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
FDNY sued for discrimination — again
Nearly three years after the city agreed to pay $98 million to settle claims of bias in its hiring of black and Hispanic firefighters, New York’s Bravest is being sued for discrimination again.
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Overtime Pay for Home Health Care
With the approach of the retirement of a huge number of Baby Boomers, the home health care industry is quickly becoming one of the fastest-growing and most scrutinized young industries in the country. Among the features of the industry that might soon be changing is its exemption from overtime pay laws. There are valid arguments on both sides of the issue, and only time (and a healthy dose of politics) will decide the issue.
The Controversy
Since its solidification as a large-scale field of work, in-home care has been exempt from some of the laws that other employers and employees must follow. While this has given caregivers a great amount of flexibility in the way they are paid by clients and the way they record their work, it has also drawn the attention of some who claim that the employment rights of caregivers are not being protected. Some caregivers might find themselves working excessive hours under difficult conditions, with no promise of extra compensation in return.
View #1
Those advocating the removal of the industry’s exemption from overtime law say that the problem is clear: In-home caregivers should have the same protections that most other employees enjoy. Nurses, doctors, and even housecleaners receive overtime pay, and non-medical caregivers should get the same. In many cases, there is a concern that family members of seniors could take advantage of the exemption and ask caregivers to do more work, possibly on their own time, without paying them more.
View #2
The opposite side—including many members of the caregiving field itself—argue that the overtime exemption is important and valuable. It gives caregivers the liberty to do the job that needs to be done without keeping cumbersome logs. The nature of the job is so complicated that overtime does not work the way it does in other industries. For example, if a caregiver wants to take some of the client’s laundry home and do it there, would she have to log the time she spends doing it and claim overtime pay for it?
At this point, and certainly in the near future if these questions continue to swirl, in-home caregivers are in a legally murky situation. If you have confusion about what your rights are in your situation, let Valli, Kane & Vagnini help you figure it out. We look forward to meeting you and helping you with your legal needs.
Environmental Discrimination: Hampering Individual Achievement
In the 1950s, segregation in America was still predominant. Separate busses and separate water fountains were mandated, dividing white from black in a manner that should never be repeated. While segregation has long been outlawed for decades from a legal standpoint, racism still rears its head in a number of arenas, from institutional to professional to educational to environmental.
Environmental discrimination came about in the 1980s, and established the desire to create a legal precedent in which racial elements influenced environmental factors. Its definition is broad, its legal influence is growing, and its affect on your situation at work or at home may be a determining factor in your need for an attorney.
What is Environmental Discrimination/Racism?
Environmental discrimination, or environmental racism, is the affect that race plays on one’s environment. Separate water fountains make for a simple example: were the water fountains used by whites in the 1950s cleaner, well-maintained, and more sterile than those used by blacks? When environmental discrimination is present, individual achievement is hampered. This is simply antithetical to the American way. Every American should have equal opportunity to move forward, work hard, and achieve his or her goals. While overcoming hardship is an essential component to success, racism is an unacceptable hardship in the United States.
How Might Environmental Discrimination Affect My Situation?
Environmental discrimination in New York may be more common than you realize. If a landlord owns properties in several neighborhoods, yet refuses to invest in maintenance on properties “because of the people in the neighborhood,” then that might legally be defined as environmental racism. Not only is that potentially illegal, it is terrible business practice, and a disservice to the community.
In business, if a franchise owner decides to invest more in “white neighborhoods” than “black neighborhoods” or “latino neighborhoods,” then environmental discrimination is clearly present.
Zoning and Environmental Discrimination
This type of discrimination may go into the government sector as well. For instance, when voter districts are changed to racially segregate a vote, then that is environmental discrimination. Zoning laws, when drawn with race as a factor, constitute racist behavior and may potentially open the doors for litigation.
If you feel you are a victim of environmental discrimination, then you need an attorney with an expert knowledge of your situation. Call the law offices of Valli, Kane & Vagnini, and put your trust into experienced attorneys.
Working Off The Clock? Think Again
With the American economy in the midst of its worst downturn in decades, corporations are trying to squeeze that last buck out of every corner they can. Job satisfaction is going down across the board. One largely unsung issue that may be elevating to epidemic proportions is “Off the Clock” work.
For many, going unpaid for the work you perform for your employer is illegal. Many corporations in the U.S. are, unfortunately, asking their workers to buck up and work without minimum wage or overtime pay. This violates both New York and Federal law. The plain fact of the matter is that the laws are designed to protect during the bad times as well as the good. Just because there is not as much money to go around does not mean that it is all right to ask workers to work off the clock without compensation.
Full Time Employees in New York
For the most part, New York State follows Federal guidelines when it comes to minimum wage and overtime. If a non-exempt employee is performing work of any sort for their employer, they are to be paid at least minimum wage for their work. If they are working over forty hours in a work week, then any time worked above that is eligible for overtime pay. Live in employees may claim overtime after forty-four hours as well. Naturally, standard exemptions apply to certain types of employees, including certain interships.
However, a controversial case is brewing in New York that might potentially change how the law sees interns nationwide. An intern is suing Harper’s Bazaar, claiming that minimum wage is due to all intern workers and that internships are exploitive. We will follow this case closely and continue to report on its significant role in the wage and hour litigation world.
Full Time Workers That Receive Tips
If your employer claims that you are not entitled to overtime pay because you receive tips in your line of work (such as a restaurant server, delivery driver, dancer, etc.), then your employer is out of compliance with New York and Federal law. All work performed by these types of workers are subject to minimum wage and overtime law.
If you are a non-exempt, hourly worker, an employer cannot refuse to pay you time working off the clock. You are entitled to be paid for all hours work at minimum wage or an overtime rate if over 40 hours in a work week. If you feel you are being forced to work “off the clock” meaning you are not being paid for your time, then you should contact an attorney familiar with these laws immediately. For a free consultation, contact the law offices of Valli Kane & Vagnini, LLP at (866) 441-2873. You need a talented lawyer that is not afraid to take on exploitive employers that disregard the law.
Gender Harassment on Late Night TV
From the average American’s point of view, workplace harassment suits may be relegated to office environments–cubicle mazes filled with discrimination by cold-blooded corporate predators. However, harassment runs across all dimensions of American employment, from corporate settings, to manufacturing, to construction, and so on. Lately, a hurricane of highly publicized lawsuits serve to expose an often ignored segment of American employment: television. At the center of it all you will find the often regarded “nicest man on television.”
Paul Tarascio is a New York-based stage manager for live television. In January, the television professional filed a lawsuit against Jimmy Fallon, as well as many employees that work on Late Night with Jimmy Fallon and NBC, claiming gender discrimination. Tarascio claims that he was replaced because Fallon prefers female stage managers. When he went to his superiors–and then to union officials–he said he was fired.
Because of the notoriety of the celebrities at the center of these types of shows, this area of law has garnered national attention. The union-driven industry is high-powered, often ego and market driven, and moves at the speed of light. Hirings and firings are as routine on television as they are among NFL coaches. Because television is a gigantic—and extremely rich—industry, many employees may refrain from bringing an action against these networks and public figures because they fear the loss of opportunities in the industry and question whether they have the wherewithal to take on these financial giants.
A similar case involving a joke made by Jay Leno on his late night show has resulted in a lawsuit. While many of the specifics of both Leno’s and Fallon’s lawsuits are not known, the lawsuits brings to light the common misconception that celebrities are somehow exempt from State and Federal discrimination laws. Discrimination on the basis of gender is just as illegal on a multi-million dollar television set as it is at your local Pizza Hut or any other employer in the country. The law makes no exception for the elite, nor should it. Discrimination in any form is wrong and it is punishable by law.
If you feel you have been victimized at your place of work due to your gender or any other protected basis, then you have the right to seek counsel and assert your legal rights. An experienced discrimination attorney can help you understand the complexities of Federal and New York workplace law as it relates to you. Call the law offices of Valli Kane & Vagnini, LLP now at (866) 441-2873 and get one of NY’s finest employment attorneys on your side.
