Davita Rx Agrees to Pay $63.7 Million to Resolve False Claims Act Allegations

DALLAS – DaVita Rx LLC, a nationwide pharmacy that specializes in serving patients with severe kidney disease, agreed to pay a total of $63.7 million to resolve False Claims Act allegations relating to improper billing practices and unlawful financial inducements to federal healthcare program beneficiaries, the Justice Department announced today.  DaVita Rx is based in Coppell, Texas.
The settlement resolves allegations that DaVita Rx billed federal healthcare programs for prescription medications that were never shipped, that were shipped but subsequently returned, and that did not comply with requirements for documentation of proof of delivery, refill requests, or patient consent.  In addition, the settlement also resolves allegations that DaVita paid financial inducements to Federal healthcare program beneficiaries in violation of the Anti-Kickback Statute.  Specifically, DaVita Rx allegedly accepted manufacturer copayment discount cards in lieu of collecting copayments from Medicare beneficiaries, routinely wrote off unpaid beneficiary debt, and extended discounts to beneficiaries who paid for their medications by credit card.  These allegations relating to improper billing and unlawful financial inducements were the subject of self-disclosures by DaVita Rx and a subsequently filed whistleblower lawsuit.
“Providers should not make patient care decisions based upon improper financial incentives or encourage their patients to do the same,” said U.S. Attorney Erin Nealy Cox for the Northern District of Texas.  “The U.S. Attorney’s Office has and will continue to work cooperatively with providers that bring such issues to light to redress the losses the federal healthcare system has incurred.”
DaVita Rx has agreed to pay a total of $63.7 million to resolve the allegations in its self-disclosures and the whistleblower lawsuit.  DaVita Rx repaid approximately $22.2 million to federal healthcare programs following its self-disclosure and will pay an additional $38.3 million to the United States as part of the settlement agreement.  In addition, $3.2 million has been allocated to cover Medicaid program claims by states that elect to participate in the settlement.  The Medicaid program is jointly funded by the federal and state governments.
“Improper billing practices and unlawful financial inducements to health program beneficiaries can drive up our nation’s health care costs,” said Civil Division Acting Assistant Attorney General Chad Readler.  “The settlement announced today reflects not only our commitment to protect the integrity of the healthcare system, but also our willingness to work with providers who review their own practices and make appropriate self-disclosures.”
“The conduct being resolved in this matter presents serious program integrity concerns” said CJ Porter, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services, “DaVita Rx’s cooperation in the investigation of this matter was necessary and appropriate to reach this resolution.”
The lawsuit resolved by the settlement was filed by two former DaVita Rx employees, Patsy Gallian and Monique Jones, under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private parties to sue on behalf of the government when they discover evidence that defendants have submitted false claims for government funds and to receive a share of any recovery.  The case is captioned United States ex rel. Gallian v. DaVita Rx, LLC, No. 3:16-cv-0943-B (N.D. Tex.).  The relators will receive roughly $2.1 million from the federal recovery.
The settlement of this matter illustrates the government’s emphasis on combating health care fraud.  One of the most powerful tools in this effort is the False Claims Act.  Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services, at 800-HHS-TIPS (800-447-8477).  HHS also offers several programs for health care providers to self-report potential fraud.  More information on self-disclosure processes can be found on the HHS-OIG website.
The investigation was conducted by HHS-OIG, the Civil Division’s Commercial Litigation Branch and the U.S. Attorney’s Office for the Northern District of Texas.  The claims asserted by the government are allegations only and there has been no determination of liability.
Assistant U.S. Attorney Lisa-Beth C. Meletta handled this matter for the U.S. Attorney’s Office.
Read the original article from the Department of Justice

