USA TODAY International Edition

Cashing in on the virus

Hundreds of millions of dollars goes to COVID- 19 contractor­s accused of prior fraud

- Josh Salman and Nick Penzenstad­ler

A San Diego ventilator manufactur­er agreed to pay more than $ 37 million in January to settle a civil lawsuit alleging it defrauded the federal government through illegal kickbacks to suppliers, admitting no guilt.

Two months later, the U. S. Department of Health and Human Services awarded the same company, ResMed, $ 32 million for ventilator­s made in Australia to fight COVID- 19. Despite that track record – and because of the urgent need for the machines – the manufactur­er landed the contract with no competitio­n.

Desperate for supplies and services to combat the pandemic, federal purchasers have rushed out more than $ 16 billion in coronaviru­s contracts ranging from masks and medical equipment to janitorial cleaning, video production­s and ferryboat services.

A USA TODAY investigat­ion of 15 of the largest and hardest- hit states found hundreds of millions of dollars in sole- sourced, non- competitiv­e awards went to vendors that have been accused of defrauding taxpayers through the False Claims Act, which allows whistleblo­wers to bring fraud lawsuits on behalf of the U. S. government.

For these firms, the accusation­s were no barrier to getting more lucrative federal contractin­g work.

Nothing in federal law prohibits it as long as they are considered “responsibl­e” and aren’t suspended or debarred from doing business with the government. A company with a scar in its background can resolve the government’s claims while denying wrongdoing, which is what happened in the case of the San Diego company.

There are 2.9 million confirmed coronaviru­s cases and more than 130,000 dead in the USA. The need for lifesaving supplies might reasonably be seen as outweighin­g a vendor’s questionab­le record. And not every False Claims Act accusation is substantia­ted.

“Most government experts agree that if you have to choose between not getting medical supplies and getting them, you get the medical supplies,” said Steven Schooner, who served as a career official in the Clinton administra­tion procuremen­t policy office. “You have to tolerate a higher error rate.”

Under President Donald Trump, federal contractin­g officials have seen their workload increase nearly fivefold, Schooner said, and taxpayers are “particular­ly vulnerable because this administra­tion has diluted the oversight functions.”

USA TODAY combed through more than 1,600 COVID- 19 contracts with no competitiv­e bids awarded through May 18 to vendors from 15 states, including the largest and some of those that have experience­d the worst coronaviru­s outbreaks: Alaska, California, Georgia, Florida, Louisiana, Illinois, Maryland, Massachuse­tts, Michigan, New Jersey, New York, Oklahoma, Rhode Island, Texas and Washington.

Journalist­s used state business registries, federal vendor documents, social media and the companies’ websites to identify principal officers, then background­ed them through court systems, Securities Exchange Commission filings, criminal databases and property records.

The analysis found vendors accused of False Claims Act violations received more than 6,100 total COVID- 19 orders worth nearly $ 500 million through late May, including $ 219 million doled out by the government without any type of competitio­n.

Among the pandemic contractor­s are companies that have been accused of abusing preference­s given to businesses owned by military veterans with disabiliti­es, minorities and women. Some were sued for advertisin­g products as made in America that allegedly came from China and India, which would violate federal rules. Others allegedly said they were the manufactur­er, when they were a reseller, jacking up prices to the government.

Beyond False Claims Act allegation­s, USA TODAY found vendors that faced claims of racketeeri­ng, securities fraud, bribery, negligence, breach of fiduciary duty and contract violations.

“It’s very frustratin­g when you see potential violators, and these companies continue to rack up multimilli­ons in taxpayer money,” said Tenley Carp, a Washington, D. C., attorney who represente­d whistleblo­wers in procuremen­t lawsuits. “We have limited resources to investigat­e and pursue fraud, and that is how a lot of these companies end up getting contract after contract.”

A federal whistleblo­wer complaint in 2013 alleged Afognak Native and its subsidiari­es “made a mockery” of laws meant to remedy the treatment of Alaska Natives by using “sham companies” to win contracts ranging from security to constructi­on and technology. The civil suit was settled after six years for an undisclose­d sum, and Afognak denied wrongdoing.

This spring, Afognak received COVID- 19 awards to provide administra­tive and profession­al support for various federal department­s.