Employment Law and Pregnancy Discrimination
Telling Your Employer About Your Pregnancy
When you are pregnant, you may wonder when and how you are going to tell your employer. The fact is under the Pregnancy Discrimination Act, and other laws against discrimination, you do not have to tell your employer at all. If you can perform your work and do it well, and do not need special accommodations, your pregnancy is legally irrelevant.
The Pregnancy Discrimination Act
The Pregnancy Discrimination Act prohibits employers with more than 15 employees from discriminating against pregnant employees.It also includes local and state government employees, federal employees, employment agency employees and labor organization employees no matter how many employees they have.
Pregnancy Discrimination and Benefits Employers must provide the same benefits to all their employees whether they are pregnant or not. This includes health insurance, retirement and disability benefits. Medical conditions related to pregnancy must be covered identically to other medical conditions.Pregnancy Discrimination and Disability If a pregnant woman can do her job for a while due to a medical condition related to her pregnancy or childbirth, the employer must treat it like any other temporarily disabled employee. This means that the employer must make accommodations or provide disability leave.More Rules on Pregnancy Discrimination
- A potential employer may not ask a pregnant job candidate any questions they would not ask a candidate that was not pregnant.
- An employer may not discriminate against an employee who might get pregnant.
- An employer may not forbid a pregnant employee from doing a job for which she is fit and she wants to do.
- Jobs must be held open for pregnancy related absence for the same amount of time as for other sickness and disability.
- Employers cannot discriminate against an employee who has had an abortion or is considering getting an abortion.
- Female spouses of male employees must be provided the same level of medical benefits than the male spouses of female employees.
- Single women must be provided the same pregnancy related benefits as married women.
- Seniority, vacation, raises, promotions and other accrued benefits for pregnant women must be granted in the same way as those on leave for non-pregnancy reasons.
If you believe you may have been a victim of pregnancy discrimination due to pregnancy, childbirth or a pregnancy related medical condition, you should consult with an employment attorney as soon as possible. A reputable employment discrimination lawyer will listen to your situation and educate you on the pregnancy discrimination laws. If you have been a victim of pregnancy discrimination an experienced employment attorney can help you recover any damages you have incurred.
What To Do If Being Harassed At Work
Those who suffer sexual harassment in the workplace do not have to tolerate the behavior; there are options. However, people who suffer through sexual harassment in the workplace are often hesitant to report the behavior. They are intimidated by the fear that reporting this degrading and demeaning behavior could have negative consequences. These feared consequences could include termination, damage to prospects of future employment, demotions and negative transfers. These potential negative consequences can be mitigated by empowering the sexually harassed individual to stop the behavior and demand redress for the professional and emotional distress as a result of the illegal behavior.
Sexual Harassment and Employment Law
Sexual harassment falls under the federal employment discrimination laws. In many areas, it not only violates United States federal law, but state and local laws. Employers are obligated to take action to prevent sexual harassment at the workplace. If sexual harassment is reported to the employer, immediate action must be taken to deal with the situation. In addition, the employee reporting sexual harassment is legally protected from retaliation by the employer.
What is Sexual Harassment?
Sexual harassment comes in many forms. Some of these forms include:
- Being directly asked for sex or sexual contact.
- Unwanted and unwelcome sexual advances. This can be requests for dates or requests for meeting outside of the workplace.
- Sexually charged speech.
- Physical contact of a sexual nature.
- Being required to function in a hostile work environment.
- Behavior deemed inappropriate to the workplace. This includes sexist and derogatory language and pornographic images in the workplace.
- Discriminatory and unfair treatment, including denial of opportunities and promotion, based on gender.
Should I Pursue a Sexual Harassment Lawsuit?
Individuals victimized by sexual harassment are often reluctant to pursue a lawsuit. They are often caught in the dilemma of fearing the potential of negative consequences of reporting sexual harassment, while knowing that action must be taken. Attorneys experienced in sexual harassment cases take great care in the way they treat clients that have been victims of harassment. Great attention will be given to the privacy of the client. And, if possible, the case will be pursued on a completely private basis through negotiations with the employer or through filings with agencies such as the EEOC which are charged with the responsibility of investigating claims of such harassment.
