Over 95% of Plaintiffs Accept World Trade Center Settlement

-10,043 plaintiffs signed releases accepting settlement terms, according to the Allocation Neutral's report to the Court, with 98% of those claiming some of the most severe injuries signing on.


-- The WTC Captive Insurance Company confirms the 95% participation threshold of eligible plaintiffs has been reached.

/PRNewswire/ -- Over 95% of the eligible plaintiffs have accepted a settlement worth at least $625 million in compensation, which will result in the dismissal of their claims against the City of New York and its contractors for injuries they say they suffered from their work during the rescue, recovery and/or clean-up efforts after the terrorist attack of 9/11. The WTC Captive Insurance Company confirms the 95% participation threshold of eligible plaintiffs has been reached, subject to the correction of certain deficiencies in some releases.

The Allocation Neutral, appointed under the agreement, reported the opt-in numbers to Judge Alvin K. Hellerstein of the U.S. District Court for the Southern District of New York, who previously had declared the settlement "fair and reasonable," in the face of "potent defenses" held by the City and its contractors under the law.

Attorneys for the plaintiffs noted that over 98% of plaintiffs in Tier 4, claiming the most severe injuries that could possibly be tied to work at the site, agreed to the settlement. In addition, over 95% of the plaintiffs in Tiers 2 and 3, with less severe injuries, also signed on.

"It has been my personal and professional mission to ensure that we negotiate a settlement that is fair and reasonable to all sides and I am extremely heartened that the overwhelming majority of plaintiffs have decided that is exactly what we achieved," said Christine LaSala, President and CEO of the WTC Captive Insurance Company. "I hope that this settlement will bring closure to the heroes on both sides of this litigation who did their best to repair this City and restore this community in those difficult days and months following 9/11."

"This process has been intense for all, but the numbers of people opting in show that the settlement we developed and the process to obtain compensation have been judged fair and transparent by those plaintiffs," said Margaret H. Warner, a partner at McDermott Will & Emery, who negotiated the settlement on behalf of the WTC Captive Insurance Company. "Crafting this settlement has been especially challenging given the emotional significance of the work done by all, plaintiffs and defendants, in aid of our country in those difficult days and months. It was important that the compensation reflect the seriousness of injuries claimed and the strength of the legal claim, while also being transparent in all respects."

"We negotiated for over two years to achieve this settlement for our clients, which we truly believe is the best result, given the uncertainty of protracted litigation," said Paul Napoli, a senior partner with the law firm Worby, Groner, Edelman & Napoli, Bern, LLP. "We are working around the clock to conclude settlements we have negotiated with a few other defendants that will add more than $100 million in additional compensation for our clients."

"This settlement is a fair and just resolution of these claims, protecting those who came to the aid of this City when we needed it most," said Mayor Michael R. Bloomberg. "We will continue our commitment to treatment and monitoring of those who were present at Ground Zero. This settlement can also help encourage the Senate to follow the lead of their colleagues in the House of Representatives and pass the James Zadroga 9/11 Health and Compensation Act, which will now be a less expensive proposition due to the payments made under this settlement agreement."

"All parties have worked tirelessly to come to a fair and just resolution to this litigation. The settlement avoids costly and time consuming litigation that serves no one's interests. The lawsuits between the City and its contractors on the one hand, and the rescue and recovery workers on the other, pit one set of heroes against another," said Corporation Counsel Michael A. Cardozo of the New York City Law Department. "We will continue to urge the Senate to pass the Zadroga Act and re-open the WTC Victim Compensation Fund."

"The City and its contractors have an array of powerful defenses to these claims and do not admit any liability. Those defenses include the important doctrine of immunity under state and federal law for those responding to a civil emergency, which will be pursued with respect to plaintiffs who have opted out," said James E. Tyrrell, Jr., a partner at Patton Boggs, LLP, who is lead defense counsel representing the City and its contractors.

"We welcome this settlement so that our clients can have compensation that offers certainty and closure," said Nicholas Papain, Andrew Carboy and Michael Block, members of Sullivan Papain Block McGrath & Cannavo P.C., representing 640 firefighters in the lawsuit.

The Amended Settlement Process Agreement was signed by plaintiffs' attorneys and the WTC Captive on June 10, 2010 but required 95 percent of the plaintiffs to accept the settlement by a certain date in order for it to become effective. The opt-in deadline date originally was set at September 8, 2010 but was extended to 11:59 p.m. Eastern Standard Time on November 16, 2010.

About the Settlement

Compensation was determined on the severity of the illness claimed and the likelihood it could be linked to work at the World Trade Center operations. For example, those claiming debilitating respiratory illnesses such as severe asthma, contracted by a non-smoker within seven months of exposure at the World Trade Center site and surrounding areas, could receive between $800,000 and $1,050,000, and approximately $1.5 million could go to compensate claims of death determined to be caused by the post 9/11 operations. Plaintiffs who have no qualifying injury, but have a legal claim for fear of becoming sick, will receive $3,250. All qualifying plaintiffs will be enrolled in a special insurance policy through MetLife to provide coverage for certain blood and respiratory cancers diagnosed during the coverage period, paying a benefit of up to $100,000.

To ensure transparency and independence in determining compensation for each plaintiff, an Allocation Neutral, a neutral third party, will oversee the valuation of each claim, assisted by a panel of independent physicians. The Garretson Firm Resolution Group, Inc., an experienced claims administration company, will serve as the Allocation Neutral. The firm and the physician panel will review the proof that each plaintiff is required to submit under the settlement, showing that he or she was present and participated in 9/11-related rescue, recovery and debris removal operations, as well as specific medical documentation. All of this information must be submitted by plaintiffs under oath and will be subject to audit. Plaintiffs can ask for the Allocation Neutral to reconsider its initial decision and, after that review, appeal to the Claims Appeal Neutral.

