False Claims Act

IBM agreed to pay $17 million to the U.S. Department of Justice (DOJ) to resolve False Claims Act allegations related to nondiscrimination obligations in federal contracts under the DOJ’s Civil Rights Fraud Initiative. IBM denied liability, and the case highlights concerns about HR practices such as compensation, hiring, and promotions, which SHRM research identifies as critical areas for assessing organizational civility.

Matrix Medical Network, HealthFair, and founder Shahriah 'James' Ekbatani agreed to pay $56.5 million to resolve allegations of violating the False Claims Act by submitting false diagnosis codes to Medicare Advantage. Matrix will pay $36.5 million, HealthFair $5 million, and Ekbatani $15 million as part of separate qui tam actions in New York and Texas.

Community Care Health Network (Matrix), HealthFair, and founder Shahriah 'James' Ekbatani agreed to pay $56.5 million to resolve allegations of violating the False Claims Act by submitting false or invalid diagnosis codes to Medicare Advantage. Matrix will pay $36.5 million, HealthFair $5 million, and Ekbatani $15 million as part of separate qui tam actions in New York and Texas.

Officium Global LLC and Loyal Source Government Services LLC have agreed to pay over $3.6 million to resolve allegations of violating the False Claims Act and Contract Disputes Act. The settlement was announced by United States Attorney Gregory W. Kehoe in Orlando, FL.

Susan Hertzberg and Matthew Theiler have agreed to pay $1.2 million to resolve allegations of illegal payments to doctors for laboratory referrals, violating the Anti-Kickback Statute.

The U.S. Attorney’s Office in the District of South Carolina announced settlements totaling over $7.9 million to resolve allegations that companies violated the False Claims Act by submitting false information to obtain ineligible Paycheck Protection Program (PPP) loans exceeding $5 million.

Oglethorpe Inc., a Florida-based psychiatric hospital operator, and its executives agreed to pay $32 million to resolve allegations of violating the False Claims Act by retaining overpayments from Medicare for admitting beneficiaries to three Ohio facilities. The settlement involves the company's founder, CEO, and COO.

Oglethorpe Inc., a Tampa-based psychiatric hospital operator, and its executives, including founder Robert Cohen, CEO John Picciano, and COO James O’Shea, agreed to pay $32 million to resolve allegations of violating the False Claims Act by failing to return Medicare overpayments for admissions to three Ohio facilities. The settlement addresses claims that the company knowingly retained improper payments from the Medicare program.

The Civil Division announced reforms to expedite the review of False Claims Act whistleblower complaints targeting fraud in federally funded, state-administered benefits programs. These changes aim to prioritize valid cases, optimize enforcement resources, and combat sophisticated fraud schemes.

IBM agreed to pay $17 million to resolve allegations under the Trump administration's Civil Rights Fraud Initiative, which linked DEI policies to the False Claims Act. The DOJ claimed IBM violated anti-discrimination requirements in federal contracts by maintaining discriminatory practices.

Five Florida ophthalmology practices have agreed to pay nearly $6 million to settle allegations of submitting fraudulent claims to Medicare and Medicaid for cranial ultrasounds. The settlement resolves violations under the False Claims Act.

Kaiser Permanente affiliates have agreed to pay $556 million to resolve allegations of violating the False Claims Act. This settlement addresses claims related to improper billing or fraudulent practices by the healthcare organization.

Clinical laboratory LTD Holding LLC and its founder/CEO pleaded guilty and agreed to pay at least $6.8 million to settle allegations of kickbacks to doctors under the False Claims Act. The settlement resolves claims that the South Carolina-based laboratory engaged in illegal kickback schemes.