Our Cases - Successful Prosecution Of Fraud

Representative Fraud and Employment Cases

A sample of cases handled by Michael A. Hirst of Hirst Law Group P.C., including his work as supervisor of False Claims Act cases for the Department of Justice and cases handled by Hirst Law Group, P.C., in private practice:

Whistleblower and False Claims Act Cases

A qui tam case under the California False Claims Act and the Insurance Fraud Prevention Act, based on allegations that The Pill Club defrauded the government in its billings of contraceptive sales. The case resulting in a multi-million dollar recovery.
A qui tam FCA fraud case against Sutter Health and Sacramento Cardiovascular Surgeons Medical Group Inc., based on allegations that the defendants violated the Anti-Kickback Statute and the Stark Law by engaging in a scheme to induce referrals and defraud the Medicare and Medicaid programs. A portion of the claims were settled in a multi-million dollar recovery, and the case is ongoing.
A qui tam FCA fraud case against Adventist Health System/West and its affiliated hospital, St. Helena Hospital, based on allegations that the companies billed Medicare for unnecessary coronary procedures, known as percutaneous coronary interventions, and related inpatient admissions. The case resulted in a multi-million dollar recovery.
A qui tam FCA fraud case against two speech language pathologists, and three hospitals, Eastern Idaho Regional Medical Center, Madison Memorial Hospital, and Idaho Falls Recovery Center, based on allegations that they billed Medicare and Medicaid for speech therapy that was actually provided by unlicensed aides. The case resulted in a multi-million dollar recovery.
A qui tam FCA fraud case against Tulare Regional Medical Center based on allegations that the hospital violated Medicare’s anti-kickback rules. The case resulted in a multi-million dollar recovery.
A fraud case against Halliburton Company subsidiary Kellogg, Brown & Root, based on a whistleblower's information that the firm defrauded the Department of Defense in its construction practices at Fort Ord, which resulted in a multi-million dollar recovery against the company.
A qui tam FCA fraud case against Tenet Healthcare, Inc., based on a whistleblower's information that the company defrauded the Medicare program by performing unnecessary heart surgeries at Redding Medical Center. The multi-million dollar recovery against the company is the largest in a medical necessity fraud case and also the largest recovery against a single hospital in Department of Justice history. The case is the subject of a book, Coronary (Simon and Schuster, 2007) by New York Times journalist and author Steven Klaidman.
A fraud case against Rain and Hail Insurance Services, Inc., based on allegations that the company falsified documents and inflated claims in administering an agricultural insurance program. The multi-million dollar recovery against the company was the largest in the history of the Federal Crop Insurance Corporation.
A fraud case against Hughes Electronics Corporation for defrauding the United States under a Department of Defense contract, which resulted in a multi-million dollar recovery against the company.
A fraud case against the California Department of Education, based on a whistleblower's information, which resulted in a multi-million dollar recovery against the state agency.
A fraud case against the Regents of the University of California (UC), based on a whistleblower's information, for submission of false and duplicative claims, which resulted in a multi-million dollar recovery against UC.
A fraud case against Horizon West, Inc., for fraudulent billings in its operation and management of nursing homes, which resulted in a multi-million dollar recovery against the company.
A fraud case against Catholic Healthcare West, based on a whistleblower's information, for submitting false claims in its billings, which resulted in a multi-million dollar recovery against the company.
A qui tam FCA fraud case against Adventist Health System/West and its affiliated hospital, White Memorial Medical Center, based on allegations that the companies violated Medicare’s anti-kickback rules. The case resulted in a multi-million dollar recovery.
A fraud case, based on a whistleblower's information, against OrthoLogic Corp. for fraudulently selling medical devices not approved by the FDA, which resulted in a million dollar recovery against the company.
A qui tam FCA fraud case against Alternative Learning Center and Adult Educational Technologies, based on allegations that the defendants falsified documentation and knowingly billed the California Department of Developmental Services for services that were not provided. The case settled, resulting in a multimillion dollar recovery.
A qui tam FCA fraud case against Glendale Memorial Hospital, owned by Catholic Healthcare West, based on allegations that the company violated Medicare’s anti-kickback rules. The case resulted in a $900,000 recovery.
A qui tam FCA fraud case against Chabad of California, based on allegations that Chabad knowingly failed to comply with federal grant requirements and falsely asserted to the government that it had implemented procedures to safeguard grant funds. In an unusual success in a fraud case based solely on motions, a federal judge granted summary judgment against Chabad, resulting in a $817,483 recovery. The Ninth Circuit Court of Appeals affirmed the judgment.
A qui tam FCA fraud case against Arete Sleep LLC and its affiliates based on allegations that the companies billed Medicare for diagnostic sleep tests that were performed by technicians lacking the licenses or certifications required by Medicare regulations. The case resulted in a $650,000 recovery.
A qui tam FCA fraud case against Longs Drugs (now owned by CVS) based on allegations that the company defrauded the government by billing Medicaid for amounts already covered by insurance companies. The case resulted in a $700,000 recovery.
A qui tam FCA fraud case against PRIDE Industries, and its subsidiary, PRIDE Industries One, based on allegations that the companies defrauded the government by submitting false claims relating to a contract to provide maintenance services at a U.S. Army base. The fraud case resulted in a $400,000 recovery.
A qui tam FCA fraud case against a Tucson Orthopedic Institute based on allegations that the company improperly billed Medicare for certain DME items and other services. The case resulted in a $158,620 recovery.

Employment Cases

An employment case against a hospital for retaliating against two employees who brought a qui tam action based on allegations that it defrauded the government through improper billing to the Medicare and Medicaid programs. The case resulted in a $442,500 recovery.
An employment retaliation case against a government contractor. The case resulted in a $370,000 recovery.
An employment case against a defendant for retaliating against three employees who brought a qui tam action against the company based on allegations that the company defrauded the government in its federal contract. The case resulted in a $187,000 recovery.
An employment retaliation case against a government grant recipient. The case resulted in a $350,000 recovery.

The information in this website is not intended to be legal advice. We recommend that anyone not currently represented by an attorney who is reading this page to understand the law involved in False Claims Act or other cases seek experienced counsel to evaluate, file and pursue, if appropriate, any potential case on your behalf.