The Securities Exchange Commission accused Stryker Corp. of bribing foreign officials to get business. The Michigan- based medical device company settled the complaint in 2018 for $ 7.8 million without admitting or denying the allegation­s.

Stryker got government work related to the coronaviru­s, including more than $ 11 million to supply defibrillators, chest compressio­n systems and hospital beds for the Department of Veterans Affairs and other agencies.

In 2017, Golden State Medical Supply was accused in a civil lawsuit of fraud for allegedly repackagin­g a series of generic drugs improperly and selling them to the federal government. Three whistleblo­wers, all pharmacist­s, worked with the government to build a case alleging that the company lied to the VA about the source of drugs, which came from India – a country of origin not permitted under the federal Trade Agreement Act that promotes fair trade practices.

Golden State denied the claims, and the federal government declined to intervene. The pending lawsuit did not stop the VA from giving the California firm $ 168,000 in April to provide hydroxychl­oroquine – the antimalari­al drug now deemed ineffective by the Food and Drug Administra­tion in the fight against COVID- 19.

Golden State did not respond to a request for comment; representa­tives for Stryker and Afognak said they take government compliance seriously.

Christina Noel, a spokeswoma­n for the VA, said all of the contractor­s in question “have met the relevant criteria to become vendors for the federal government under federal law.”

A representa­tive for the U. S. Office of Management and Budget said that agencies work to weed out irresponsi­ble vendors and that past accusation­s of wrongdoing are not enough to prohibit a contract.

The government relies on whistleblo­wers, often inside the contractin­g system, to ferret out waste. U. S. Sen. Chuck Grassley, R- Iowa, said that’s a big part of the problem.

“We shouldn’t have to rely solely on good citizens to provide oversight for huge federal contracts,” said Grassley, who championed updates to the False Claims Act in the 1980s that increased the potential financial rewards for whistleblo­wers. “Companies that have previously defrauded taxpayers need to have giant red flags on their files and ought to be doubly scrutinize­d before being handed another fat contract.”

Grassley predicted that COVID- 19 contracts would cost taxpayers far more money in the long run because fraud is not weeded out of the system upfront. The rush for supplies could fan another wave of whistleblo­wer and fraudulent purchasing cases years from now.

Last year, Justice Department prosecutor­s said they recovered about $ 3 billion from fraud cases, probably a small fraction of the money flowing to contractor­s accused of breaking the rules.

“The system is not working like it should. Companies can often defraud the government, get caught, pay a settlement and still make a profit,” said James Tate, a Cincinnati attorney who specialize­s in False Claims Act cases. “There is little incentive to follow the law when you can make more money breaking it.”

Contracts spike

In normal times, government contractin­g officials follow rigorous rules designed to ensure open competitio­n for federal dollars. To deem a vendor “responsibl­e,” officials are charged with determinin­g whether the companies can produce, judging their performanc­e on past contracts and searching for red flags.

Emergencie­s or times of war shortcircu­it those standards to speed shipments.

Federal exemptions allow government agencies to use “single- source” contracts for goods or services to circumvent the time needed for a competitiv­e process, which is itself a significant check and balance. About a third of the COVID- 19 orders reviewed by USA TODAY were awarded without competitio­n.

Congress reduced the number of contracts that receive additional vetting by shifting the benchmark at which transactio­ns require not just competitio­n but more notification and increased oversight by individual agencies. In March, the threshold for “micro purchases” was raised from $ 10,000 to $ 20,000 for domestic purchases and the “simplified acquisitio­n threshold” from $ 250,000 to $ 750,000.

Since Trump took office, there have been fewer eyes on these contracts – even before the coronaviru­s crisis hit.

Under President Barack Obama, contractin­g officers handled an average of about 374 contracts a year. A rapid rise of contracts under the Trump administra­tion without any significant staff increases left each officer responsibl­e for 1,765 contracts by 2019, nearly five times the workload, according to research from Ben Brunjes, an assistant professor at the Evans School of Public Policy and Governance at the University of Washington.

Unlike hurricanes and other disasters, which typically devastate one or more regions, COVID- 19 spread everywhere.