Kenneth R. Feinberg, former Special Master for the U.S. Government's September 11th Victim Compensation Fund, will serve as the Claims Appeal Neutral. He will serve pro bono. Mr. Feinberg will determine appeals requested by plaintiffs seeking review of the Garretson Firm's decisions. His determinations will be binding and may be used to adjust a plaintiff's final compensation.

About the WTC Captive Insurance Company

In the absence of commercially available insurance, the WTC Captive Insurance Company was formed in July 2004 to insure the City of New York and nearly 140 contractors, subcontractors and others it engaged against claims arising out of the debris removal process that began immediately after the collapse of the twin towers of the World Trade Center on September 11, 2001. The mission of the WTC Captive is to insure and defend in court, and thereby to protect, the City and the contractor and subcontractor policyholders as claims are processed, adjudicated and resolved.

Organized as a not-for-profit corporation under the laws of the State of New York and licensed by the New York State Insurance Department, the WTC Captive is governed by a five-member Board of Directors composed of current and former City officials plus a representative of the City's lead contractors.

The WTC Captive was funded with just under $1 billion in federal funds provided through a grant from the Federal Emergency Management Agency (FEMA)—part of the $20 billion of such funds requested by the Administration and authorized by Congress to help New York City and its people recover and rebuild after 9/11.

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Justice Department Signs Agreement With City of Atlanta To Ensure Civic Access for Persons With Disabilities

/PRNewswire/ -- The Justice Department today announced an agreement with the city of Atlanta to improve access to all aspects of civic life for persons with disabilities. The agreement was reached under Project Civic Access (PCA), the department's wide-ranging initiative to ensure that cities, towns and counties throughout the country comply with the Americans with Disabilities Act (ADA). The department has conducted compliance reviews with certain localities in all 50 states, helping to improve the lives and broaden opportunities for millions of Americans with disabilities.

"Civic access is a basic and critical civil right, and it ensures individuals with disabilities can play productive, fulfilling roles in their communities," said Thomas E. Perez, Assistant Attorney General for Civil Rights. "City officials are to be commended for making this commitment to fulfill the ADA's promise of equal access to city programs and services."

PCA was initiated to ensure that persons with disabilities have an equal opportunity to participate in civic life, a fundamental part of American society. As part of the PCA initiative, Justice Department investigators, attorneys and architects survey state and local government facilities, programs and services in communities across the country to identify the modifications needed for compliance with ADA requirements. The agreements are tailored to address the steps each community must take to improve access. This agreement is the 174th under the PCA initiative and the 13th agreement reached this year.

"Like other communities throughout the United States, Atlanta still has some work to do to achieve full ADA compliance," said Assistant Attorney General Perez. "This agreement sets out a realistic plan with specific steps and reasonable timeframes for the city to get there."

Under the agreement announced today, the city of Atlanta will take several important steps to improve access for individuals with disabilities, such as:

-- Making physical modifications to its facilities so that parking,
entrances and routes into facilities, parking lots, public telephones,
restrooms, service counters and drinking fountains are more
accessible;
-- Making specific modifications to improve access to city parks and
tennis courts;
-- Officially recognizing Georgia's telephone relay service and training
staff to use the relay service to ensure effective communication for
people who are deaf or hard of hearing;
-- Continuing to ensure that 9-1-1 emergency service calls placed by
persons with disabilities who use text telephones (TTYs) are answered
as quickly as other calls, that such calls are monitored for timing
and accuracy, and that employees are trained and practiced in using a
TTY to make and receive calls;
-- Implementing a plan to improve the accessibility of city sidewalks and
provide for the installation of accessible curb ramps throughout
Atlanta;
-- Ensuring that the city's official website is accessible to persons
with disabilities, including individuals who are blind or have low
vision;
-- Ensuring equal access to emergency management services for persons
with disabilities;
-- Developing a method for providing information for interested persons
with disabilities concerning the existence and location of the city's
accessible services, activities and programs;
-- Installing signs at inaccessible entrances to facilities directing
persons with disabilities to accessible entrances;
-- Posting, publishing and distributing a notice to inform members of the
public of the ADA's provisions and their applicability to the city's
programs, services and activities; and
-- Adopting a grievance procedure to deal with complaints of disability
discrimination relating to city programs and services.


Today's settlement agreement was reached under Title II of the ADA, which prohibits discrimination against individuals with disabilities by state and local governments. The agreement will remain in effect for three years. The department will monitor compliance with the agreement until required actions have been completed.

Atlanta is the capital and most populous city in the state of Georgia. With a 2008 estimated population of 537,958, it is the urban core of one of the fastest-growing metropolitan areas in the United States. According to Census data, more than 22 percent of people living in Atlanta are individuals with disabilities.

People interested in finding out more about the ADA, today's agreement, the Project Civic Access initiative, or the ADA Best Practices Tool Kit for State and Local Governments can access the ADA home page at http://www.ada.gov/ or call the toll-free ADA Information Line at (800) 514-0301 or (800) 514-0383 (TDD).

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Justice Department Reaches Settlement With Georgia Regarding State's Seven Psychiatric Hospitals

/PRNewswire-USNewswire/ -- The Justice Department announced Janaury 15 that it has reached a settlement with the State of Georgia regarding the conditions at Georgia's seven psychiatric hospitals. The Department opened its investigation of Georgia's psychiatric hospitals in 2007 and issued findings regarding Georgia Regional Hospital at Atlanta on May 30, 2008. The Department subsequently entered into negotiations regarding remedies the State was required to implement to correct unconstitutional conditions at all the hospitals. The other state facilities involved in today's settlement include: Georgia Regional Hospital at Savannah, Central State Hospital in Milledgeville, Southwestern State Hospital, East Central State Hospital, West Central State Hospital, and Northwest Georgia Regional Hospital at Rome.

"When a state undertakes to care for persons with mental illness and developmental disabilities, it accepts responsibility to protect them from harm," said Grace Chung Becker, Acting Assistant Attorney General for the Civil Rights Division. "The Department commends Governor Sonny Perdue, State Attorney General Thurbert Baker, and the Georgia Department of Human Resources for their willingness to work aggressively to address the conditions at these seven psychiatric hospitals. The leadership of the State in amicably resolving this matter has been paramount to today's exceptional result on behalf of the people of the State of Georgia. We are pleased that we have cooperatively achieved a settlement agreement that will benefit the lives of persons with mental health problems and developmental disabilities in Georgia's psychiatric hospitals."

Under the terms of the settlement agreement, the State will work to ensure that patients at the seven hospitals are safe and receive the care and services necessary to meet their individualized needs. Specifically, the State has agreed to undertake a variety of measures, including improving medical and mental health care and ensuring that patients are free from undue bodily restraint. The State will also improve discharge planning and ensure that each patient is served in the most integrated setting appropriate.

Today's settlement with the State of Georgia is the result of a cooperative effort by State entities and the Justice Department to reach a settlement that will make meaningful changes to improve the care and treatment of patients at Georgia's seven psychiatric hospitals. This Administration is firmly committed to the vigorous protection of the rights of persons with disabilities.

The Civil Rights Division is authorized to conduct investigations of public psychiatric hospitals under the Civil Rights of Institutionalized Persons Act (CRIPA). This statute allows the federal government to identify and root out systemic abuses such as those discovered in Georgia. The Civil Rights Division has successfully resolved similar investigations in other in-patient mental health facilities in the District of Columbia, Vermont, and California, among other states. The Civil Rights Division has open investigations of mental health facilities in Delaware, New Jersey, New York, North Carolina and Oregon.

CRIPA authorizes the Attorney General to investigate conditions in certain institutions owned or operated by, or on behalf of, state or local governments. These institutions include nursing homes, residential facilities serving people with mental or other developmental disabilities, mental health facilities, jails, prisons, and juvenile justice facilities.

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Georgia Whistleblower Gets Big Settlement in Suit Against Defense Contractor

/PRNewswire/ -- According to whistleblower attorney Lee Tarte Wallace, a defense contractor has agreed to pay $4,000,000 to settle a lawsuit brought by whistleblower Buster Roderigas of Winder, Georgia. The suit, which was brought on behalf of the U.S. government, alleges that L-3 Vertex Aerospace overbilled and submitted fraudulent invoices to the government.

Wallace, of The Wallace Law Firm, L.L.C., in Atlanta, Georgia, represented Roderigas. She says Roderigas will receive $720,000 of the $4,000,000, and L-3 will pay an additional $318,425 in attorneys' fees.

"With the economic problems we have now, whistleblower suits are critically important. The U.S. simply can't afford to lose taxpayer money to fraud," says Wallace.

Wallace filed Roderigas' suit three years ago. Roderigas had been the acting assistant site supervisor for L-3 in Taji, Iraq, where L-3 has a contract to repair and maintain Army helicopters.

According to the lawsuit, L-3 sent a memo to its Taji employees, instructing them to take an hour and a half for lunch, but to bill for an hour of that time. Roderigas says he was told the military had approved the practice.

The lawsuit states that in September 2005, Roderigas learned from senior-level L-3 employees that L-3 had been billing the government for the time its employees were spending at lunch, and that the military had never approved it. The senior-level employees thought the overbilling had gone on for only a few months, but Roderigas offered to help prove it had gone on longer.

"All he ever wanted was to get the money back to the taxpayer coffers, where it belonged," says Wallace. "He should have been treated like a hero. Instead, he went through hell."

Roderigas claims he was told that he would need to re-apply for his job, and that his site no longer had a bed for him. He was given 24 hours to report for a new job in Balad, Iraq, and then was put on a helicopter that flew past Balad into an airport that had no flights to Balad for several days. To try to meet L-3's deadline, Roderigas got a ride with a Blackwater security patrol on its way to another heliport. The convoy was ambushed on a back road, and the vehicle directly behind Mr. Roderigas' was hit and blown off the road. Roderigas says that when he finally did reach Balad, he was told the site had no job for him - and no bed.

Roderigas returned to the U.S. and filed suit against L-3 Vertex Aerospace, a subsidiary of L-3 Communications Corp. The suit was filed under the False Claims Act, which allows whistleblowers to sue on behalf of the United States when they learn about fraud against the government. Wallace says, "It's a win-win situation. The U.S. gets paid back, and people get encouraged to report fraud against the government."

"Buster is a real American hero," Wallace says. "He stood up for what was right, even though it cost him. Thanks to him, taxpayers are getting back a big chunk of money."

A veteran, Roderigas was shot down in a helicopter in the Vietnam War.

Roderigas took the job with L-3 in 2004, because he had a premonition he needed to be near his son, who was serving in Iraq as a Bradley Commander. In May 2005, Roderigas' son was seriously injured when a roadside bomb hit his Bradley. Roderigas was able to be at his son's side in a military hospital.

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More Than $1 Billion Recovered by Justice Department in Fraud and False Claims in Fiscal Year 2008

PRNewswire-USNewswire/ -- The United States secured $1.34 billion in settlements and judgments in the fiscal year ending Sept. 30, 2008, pursuing allegations of fraud against the federal government, the Justice Department announced today. This brings total recoveries since 1986, when Congress substantially strengthened the civil False Claims Act, to more than $21 billion.

"Now, more than ever, it is crucial that taxpayer dollars aren't lost to fraud," said Gregory G. Katsas, Assistant Attorney General for the Department's Civil Division. "The billion dollars collected this year is only part of the story. By rooting out fraud and vigorously pursuing it, the Department, with the help of concerned citizens who report fraud in hotline calls and in qui tam complaints, undoubtedly saves the country many times that amount in aborted schemes and misconduct."

Assistant Attorney General Katsas also paid tribute to Senator Charles Grassley of Iowa and Representative Howard L. Berman of California who sponsored the 1986 amendments to the False Claims Act, the government's primary weapon to fight government fraud. "Without this important legislation strengthening the Act and, in particular, the qui tam provisions which encourage private citizens to uncover government fraud, such recoveries would not have been possible."

Almost 78 percent of this year's recoveries are associated with suits initiated by private citizens (known as "relators") under the False Claims Act's qui tam provisions. These provisions authorize relators to file suit on behalf of the United States against those who have falsely or fraudulently claimed federal funds. Such cases run the gamut of federally funded programs from Medicare and Medicaid to defense procurement contracts, disaster assistance loans and agricultural subsidies. Persons who knowingly make false claims for federal funds are liable for three times the government's loss plus a civil penalty of $5,500 to $11,000 for each claim.

Relators recover 15 to 25 percent of the proceeds of a successful suit if the United States intervenes in the qui tam action, and up to 30 percent if the government declines and the relator pursues the action alone. In fiscal year 2008, relators were awarded $198 million. (This figure does not include relator shares awarded after Sept. 30, 2008.)

As in the last several years, health care accounted for the lion's share of fraud settlements and judgments-$1.12 billion. This number includes both qui tam claims and those initiated by the United States. The Department of Health and Human Services reaped the biggest recoveries, largely attributable to its Medicare program and the federal/state Medicaid program which funds health care for the needy. Recoveries were also made by the Office of Personnel Management which administers the Federal Employees Health Benefits Program, the Department of Defense for its TRICARE insurance program, the Department of Veterans Affairs and others.

The largest health care recoveries came from pharmaceutical companies and related entities. Settlements with Cephalon Inc., Merck & Co. and CVS Caremark Corp. accounted for more than $640 million. In addition to federal recoveries, these pharmaceutical fraud cases returned $430 million to state Medicaid programs.

The Civil Division's investigation of the pharmaceutical industry is part of a Department-wide effort. Typical allegations include "off-label" marketing, which is the illegal promotion of drugs or devices that are billed to Medicare and other federal health care programs, for uses that were neither found safe and effective by the Food and Drug Administration nor supported by the medical literature; paying kickbacks to physicians, wholesalers and pharmacies to induce drug or device purchases; establishing inflated drug prices knowing that federal health care programs use these prices to reimburse providers, then marketing the "spread" between the federal reimbursement and the provider's lower cost to induce drug purchases; and knowingly failing to report the company's true "best price" for a drug to reduce rebates owed to the Medicaid program.

The Department also collected $133 million in defense procurement fraud. Defense contract recoveries included a $53 million settlement with Pratt & Whitney, a division of United Technologies Corporation, and PCC Airfoils LLC, a subsidiary of Precision Castparts Corporation. The settlement resolved allegations that Pratt & Whitney and PCC Airfoils knowingly submitted false claims to the Air Force for defective turbine blades sold to the government to retrofit the F100-PW-220 engines in F-16 and F-15 aircraft. This case was pursued as part of a National Procurement Fraud initiative, launched in October 2006, to promote the early detection, identification, prevention and prosecution of procurement fraud.

FACT SHEET: SIGNIFICANT RECOVERIES IN FISCAL YEAR 2008

Among the Department's most significant settlements and judgments in fiscal year 2008 were:

* $361.5 million from Merck & Company to resolve allegations that the pharmaceutical manufacturer knowingly failed to pay proper rebates to Medicaid and other government health care programs, and paid kickbacks to health care providers to induce them to prescribe the company's products. The settlement resulted from two lawsuits brought under the qui tam provisions of the False Claims Act.

In the first, which accounted for $221.9 million of the $361.5 settlement, a former Merck employee alleged that the company violated the Medicaid Rebate Statute by providing deep discounts to hospitals that used its drugs Zocor and Vioxx in place of competitors' brands, without reporting those discounts and other cost information to reflect its "best price," as required by the statute to ensure that Medicaid obtains the benefit of the same price concessions other purchasers enjoy. This suit also alleged that Merck paid kickbacks to physicians, disguised as fees for training, consultation, and market research, to induce them to prescribe its drugs, also contrary to law. The United States paid the relator $46.6 million as his share of the settlement under the False Claims Act's qui tam provisions. In addition to the federal recovery, Merck paid $162 million to state Medicaid programs.

In the second lawsuit, which accounted for the remaining $139.6 million of the settlement, a physician alleged that Merck provided deep discounts to hospitals to induce them to administer its antacid, Pepcid, as a means to boost sales through continued use after the patient's discharge. The suit went on to allege, similar to the first suit, that Merck knowingly failed to report these discounts as required by the Medicaid Rebate Statute, which resulted in illegal and inflated claims to federal and state Medicaid programs. In addition to paying the United States $139.5 million in federal claims, Merck paid $114 million to settle state Medicaid claims. The relator received $24 million as his federal share of the settlement and an additional sum for the state recoveries. Merck also entered into a Corporate Integrity Agreement with the Inspector General of the Department of Health and Human Services (HHS) to ensure compliance with federal health insurance programs in the future.

For the original press release, see:
http://www.usdoj.gov/opa/pr/2008/February/08_civ_094.html
http://www.usdoj.gov/usao/pae/News/Pr/2008/feb/steinkrelease.pdf


* $258 million from Cephalon Inc. to resolve claims that the company marketed three drugs for uses not approved by the Food and Drug Administration (FDA). By promoting the drugs for so-called "off label" uses, Cephalon caused providers to charge federal health insurance programs such as Medicare, Medicaid, TRICARE and the Federal Employees Health Benefits Program for unapproved uses of the drugs not covered by the programs. The settlement resolved four lawsuits, three of which were brought by former Cephalon sales representatives under the qui tam provisions of the False Claims Act. Consistent with those provisions, the relators who filed the suits will share $46.7 million as their part of the settlement. In addition to the $258 million recovered for federal programs, the United States recovered $116 million for the Medicaid programs in 14 states and the District of Columbia. Cephalon also pleaded guilty to related criminal charges, paid $50 million in fines and forfeitures and entered into a five-year Corporate Integrity Agreement with the Inspector General of HHS to ensure strict compliance in the future.

For the original press release, see:
http://www.usdoj.gov/opa/pr/2008/September/08-civ-860.html


* $225 million from Amerigroup Corporation to settle both federal and state allegations that Amerigroup, together with its Illinois subsidiary, systematically avoided enrolling pregnant women and other high-cost patients in the company's managed care program in Illinois. The program was funded by Medicaid, which required open enrollment to all eligible beneficiaries. By excluding pregnant women and other high-cost patients, Amerigroup increased its profits in conflict with the law. The United States and Illinois jointly brought suit under the federal False Claims Act and the Illinois Whistleblower Reward and Protection Act. In October 2006, following a lengthy trial, the court entered judgment for $334 million. Amerigroup appealed and the parties entered negotiations leading to settlement. The relator received $56.25 million as his share of the federal and state recoveries. In conjunction with the settlement, Amerigroup entered into a Corporate Integrity Agreement with the Inspector General of HHS to ensure future compliance.

For the original press release, see:
http://www.usdoj.gov/opa/pr/2008/August/08-civ-723.html



* $75 million to settle claims that Kyphon Inc., now Medtronic Spine LLC, violated the False Claims Act by knowingly causing the submission of false claims to Medicare for its kyphoplasty procedure-a minimally-invasive surgery used to treat compression fractures of the spine. The settlement resolved a lawsuit filed by two former Kyphon employees under the qui tam provisions of the False Claims Act. The suit alleged that Kyphon engaged in a seven-year marketing scheme that resulted in certain hospitals billing Medicare for kyphoplasties performed on an inpatient basis rather than for less costly and clinically appropriate outpatient kyphoplasty treatment. This conduct resulted in the Medicare program paying more for inpatient kyphoplasty procedures. The relators received a total of $14.9 million as their share of the settlement. In conjunction with the settlement, Kypon entered into a Corporate Integrity Agreement with the Inspector General of HHS to ensure future compliance.

For the original press release, see:
http://www.usdoj.gov/opa/pr/2008/May/08-civ-455.html


* $74 million from Staten Island University Hospital (SIUH) to resolve two False Claims Act qui tam suits and two other matters. In the first action, a physician and former SIUH Director of Chemical Dependency Services, filed suit alleging that SIUH fraudulently billed Medicare and Medicaid for substance abuse and alcohol detoxification services provided to inpatients in unlicensed beds, in violation of state law, between 1994 and 2000. SIUH paid the United States $11.8 million in settlement of this qui tam action, with the relator receiving $2.3 million as his share of the government's recovery. In related allegations of inflated Medicaid billings asserted under New York State's false claims statute, SIUH paid New York $14.88 million, with the relator receiving $2.97 million as his share of the state's recovery.

In the second action, the widow of an SIUH cancer patient filed suit alleging that between 1996 and 2004, SIUH submitted false claims to Medicare and TRICARE using incorrect codes for cancer treatments not covered by the programs. SIUH paid the United States $25 million, including a relator share award of $3.75 million. In the third matter, the United States alleged that SIUH deliberately inflated the number of residents it employed to fraudulently increase Medicare reimbursement between 1996 and 2003. SIUH paid the United States $35.7 million in settlement of this matter. Lastly, SIUH paid the United States $1.47 million to settle allegations that it billed Medicare and Medicaid for treating psychiatric patients in unlicensed beds from 2003-2005. In conjunction with the settlement, SIUH also entered into a Corporate Integrity Agreement with the Inspector General of HHS to ensure future compliance.

For the original press release, see:
http://www.usdoj.gov/usao/nye/pr/2008/2008sep15.html


* $60 million from Lester E. Cox Medical Centers, a health care system headquartered in Springfield, Mo., to settle claims that it violated the False Claims Act, the Anti-Kickback Statute and the Stark Statute between 1996 and 2005. The United States alleged that Cox entered into illegal financial relationships with referring physicians at a local physician group and engaged in improper billing practices with respect to Medicare. Under the Stark Statute, providers such as Cox are prohibited from billing Medicare for referrals from doctors with whom the providers have a financial relationship, unless that relationship falls within certain exceptions. The United States contended that Cox and the referring physicians ran afoul of the Stark Statute, as well as the Anti-Kickback Statute, which prohibits offering inducements to providers in return for patient referrals. The settlement also resolves claims that Cox included non-reimbursable costs on its Medicare cost reports and improperly billed for dialysis services. In conjunction with the settlement, Cox entered into a Corporate Integrity Agreement with the Inspector General of HHS to ensure future compliance.

For the original press release, see:
http://www.usdoj.gov/opa/pr/2008/July/08-civ-638.html
http://www.usdoj.gov/usao/mow/news2008/cox.settlement.htm


* $53 million from Pratt & Whitney, a division of United Technologies Corporation, and PCC Airfoils LLC, a subsidiary of Precision Castparts Corporation, to resolve allegations that the companies knowingly submitted false claims for defective turbine blades purchased by the Air Force to retrofit the F100-PW-220 engines found in F-16 and F-15 aircraft. The settlement includes corrective action to replace defective blades and inspection of potentially serviceable blades to ensure their integrity. The case was pursued as part of a National Procurement Fraud Initiative launched in October 2006, to promote the early detection, identification, prevention and prosecution of procurement fraud.

For the original press release, see:
http://www.usdoj.gov/opa/pr/2008/August/08-civ-675.html



* $26 million from St. Joseph's Hospital of Atlanta to resolve allegations that the hospital falsely claimed Medicare reimbursement for inpatient admissions that were, in fact, less costly outpatient visits. A registered nurse, formerly employed by the hospital, initiated suit under the False Claims Act's qui tam provisions. The complaint alleged that the hospital improperly billed for short inpatient admissions, usually of one day or less, when the service should have been billed as an outpatient "observation" or emergency room visit. Medicare reimburses hospitals a higher rate for inpatient admissions than it does for observation care or emergency room visits. The nurse who triggered the investigation received $4.94 million as her share of the recovery. St. Joseph's entered into a Corporate Integrity Agreement with the Inspector General of HHS in conjunction with the settlement, to ensure future compliance.

For the original press release, see:
http://www.usdoj.gov/usao/gan/press/2007/12-21-07.pdf


$23.2 million from Bechtel Infrastructure Corp. and PB Americas Inc. to settle allegations of false claims for federal highway funds in connection with the firms' failure to provide adequate management and quality assurance services during the construction of the Central Artery Tunnel, known as the Big Dig, in Boston. The recovery, part of a $458 million settlement of state and federal claims, resolved parts of a qui tam lawsuit, a related federal investigation and additional claims that Bechtel and PB Americas violated federal and state criminal and civil laws in connection with their services on the Big Dig. In addition to the federal recovery, the companies paid $40 million in state claims and $335 million into a state warranty fund for future repairs to the Big Dig. The private citizen who filed the suit received $54,000 and $96,000 as his share of the federal and state recoveries, respectively.

For the original press release, see:
http://www.usdoj.gov/opa/pr/2008/January/08_crt_048.html
http://boston.fbi.gov/dojpressrel/pressrel08/govtclaimsettlement012308.htm



* $21.1 million from CVS Caremark Corp. to settle claims that from 2000-2006, the company illegally switched patients from the tablet version of the drug Ranitidine (generic Zantac) to a more expensive capsule version for the sole purpose of increasing Medicaid reimbursement. For example, CVS pharmacies in Illinois would charge Medicaid $79.80 for 60 Ranitidine capsules, rather than $17.10 for the tablets prescribed, increasing reimbursement by $62.70 on a single prescription. CVS Caremark is headquartered in Rhode Island and operates more than 6,000 pharmacies nationwide. The settlement resolves qui tam claims under federal and state false claims statutes. In addition to the federal recovery, CVS Caremark paid $15.6 million to 23 states and the District of Columbia. The qui tam plaintiff received $4.3 million as his share of the federal and state settlements. CVS Caremark also entered into a Corporate Integrity Agreement with the Inspector General of HHS to ensure future compliance.

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Plantation Pipe Line Will Pay Penalty for Fuel Spills in Va., N.C., Ga.

PRNewswire-USNewswire/ -- Plantation Pipe Line Company, Alpharetta, Ga., has agreed to pay a civil penalty and implement safeguards in order to resolve a Clean Water Act lawsuit over fuel pipeline spills in three states, the Justice Department, the U.S. Environmental Protection Agency (EPA) and state of North Carolina announced.

The company has agreed to pay a $725,000 penalty for discharges of jet fuel and gasoline in Virginia, Georgia and North Carolina, and for inadequate spill prevention safeguards at a Virginia facility. The company also has agreed to implement $1.3 million in new spill prevention safeguards.

"Companies like Plantation Pipe Line that operate oil production infrastructure have a responsibility to ensure the safety and integrity of their operations," said Ronald J. Tenpas, Assistant Attorney General for the Justice Department's Environment and Natural Resources Division. "We continue to work closely with the Environmental Protection Agency to enforce this nation's environmental laws."

"Federal oil pollution prevention requirements, along with regular pipeline upgrades, are designed to prevent the kinds of oil spills that have occurred on Plantation's pipeline system," said Donald Welsh, administrator for EPA's mid-Atlantic region. "The pipeline upgrades required in this settlement will help protect the environment by preventing future spills."

"Oil spills can cause significant harm to the environment," said Jimmy Palmer, EPA Regional Administrator in Atlanta. "EPA will continue to ensure that facilities handling oils follow established procedures to minimize risk to our water and sensitive ecosystems."

The lawsuit cited Plantation for four separate fuel spills from 2000 to 2006, totaling 1,005 barrels (or 42,210 gallons):

-- On Nov. 27, 2006, at least 97 barrels of gasoline leaked from a
Plantation pipeline in Mecklenburg County, N.C., some flowing into Paw
Creek.
-- On Feb. 22, 2003, at least 788 barrels of gasoline spilled from a
pipeline in Hull, Ga., some entering a tributary of East Sandy Creek.
-- On Mar. 13, 2002, at least 20 barrels of jet fuel were discharged from
a pipeline in Alexandria, Va., some flowing to a tributary of Hooff
Run.
-- On Jan. 10, 2000, at least 100 barrels of jet fuel leaked from a
pipeline in Newington, Va., some of which spilled into Accotink Creek.