Civilian FDNY employees file discrimination lawsuit

According to a new lawsuit, discrimination in the FDNY isn’t limited to actual firefighters.
In a new class-action lawsuit, filed by seven civilian employees Dec. 1, the New York City Fire Department is accused of racially discriminatory practices against its Black civilian employees. Black firefighters settled a lawsuit three years ago after accusing FDNY officials of discrimination. Civilian FDNY employees filed a complaint about discriminatory practices with the U.S. Equal Employment Opportunity Commission in 2016.
The lawsuit claims that FDNY leadership hasn’t implemented human resources practices that could reduce or stop discrimination; an inside group, good old boy network has kept non-whites out of decision-making positions; white employees are promoted more and compensated more than nonwhite employees; and City Hall has failed to exercise control over the FDNY’s practices.
The lawsuit, filed in U.S. District Court for the Southern District of New York, states that the FDNY’s practices violate the U.S. Civil Rights Act and New York City’s own Human Rights Law.
Plaintiff Stephanie Thomas, an African-American computer specialist, has worked for the FDNY for almost 30 years. She told reporters during a news conference at City Hall that she hasn’t received any discretionary raises (only minimal) and has been denied a promotion her entire time there.
Thomas explained, “I work very hard and have been commended for the work I do, but I have been literally stuck—for 30 years—at the same level and pay grade as recently hired computer specialists. I have received only the small raises negotiated by my union, and never a discretionary raise like my white [co-workers].”
The other six employees in the lawsuit include Annette Richardson, Deborah Bowman, Lia Horsley, Debra Poe, Dino Riojas and Arlene Simmons.
“The city is aware of this problem and has chosen to sit on its hands and do nothing,” said Sara Wyn Kane, the plaintiff’s attorney. “As stated in the lawsuit, the city’s own workforce profile data for 2014 show that 41 percent of its hires were white and 27 percent were African-American. But at FDNY, 59 percent were white and only 14 percent were African-American. In other words, FDNY hired African-Americans at only about half of the rate at which other city agencies did.”
Retired judge and well-known civil rights attorney U.W. Clemon is also part of the plaintiffs’ legal team and said that the lawsuit against the FDNY shows him that the fight is not over.
“The fight that is being waged here by these brave African-Americans is reminiscent of the earlier civil rights era, and represents a new battleground,” stated Clemon. “It’s a shame that discrimination is still rife in the Fire Department of the largest American city. I want to commend the bravery of the FDNY 7 for filing this lawsuit, knowing that they will still have to go to work every day and face the perpetrators of these discriminatory practices.”
Discrimination accusations with the FDNY aren’t new. In the 1970s the Vulcan Society (which represents Black firefighters) and the Department of Justice filed a lawsuit against the FDNY over its entry level exams, which were deemed to be discriminatory against Black and Latino applicants. Despite Federal Judge Edward Weinfeld’s order to hire one minority applicant for every three white candidates, the FDNY remained 93 percent white. In 2007, the Vulcan Society and the Department of Justice filed a class action suit against the FDNY over its “virtual exclusion” of nonwhite firefighters. Judge Nicholas Garaufis granted the plaintiffs $100 million in back pay and benefits to compensate for FDNY applicants who were improperly barred from entry.
An elected official recently commented that there shouldn’t be racism within an agency whose main job is to protect New Yorkers.
“There is no place for bigotry or hatred in the City of New York, especially when it comes to those sworn to protect New Yorkers,” said Councilwoman Vanessa Gibson in a statement. “It is disappointing and disturbing that a man who was forced out of his job as a NYC EMT for racist, sexist and anti-Semitic tweets could be sworn in as firefighter just four years later.”
The plaintiffs want the court to appoint an outside monitor or task force going forward for five years or more; require FDNY to create plans to increase representation of African-Americans in civilian positions in which they’re represented and in EMS positions above lieutenant (with the court’s approval); appoint an outside monitor to audit compensation of civilian employees; and require FDNY to view and modify its human resources practices.
By Stephon Johnson
Read the original article from The Amsterdam News

The EEOC and Sara Lee: A Landmark Discrimination Case in Texas

After a two year investigation into complaints of civil rights and health violations, the Equal Employment Opportunity Commission (EEOC) announced a $4 million settlement for former employees at the Sara Lee factory located in Paris, Texas. This case marks the largest settlement in EEOC history involving a hostile work environment. The EEOC took on the case after twenty-five workers filed complaints against the company during their time at the now-shuttered factory, which closed in 2011. Attorneys now estimate that over seventy employees stand to benefit from the settlement. In addition to financial reparations, the company will be required to implement measures to prevent workplace discrimination and to submit regular reports to the EEOC. Read on for a look inside the landmark case.


THE ALLEGATIONS AGAINST SARA LEE

The EEOC’s two year investigation found that black employees were targets of intimidation and were denied promotions that went to their white peers. Black employees reported racial slurs and graffiti during their time at the factory, incidents which were corroborated by the EEOC. A lawsuit filed separately from the EEOC complaint revealed that the graffiti included racial slurs, threats, and crude drawings of apes and black men with nooses. A large portion of the alleged abuse came from white supervisors within the factory and several Sara Lee officials have been accused of ignoring complaints from black employees about the conditions within the factory. In addition, workers were reportedly exposed to black mold asbestos and other toxins during their daily work. The working conditions were so hazardous that:

One of the cake lines was nicknamed the ‘cancer line,’ because so many people were getting sick, said Sara Kane, one of the workers’ attorneys, of the law office Valli, Kane & Vagnini.

According to the investigation, black employees were exposed to these conditions while their white colleagues were promoted to positions located in safer areas of the factory. These white employees were allegedly often less-experienced than their black co-workers but they received promotions nevertheless.
According to the EEOC’s report, several black employees contracted cancer and other diseases as a direct result of their exposure to toxins in the workplace. When black employees reported their diseases to management, their complaints were either ignored or dismissed as being unrelated to working conditions within the factory. The closure of the factory in 2011 meant that the EEOC had relatively limited exposure to the physical conditions of the factory, so the investigation did rely heavily on interviews with employees.


 THE ROLE OF THE EEOC

The EEOC enforces federal laws against discrimination in most companies with 15 employees or more (although this can vary according to certain jurisdictions and circumstances). The EEOC processes both private sector and federal sector violations of discrimination laws, although it takes a more active investigative role in private sector cases. There are two distinct private sector and a federal sector mediation programs, which each offer dispute resolution with EEOC cooperation. If conciliation cannot resolve a private sector dispute, the EEOC has the right to pursue litigation and also has a right to participate in an ongoing lawsuit. According to the EEOC website,

The EEOC has the authority to investigate charges of discrimination against employers who are covered by the law. Our role in an investigation is to fairly and accurately assess the allegations in the charge and then make a finding. If we find that discrimination has occurred, we will try to settle the charge. If we aren’t successful, we have the authority to file a lawsuit to protect the rights of individuals and the interests of the public. We do not, however, file lawsuits in all cases where we find discrimination.

The EEOC may handle tens of thousands of complaints every year, but they very rarely escalate to the heights that the Sara Lee case has, which makes the future of Sara Lee critically important. If Sara Lee complies with the EEOC regulations and actively changes its workplace environment in the coming years, it will serve as a model for other companies that have had large-scale reports of discrimination. The successful transformation of the Sara Lee case will lie with its parent company–Tyson Foods.


A NEW NAME AND A NEW BRAND

In 2012, so chronologically after the alleged abuse occurred, Sara Lee went through a major re-branding, effectively splitting the business in two. The food side of the business was labeled Hillshire Brands while the tea and coffee end of the company (centered in Europe) was named D.E. Master Blenders 1753. The name change was speculated to have been prompted by lackluster sales of meat products.
In 2014, Hillshire Brands completed a merger with Tyson Foods, Inc. which The Wall Street Journal referred to as the “meat industry’s biggest deal.” After the merger, Hillshire’s chief executive Sean Connolly stepped down, clearing the way for new leadership. However, the Sara Lee discrimination case did not disappear with the name change. Although headlines associate the case with Sara Lee, Tyson is now liable for the settlement and for rebuilding the brand’s image in the wake of the EEOC investigation. In an interview with Buzzfeed News, Tyson Foods spokesperson Worth Sparkman said the company is

‘Committed to treating our team members with dignity and respect and have a policy against harassment and discrimination,’ noting Tyson Foods requires annual training and offers a toll-free help line for workers to report any concerns without fear of retaliation. ‘While we don’t agree with all of the allegations in this case, we oppose any unlawful discrimination in the workplace and believe it makes sense to resolve this matter,’ Sparkman wrote in an email. When asked which allegations the company disagrees with Sparkman said, via email, ‘We’ll point out that any alleged conduct in this case occurred before portions of Sara Lee were acquired by Tyson Foods in 2014.’

The Tyson brand has also had a series of legal skirmishes over working conditions over the past few years. This November, the Supreme Court heard a case against Tyson in which employees argued that Tyson unlawfully failed to pay for the time it took them to put on and then remove safety equipment during their daily tasks. In a lower court, employees were awarded half of what their counsel requested. The case has raised interesting questions about collective action lawsuits, as the case involves more than 3,000 workers in total: Should that many employees be allowed to file their complaint at one time, in a single case?
The Supreme Court has approached the case less as an issue of wage violations and more as a debate over what the threshold should be for the number of participants in a collective action lawsuit. Yet, if the Supreme Court rules in favor of the employees, Tyson may pay out even more than they it in the Sara Lee case–approximately $6 million.


CONCLUSION

The Sara Lee case is a unique one in that a significant number of workers were courageous enough to file complaints and patient enough to wait for the legislative process to work over several years. Not every discrimination case is investigated by the EEOC, either because there is not sufficient evidence or because victims do not feel safe reporting misconduct. Hopefully, the Sara Lee case will inspire other companies to enact preventative measures to disband discrimination. The EEOC has delivered a decisive victory for the employees of the Texas factory, and we’ll have to see what effects it might have in future discrimination cases.


By Jillian Sequeira
Read the original article from Law Street Media

City of Dallas Settles Unpaid Overtime Case

City of Dallas settles unpaid overtime pay case for $XXX

Multiple NY Personal Trainers file suit alleging, among other violations, that Equinox’s flat personal training rate of pay violated Federal and State overtime laws.

Watch The ABC Story: View Here

Actual Case Complaint: Download File