Whether it is sexual harassment or other forms of discrimination in the workplace, it is important to understand the rights and legal options of the worker. If an employer has violated your rights, set up a no cost consultation with a law firm that is experienced in workplace discrimination.
The Fair Employment Opportunity Act of 2011 – Eliminating a Catch-22
NYC employment attorneys have pointed out that the Equal employment Opportunity Commission (EEOC) held a public hearing. A disturbing trend triggered this hearing. Several companies had been discriminating against job applicants who were unemployed. These job applicants had been excluded from any hiring consideration. Some even ran ads saying that a candidate would only be considered if employed. Ads would have statement like “Unemployed candidates will not be considered at all” or “No candidate will be considered by client if not currently employed, whatever the reason.” The same NYC employment attorneys also point that however disturbing and discriminatory this may seem, it is legal. At least for now.
The Fair Employment Opportunity Act of 2011 is designed to prohibit employers and employment agencies from using unemployment as a sole factor to screen out or exclude job candidate.
In this time of severe recession, many workers are merely victims of the economy. However, as NYC employment attorneys have noted, many employers hang on to the outmoded idea that unemployed people are somehow damaged, are poor workers and weak links.
Employers and staffing firms are not correcting this issue on their own. In fact, the NELP says that these firms are continuing to deny job openings to unemployed candidates.
This is a demoralizing double whammy to those who have lost a job and learn they will not be considered for new openings because they are not working. This old Catch 22 states that you have to have a job to get a job. The fact is there are currently highly qualified, skilled, experienced workers who cannot seem to get their foot in the door because they lost a job through no fault of their own. The NYC employment attorneys state that this makes no sense from a business standpoint.
The Fair employment Opportunity Act of 2011 is designed to stop employers and employment agencies from discriminating against job candidates who are not working. The job search environment is already tough. The Bureau of Labor Statistics states that there is one job opening for every five unemployed workers and the job crises has a long way to go.
The NYC employment attorneys are confident that this new legislation will eliminate the discriminatory practices that are making a long term unemployment problem even worse. Apparently, this legislation has strong support and, if enacted, unemployed job candidates should get a fairer shot at job openings.
Employment and the Expansion of Disability Claims
The rules issued by the Equal Employment Opportunity Commission (EEOC) expand the protection granted employees under the Americans with Disabilities Act (ADA). These rules were authorized by the ADA Amendments (ADAA) and were passed by Congress in 2008. The results are a significant expansion of the number of individuals claiming ADA protection.
Americans with disabilities are a large and economically disadvantaged group. The goals of ADA mandates are similar to civil rights. One goal is to make sure people with disabilities have access to employment. In the past, employers traditionally shut out disabled people from employment. A second goal is to increase job opportunities for disabled. As a group, people with disabilities earn less than people without disabilities. Employers that will be affected. Employers that employ 15 or more employees who work for at least twenty calendar weeks within a year. The EEOC points out that tracking this can become rather complicated and recommends staying in close communication to ensure compliance. Broad is the protection. The ADAA has expanded the definition of “disability”. As a result, employees will have a much easier time when seeking the law’s protection.
Do I fall under this broad coverage? According to the EEOC, an individual with a disability is a person who:
- Has a physical or mental impairment that substantially limits one or more major life activities;
- Has a record of such an impairment; or
- Is regarded as having such an impairment.
The key is how limited you are in performing your major life activities. For example, doctors may have diagnosed you as being clinically depressed. However, you may not be qualified for coverage because you are not substantially limited in performing major life activities.
What are my rights?If you are covered under the ADA, your employer must make “reasonable accommodations” as long it does not cause the employer “undue hardship”. Undue hardship for the employer means it would cause significant difficulty or expense. Reasonable accommodation can take many forms, but some common examples are included here:
- Part time and job sharing
- Flexible schedules
- Time off for doctor’s appointments, support groups and therapy
- Flexible break time to meet individual needs
- Additional leave time
Filing a Charge. If you think an employer has discriminated against you because of your disability, you may file at the nearest EEOC office or find an experienced employment attorney. If you have no office in your area, it can usually be over the phone.