The lawsuit also cited Plantation Pipe Line for failing to prepare and implement a required spill prevention, control and countermeasure plan for a 420,000-gallon oil storage tank at its Newington, Va., facility.

The settlement requires Plantation to pay a $715,000 penalty to the federal government's Oil Spill Liability Trust Fund and $10,000 to the North Carolina Department of Environment and Natural Resources. In addition, the company will implement $1.3 million in spill prevention safeguards, including upgrades to pipelines and excavating buried valves to improve regular inspection capabilities.

The Clean Water Act prohibits discharges of oil into waterways and coastal areas in quantities that may be harmful to the environment or public health. Oil spills threaten both fresh water and marine environments, harming plant and animal life through physical damage and the toxicity of the oil itself, which may poison exposed organisms. For more information on the effects and cleanups of oil spills, visit: http://www.epa.gov/oilspill.

The proposed consent decree, filed by the U.S. Department of Justice on behalf of EPA and North Carolina, is subject to a 30-day public comment period and final court approval. A copy of the proposed consent decree is available on the Justice Department Web site at www.usdoj.gov/enrd/Consent_Decrees.html.

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Builders Insurance and Home Builders Association of Georgia Reach Agreement to Resolve Proxy Contest

/PRNewswire/ -- Builders Insurance (a Mutual Captive Company), and the Home Builders Association of Georgia ("HBAG") today announced that they have reached agreement in principle to resolve and conclude HBAG's proxy contest and other outstanding issues between the parties. As part of the resolution, HBAG and HBAG's local associations will enter into endorsement agreements with Builders Insurance.

"We are pleased to have reached these agreements and to be moving forward with the Home Builders Association of Georgia," said Patrick Mitchell, President and Chief Executive Officer of Builders Insurance. "We especially want to thank Georgia Commissioner of Insurance John Oxendine for working with the parties through the settlement process."

Allen Richardson, Chairman of the Board of Directors of Builders Insurance stated, "Builders Insurance and HBAG have a long history of mutually beneficial cooperation. With the proxy contest behind us, we can continue to offer a choice of products that meet the unique needs of home builders at affordable prices."

"On behalf of HBAG, I am delighted that we were able to reach a resolution that serves the best interests of all parties," said Charles A. Eison, Sr., President and Chief Executive Officer of HBAG. "We are committed to continuing to represent the homebuilders of Georgia and look forward to working together with Builders Insurance to do so."

The settlement agreements are subject to execution of final documentation.

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Winder, Georgia Public Housing Authority Settles Race Discrimination Housing Complaint With Justice Department

PRNewswire-USNewswire/ -- The Justice Department today announced a settlement that, pending court approval, will require the Housing Authority for the City of Winder, Ga., (WHA), to pay up to $490,000 to resolve allegations that it engaged in a pattern or practice of discriminating against African-American tenants and housing applicants.

The WHA is a public housing authority that provides housing for persons of low income in Barrow County, Ga. Currently, the WHA owns and maintains nine public housing complexes in the city of Winder, and the neighboring towns of Statham and Braselton, Ga.

The complaint, which was filed today in the U.S. District Court in Gainesville, Ga., in conjunction with the consent decree, alleges that the WHA maintained racially segregated housing by assigning applicants to vacant units based on race, rather than in order of their placement on WHA's waiting list. The complaint also alleges that the WHA subjected African-American tenants to inferior terms and conditions of rental.

"Every person, including individuals who seek public assistance, has a right to be free from racial discrimination in housing," said Grace Chung Becker, Acting Assistant Attorney General for the Justice Department's Civil Rights Division. "The Department will continue its vigorous enforcement of the Fair Housing Act."

Upon court approval, the consent decree will require the WHA to implement nondiscriminatory policies and procedures to ensure compliance with the Fair Housing Act. The WHA will also provide training on the nondiscriminatory policies and procedures and the Fair Housing Act to its employees responsible for making housing decisions. In addition, WHA will ensure that housing units are made available for rent on an equal basis with the same terms and conditions for all persons, regardless of race.

In addition, the WHA will establish a $450,000 fund to compensate individuals who suffered damages as a result of the WHA's conduct and will pay a $40,000 civil penalty to the United States.

Individuals who believe that they may have been victims of housing discrimination can call the Housing Discrimination Tip Line at 1-800-896-7743, e-mail the Justice Department at fairhousing@usdoj.gov, or contact the U.S. Department of Housing and Urban Development at 1-800-669-9777.

The federal Fair Housing Act prohibits discrimination in housing based on race, color, religion, national origin, sex, disability and familial status. Since Jan. 1, 2001, the Justice Department's Civil Rights Division has filed 267 cases to enforce the Fair Housing Act, 77 of which have alleged discrimination based on race. More information about the Civil Rights Division and the laws it enforces is available at http://www.usdoj.gov/crt.

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Georgia to Offer More Community Living Alternatives for Individuals With Disabilities

PRNewswire--- More than 2,300 individuals with disabilities currently institutionalized in Georgia's eight public psychiatric hospitals and mental retardation facilities will have the opportunity to live in their communities with appropriate supports tailored to meet their individualized needs as a result of a settlement agreement between the state of Georgia and the HHS Office for Civil Rights (OCR).

Under the settlement, signed Tuesday, Georgia also will involve consumers and advocates in planning how best to provide adequate community services to meet the needs of all Georgians with disabilities who are either living in institutions or at risk of institutionalization without community supports.

"Georgia's commitment to improve its community services through this settlement furthers the President's New Freedom Initiative by supporting independent living and individual choice," HHS Secretary Mike Leavitt said. "This agreement provides persons with disabilities greater opportunities to live within their home communities and have full access to community life."

By enhancing community alternatives to institutionalization under the settlement, Georgia will promote individuals' rights under the United States Supreme Court's 1999 ruling in Olmstead v. L.C. that the unnecessary institutionalization of individuals with disabilities constitutes discrimination under the Americans with Disabilities Act (ADA).

"Every Georgian who faces mental illness or developmental disabilities has the right to be treated in a way that not only ensures the best outcome, but allows for the highest quality of life," said Georgia Governor Sonny Perdue. "We've worked hard to make this agreement work, and the state of Georgia is committed to completing this effort."

The agreement settles statewide complaints filed with OCR by the Georgia Advocacy Office, Atlanta Legal Aid Society, Georgia Legal Services Program, and the Disability Law and Policy Center of Georgia. The complaints alleged that, in violation of the ADA, Georgia has failed to treat individuals with developmental disabilities and mental health disabilities in the most integrated setting appropriate to their needs -- the setting that enables persons with disabilities to interact with people without disabilities to the fullest extent possible. "In this voluntary compliance agreement with the Federal Government, Georgia promises a serious effort to end the illegal segregation of its citizens with disabilities and to provide appropriate community alternatives," said Sue Jamieson, the attorney with the Atlanta Legal Aid Society, who originally filed the Olmstead case, which arose in Georgia. "If the agreement results in long overdue residential supports and other needed community services, it could finally begin to heal the wounds we have all suffered from institutionalizing people who should be our neighbors."

Georgia's implementation of the settlement agreement will rely, in part, on a $44 million dollar Money Follows the Person Rebalancing Demonstration Grant, which was awarded to the state by the HHS Centers for Medicare & Medicaid Services on June 30, 2008. This grant will allow Georgia to "rebalance" its Medicaid program away from long-term institutional care to one that offers individuals the option to live in the community. Experts from HHS' Substance Abuse and Mental Health Services Administration will also work with Georgia officials to develop its community mental health system to carry out the requirements of the agreement.

"This settlement is a model for states in meeting their ADA obligations to eliminate unlawful institutionalization and provide adequate community alternatives," said OCR Director Winston Wilkinson. "To combat ongoing disability discrimination, the HHS Office for Civil Rights will continue its enforcement efforts, along with promoting voluntary compliance and technical assistance to ensure states comply with the ADA and Olmstead decision."

Saint Joseph's Hospital of Atlanta to Pay U.S. $26 Million to Settle False Claims Allegations

Settlement Resolves Investigation of Hospital's Claims for Inpatient Admissions

WASHINGTON, Dec. 21 /PRNewswire-USNewswire/ -- Saint Joseph's Hospital of Atlanta Inc. and Saint Joseph's Health System Inc. have agreed to pay the United States $26 million to settle allegations that the medical facility violated the False Claims Act with regard to billing for inpatient admissions and other services, the Justice Department announced today. The settlement resolves an investigation primarily focusing on Saint Joseph's Hospital's submission of Medicare claims from the years 2000 through 2005, where services that should have been billed as "outpatient visits" were charged at the higher rate as "inpatient admissions."

The settlement covers claims submitted by Saint Joseph's Hospital for short inpatient admissions, usually of one day or less but sometimes longer, where the services were such that they should have been billed on an outpatient "observation" basis or as an emergency room visit. It also covers claims where the hospital admitted patients for three days, without meeting the criteria for a covered admission, so the patients would qualify under Medicare payment rules for subsequent coverage for skilled nursing facility services. In addition, the settlement includes certain claims submitted by the hospital for inpatient admissions relating to placement of carotid artery stents, which were not covered under Medicare benefits.

The qui tam, or whistleblower lawsuit, was filed by Tami Ramsey, a former hospital employee. Ms. Ramsey, a registered nurse, will receive $4.94 million as her share of the recovery in the case.

"This significant settlement demonstrates our commitment to protect public funds from fraud and abuse," said David E. Nahmias, U.S. Attorney for the Northern District of Georgia. "Every hospital that submits claims to the Medicare program must ensure that its services are billed appropriately. We will continue to vigorously pursue Medicare providers who disregard billing rules."

"Health care providers in the Medicare program have an obligation to turn square corners when dealing with the government," said Jeffrey S. Bucholtz, the Acting Assistant Attorney General for the Civil Division. "This means that hospitals must go the extra mile to ensure that any claims for payment they submit to Medicare reflect the correct level of service."

The United States has agreed to dismiss the lawsuit as a result of today's settlement. As a condition of continued participation in federal health care programs, the Office of Inspector General (OIG) of the Department of Health and Human Services has required Saint Joseph's Hospital and Health System to enter into a Corporate Integrity Agreement. The agreement subjects Saint Joseph's to strict policies and procedures to ensure future compliance with applicable statutes and regulations that govern the use of federal health care funds.

"Any time a false claim is submitted for payment, the Medicare program suffers," said U.S. Department of Health and Human Services Inspector General Daniel R. Levinson. "OIG will work closely with our law enforcement partners to identify and hold accountable providers who obtain crucial Medicare dollars through inappropriate billing."

The investigation was jointly handled by the U.S. Attorney's Office in Atlanta; the Commercial Litigation Branch of the Justice Department's Civil Division; and the Department of Health and Human Services, Office of Inspector General.