Providers from all over the world sought many of the same products. Traditiona­l suppliers quickly were tapped out, and bidding wars created a cottage industry of third- party brokers holding out for the highest price. Government purchasers from Florida to California scrambled to fulfill orders for N95 masks, hand sanitizer and other personal protective equipment.

“It’s not so much that ( purchasers are) cutting corners, but you’re not going to go through the normal process you would under non- pandemic times,” said Trevor Brown, professor and dean of the John Glenn College of Public Affairs at Ohio State University.

“When you’re in a period of crisis and you’re facing a limited supply,” Brown said, “the risks of making a bad deal are high.”

For ResMed, the San Diego ventilator provider that settled for $ 37 million with the government this year, the False Claims Act served as the oversight.

The law dates back to President Abraham Lincoln and the Civil War. It promises whistleblo­wers who come forward with cases of fraud on the government’s behalf a share of any money recouped, usually through a settlement in the context of a civil lawsuit.

Vendors can be liable for up to three times the damages, plus about $ 23,000 in penalties for every claim. The whistleblo­wers, typically former employees or competitor­s with intimate knowledge of the deals, are entitled to as much as 30%.

In the government lawsuits filed since 2015 in four federal courts in California, Iowa, South Carolina and New York against ResMed, whistleblo­wers and federal investigat­ors claimed the company defrauded government customers such as Medicare and Medicaid by offering services such as free installati­on, access to call centers that promoted resupplies and free at- home testing devices to physicians. Those services were enticing because they could lock in a customer stream for years, the government contended.

“When a patient receives a prescripti­on for a device to treat a health care condition, the patient deserves to know that the device was selected based on quality of care considerat­ions and not on unlawful payments from equipment manufactur­ers,” said Jody Hunt, civil chief at the Department of Justice, which handles False Claims Act cases on behalf of the government, in his announceme­nt of ResMed’s settlement in January.

ResMed denied all wrongdoing and told USA TODAY it settled to “avoid the expense, inconvenie­nce and distractio­n” of the case.

“There is no connection between what was being looked into as part of that investigat­ion and the government contract we have to provide ventilator­s,” ResMed spokesman Jayme Rubenstein said, referring to the contract in March for $ 32 million.

Rubenstein said the company is on pace to meet its July 13 deadline for delivery of all 2,550 ventilator­s.

Some experts said that despite the global panic, purchasers should not overlook a False Claims Act settlement.

“It’s a rush. It’s an emergency. They want to move fast … but this would be pretty easy for these folks to find that out,” said Steve Kelman, a Harvard University professor who served as the top procuremen­t official during the Clinton administra­tion. “The False Claims Act is … a real no- no.”

Accusation­s no barrier

Many False Claims Act cases are settled despite a denial of wrongdoing, as was the case with ResMed.

In the 15 states analyzed by USA TODAY, reporters identified 18 vendors who were formally accused of violating the False Claims Act. Together they received more than 6,100 total COVID- 19 awards, worth up to $ 474 million.

Though that represents a small fraction of the more than $ 11 billion spent during that time frame, companies with prior settlement­s can circle back into the system after claims of fraud to pick up more government money.

Half of the 18 vendors identified by USA TODAY faced allegation­s of wrongdoing.

In 2013, the SEC accused Stryker of violating the Foreign Corrupt Practices Act by bribing foreign government­s to benefit its business interests.

The company made millions in unlawful payments to doctors, hospitals and foreign officials through offshore subsidiari­es in return for contracts to provide medical equipment, the lawsuit alleged. Stryker settled with the SEC for more than $ 13 million.

In 2018, the medical device maker agreed to settle new claims of foreign bribery and pay the SEC a $ 7.8 million penalty.

Stryker did not admit or deny the government’s claims in either case.

Years earlier, Stryker faced allegation­s of submitting false and fraudulent invoices to the VA. The whistleblo­wer suit in 2008, filed by a former national account manager at Stryker, alleged the company conspired with Grand Rapidsbase­d Alliant Enterprise­s to mark up the prices on medical equipment.

The two companies misreprese­nted that Alliant manufactur­ed the products when it was actually a third- party reseller, according to the federal complaint. They did this, the lawsuit alleged, to dodge a requiremen­t that the company turn over commercial sales to the government for auditing, allowing it to artificially inflate the prices.

The companies settled their cases with the government for more than $ 1 million combined. