USA, ex. rel., Lauren Kieff, et al. v. Wyeth
United States of America et al., ex rel. Lauren Kieff, v. Wyeth, No.1:03-CV-12366-DPW (D.Mass.): A qui tam action alleging that drug manufacturer Wyeth overcharged the state Medicaid programs by not providing them the statutorily required “best price” for a widely prescribed drug. This action resulted in a recovery of more than $780 million by the government.
USA, ex. rel. O’Connor v. National Spine and Pain Centers, LLC
United States of America ex rel. Michelle O’Connor v. National Spine and Pain Centers, LLC, et al. (E.D. Va.): Cohen Milstein represented the whistleblower, a physician assistant and former employee of PMA in this qui tam action. The whistleblower alleged that PMA, which operates several pain management practices in Virginia, doing business as National Spine & Pain Centers, overcharged Medicare, TRICARE, and the Federal Employees Health Benefits Program for medical services and ordered quantitative urine drug tests that were medically unnecessary, and which were billed to the federal health care programs. On April 19, 2019, the United States Government reached a settlement with PMA for approximately $3.3 million.
USA, State of Maryland ex rel. J. Doe v. Shore Health System, Inc.
United States of America and The State of Maryland ex rel. J. Doe v. Shore Health System, Inc. (D. Md.): Cohen Milstein represented the whistleblower who brought forward and filed a qui tam lawsuit, alleging that Shore Health System, a subsidiary of the University of Maryland Medical System that operates two hospitals and several non-hospital outpatient centers located on Maryland’s Eastern Shore, overcharged the Medicare and Maryland Medicaid programs between 2014 – 2018 for services provided to Medicare and dual eligible Medicare and Medicaid beneficiaries. On July 16, 2021, the Maryland U.S. Attorney’s Office and the State of Maryland reached a $9.5 million settlement.
COVID-19 Waiver Program FCA Litigation
United States et al., ex rel. Bay Area Whistleblower Partners v. ReNew Health Group LLC et al. (C.D. Cal.): Cohen Milstein represented whistleblowers in a lawsuit alleging that ReNew Health, which owns and operates dozens of nursing facilities throughout California, submitted millions of dollars of false claims to Medicare and California Medicaid under the COVID-19 waiver program for skilled care beginning at the start of the pandemic in March 2020. The whistleblower lawsuit prompted an investigation by the U.S. Department of Justice and the California Department of Justice’s Division of Medi-Cal Fraud and Elder Abuse. This investigation culminated in the first False Claims Act settlement regarding fraud in the COVID-19 Waiver Program, totaling more than $7 million.
United States ex. rel. Detroit Integrity Partners v. Detroit Nursing Center, LLC, et al.
United States ex. rel. Detroit Integrity Partners v. Detroit Nursing Center, LLC, et al. (E.D. Mich.): Cohen Milstein represented Detroit Integrity Partners, a whistleblower, who brought a False Claims Act and Michigan Medicaid False Claim Act qui tam lawsuit against the owners and operators of six Detroit area nursing homes. The whistleblower alleged that the defendants defrauded the Medicare and Medicaid programs. Specifically, the nursing homes were severely understaffed and provided grossly substandard care to residents and submitted false claims to Medicare and Medicaid for payment for the noncompliant services. On June 17, 2025, the United States and Michigan reached a $4.5 million settlement with the defendants.