count included domestic and foreign affiliates.

    According to DOJ, Aquatherm is 99% owned by Aquatherm Besitzgesellschaft mbH & Co. KG, a German company. The government alleged that Aquatherm exceeded the 300-employee limit when its domestic and foreign affiliates were included, making it ineligible for the loan. Aquatherm later received full forgiveness from the SBA.

    The settlement also resolved claims brought under the qui tam⁠ provisions of the False Claims Act. DOJ said the whistleblower will receive a share of the recovery.

    The case highlights a recurring PPP enforcement issue: affiliate headcount. For public-record screening, foreign ownership, control, affiliated entities, employee count, and forgiveness records can all create eligibility questions requiring verification.

  • Former Intelligence Contractor Pleads Guilty in Kickback Scheme

    Former Intelligence Contractor Pleads Guilty in Kickback Scheme

    A former Intelligence Community contractor pleaded guilty to conspiring to commit offenses against the United States after admitting that he solicited and accepted illegal kickbacks tied to government procurement.

    According to the DOJ⁠, David Duggin, 55, of Orrtanna, Pennsylvania, was a former senior systems engineer and on-site contractor at a U.S. government Intelligence Community agency. Prosecutors said Duggin and co-conspirators used his on-site access to sensitive information to help obtain government contracts for millions of dollars of hardware and software purchased by U.S. government customers.  

    The DOJ said Duggin received at least $510,000 in illegal kickbacks in exchange for influencing the procurement process to favor his co-conspirators. The alleged conspiracy began at least as early as June 2018 and continued through at least April 2024.  

    The case is being investigated by the Defense Criminal Investigative Service and the FBI Baltimore Field Office, with prosecutors from the Antitrust Division and the U.S. Attorney’s Office for the District of Maryland. The DOJ also highlighted the Procurement Collusion Strike Force⁠, which targets bid rigging, price fixing, market allocation, and related fraud affecting government spending.

    For Find Corporate Waste⁠, the case is another reminder that taxpayer-funded procurement fraud often depends on insiders, access, and certification-driven trust. 

  • Circle Medical to Pay $3.325M Over Alleged False Healthcare Claims

    Circle Medical to Pay $3.325M Over Alleged False Healthcare Claims

    San Francisco-based Circle Medical Care of California, Circle Medical Technologies, Inc., and Chief Medical Officer Dr. Nicole Tsang, D.O., agreed to pay $3,325,000 to resolve allegations that they submitted false claims to federal healthcare programs and California commercial insurers.

    According to the DOJ⁠, Circle operates an online telehealth platform offering mental health and primary care services through contract providers, including nurse practitioners and physician assistants. The government alleged that from January 1, 2018 through May 31, 2025, Circle submitted claims using the names and NPI numbers of rendering providers who did not actually provide or supervise the services billed. The claims allegedly involved programs including Medicare, Medicaid, and TRICARE.  

    The settlement allocates $475,000 to the United States and $2.85 million to California. The matter began as a qui tam whistleblower case filed by Jason Vellen, who will receive $80,750 from the federal recovery and $997,500 from California.  

    This case fits the broader Find Corporate Waste focus on healthcare payment integrity: claims data, provider identifiers, supervision rules, and federal program billing requirements can expose recoverable taxpayer losses. 

  • Ahold Delhaize USA to Pay $40M Over Allegedly Inflated Pharmacy Prices

    Ahold Delhaize USA to Pay $40M Over Allegedly Inflated Pharmacy Prices

    Ahold Delhaize USA Inc.⁠, the parent company behind supermarket pharmacy brands including Giant, Hannaford, Stop & Shop, Food Lion, and others, has agreed to pay $40 million to resolve False Claims Act allegations involving prescription drug pricing.

    According to the DOJ⁠, Ahold Delhaize allegedly reported inflated “usual and customary” prices on claims submitted to Medicare Part D, Medicaid, and TRICARE. Prosecutors said the company operated prescription savings programs that offered discounted prices to enrolled customers, but allegedly failed to report those discounted prices as the pharmacies’ usual and customary prices.

    That distinction matters because usual and customary prices can operate as ceiling prices in federal health care reimbursement formulas. The government alleged that by reporting higher prices, Ahold Delhaize caused federal health care programs to pay more than they should have paid on pharmacy claims.

    Of the $40 million settlement, $32.9 million represents the federal share, with the remainder going to participating states.

    The case began as a whistleblower action filed by Lawrence LaBenne, a Pennsylvania pharmacist at an Ahold Delhaize supermarket.

    He will receive $6,083,587 from the federal recovery.

    The settlement is another example of how pricing representations, claim-level billing data, and insider knowledge drive many False Claims Act recoveries.

    For Find Corporate Waste⁠, the case fits the broader enforcement pattern: federal programs rely on accurate certifications and truthful claim data, and public money can be recovered when those representations are allegedly false.

  • $56.5M Settlement Targets Medicare Diagnosis Codes Scheme

    $56.5M Settlement Targets Medicare Diagnosis Codes Scheme

    Community Care Health Network LLC, doing business as Matrix Medical Network, DPN USA, doing business as HealthFair, and Shahriah “James” Ekbatani agreed to pay $56.5 million to resolve False Claims Act allegations over unsupported Medicare Advantage diagnosis codes, the DOJ announced.

    Matrix will pay $36.5 million, HealthFair will pay $5 million, and Ekbatani will pay $15 million.

    The DOJ alleged the defendants caused Medicare Advantage Organizations to submit false or invalid diagnosis codes to CMS, increasing risk-adjusted taxpayer payments.

    Matrix allegedly used in-home assessments to report unsupported conditions. HealthFair allegedly used mobile assessment buses to report unsupported diagnoses under Ekbatani’s direction.

    The whistleblowers will receive major awards. Former Matrix employee Nancy Cahill will receive $7.3 million. Former HealthFair chief medical officer Dr. Robert Oristaglio Jr. will receive $3.6 million.

    Insiders with knowledge of unsupported diagnosis coding, chart-review pressure, mobile assessments, or Medicare Advantage billing failures may have information relevant to public-fraud enforcement.

    Find Corporate Waste helps protect insiders while exposing fraud, waste, and abuse in taxpayer-funded programs.

  • Contractors to Pay $3.6M Over False Veteran-Owned Small Business Certification

    Contractors to Pay $3.6M Over False Veteran-Owned Small Business Certification

    Two government contractors agreed to pay more than $3.6 million to resolve allegations involving False Claims Act and Contract Disputes Act liability tied to federal set-aside contracts, according to the DOJ.

    The settlement involves Officium Global LLC and Loyal Source Government Services LLC. Prosecutors said Officium Global allegedly submitted false or fraudulent claims for payment on seven service-disabled veteran-owned small business set-aside contracts awarded between May 2017 and June 2018.

    According to the settlement agreement, Officium Global was allegedly not entitled to those contracts because its management and daily business operations were not controlled by a service-disabled veteran. The DOJ said the company submitted, or caused to be submitted, false certifications and statements representing that it met all requirements to be a service-disabled veteran-owned small business when it did not.

    Officium Global will pay more than $1.8 million to resolve the False Claims Act allegations. Loyal Source Government Services will separately pay more than $1.8 million to resolve Contract Disputes Act allegations tied to alleged breaches of the same seven contracts.

    The case began as a qui tam lawsuit filed by relator Jeremy Lavin in the Middle District of Florida. Under the False Claims Act, private citizens may sue on behalf of the United States and share in the recovery.

    The DOJ said Lavin will receive more than $680,000 from the settlement proceeds.

    The case is United States ex rel. Lavin v. Loyal Source Government Services, LLC et al., No. 6:19-cv-958, in the U.S. District Court for the Middle District of Florida. 

    Find Corporate Waste tracks False Claims Act recoveries involving government contracting fraud, small-business set-asides, and eligibility certifications. Anyone with inside knowledge of set-aside control failures, pass-through contracting arrangements, or false small-business certifications may have information relevant to public-fraud enforcement.

  • Oglethorpe Pays $32M Over Medicare Overpayment Allegations

    Oglethorpe Pays $32M Over Medicare Overpayment Allegations

    Oglethorpe Inc. and three top executives agreed to pay $32 million to resolve False Claims Act allegations tied to Medicare overpayments at behavioral health facilities.

    According to the DOJ, Oglethorpe, its founder Robert Cohen, CEO John Picciano, and COO James O’Shea allegedly failed to return overpayments that the company’s own consultants had identified.

    The alleged overpayments involved Medicare beneficiaries admitted to Ridgeview Behavioral Hospital, Georgetown Behavioral Hospital, and The Woods at Parkside, despite allegedly not qualifying for inpatient psychiatric care.

    The case stands out because Oglethorpe had already entered a 2021 Corporate Integrity Agreement after an earlier FCA settlement. Following alleged violations, the defendants agreed to a 10-year exclusion from Medicare, Medicaid, and all federal health care programs beginning in July 2026.

    The lawsuit was filed by four former Oglethorpe employees under the FCA’s whistleblower provisions. Their relator share has not yet been determined.

  • VSoft to Pay Nearly $2.3M Over PPP Eligibility Allegations

    VSoft to Pay Nearly $2.3M Over PPP Eligibility Allegations

    VSoft Corporation has agreed to pay $2,291,927.07 to resolve False Claims Act allegations that it improperly obtained a second-draw Paycheck Protection Program loan.

    According to the DOJ, VSoft, an Atlanta-based banking and payment solutions provider, allegedly certified that it qualified as a small business with fewer than 300 employees when applying for a $1,259,732 PPP loan. Prosecutors alleged that VSoft was actually part of an international corporate structure with multiple locations worldwide and employee totals well above the second-draw PPP limit.

    This is exactly the kind of case Find Corporate Waste was built to track: follow the money, stop the fraud, and protect taxpayer dollars. Pandemic relief was designed to keep legitimate small businesses alive, not to subsidize companies that allegedly avoided size and affiliation rules.

    The case began as a whistleblower action under the False Claims Act: United States ex rel. GHGH2, Inc. v. Vsoft Technologies Corporation, Case No. 3:24-cv-999 (W.D.N.C.).

    The settlement resolves allegations only, with no determination of liability. But the message is clear: insiders, competitors, lenders, and data reviewers remain essential to exposing improper relief claims and helping recover public funds.

  • Canadian Steel Companies to Pay $19M Over False Claims Act Trade Fraud Allegations

    Canadian Steel Companies to Pay $19M Over False Claims Act Trade Fraud Allegations

    Two Canada-based steel companies and their owner have agreed to pay $19 million to resolve False Claims Act allegations involving evaded customs duties on imported steel.

    According to the DOJ, Farjess Inc., Royal Canadian Steel Inc., and part-owner and president Feroz Jessani allegedly failed to pay duties owed on flat-rolled steel manufactured in Europe and Asia.

    Federal officials said the companies represented that certain steel originated in Canada or the United States, when they allegedly knew the steel actually came from China, Indonesia, Italy, Turkey, or Vietnam.

    The alleged conduct occurred from May 2019 through January 2025.

    This case matters because trade fraud is not just a customs issue. It is a taxpayer issue, a market fairness issue, and a direct threat to American businesses that follow the rules.

    Importers are required to accurately declare the country of origin, value, duty status, and amount of duties owed when goods enter the United States. When those declarations are false, the government can lose revenue while competitors gain an unfair advantage.

    That is exactly why the False Claims Act remains one of the government’s strongest tools against corporate fraud.

    The statute allows the government to recover funds when false statements or fraudulent conduct cause financial harm to the United States.

    It also allows whistleblowers to bring cases on behalf of the government and share in any recovery.

    The whistleblower in this case was Shamsh Dhala, a broker who worked with Farjess Inc.

    Dhala filed the case under the qui tam provisions of the False Claims Act in the Eastern District of Michigan.

    The case is captioned United States ex rel. Dhala v. Royal Canadian Steel Inc. et al., No. 2:23-cv-12097.

    As part of the settlement, Dhala will receive approximately $3.61 million.

    For Find Corporate Waste, the message is clear: corporate fraud often hides in ordinary paperwork. A customs form, shipment record, invoice, certification, billing file, or loan application can become the starting point for a major federal recovery.

    This settlement also fits into a broader enforcement pattern. The DOJ said the case was coordinated through its Trade Fraud Task Force, a cross-agency effort focused on tariff evasion, customs fraud, prohibited imports, threats to domestic industry, and conduct that weakens national security.

    The same logic applies across the areas covered by Find Corporate Waste: False Claims Act cases, government contracting abuse, pandemic relief fraud, healthcare fraud, customs fraud, and other schemes involving public money.

    When companies cheat the system, the cost does not disappear. It is shifted onto taxpayers, lawful competitors, American workers, and the public.

    If you have information about customs fraud, government contract abuse, healthcare billing fraud, pandemic relief misuse, or other misuse of taxpayer funds, Find Corporate Waste wants to hear from you.

    The strongest cases often begin with a person willing to connect the dots.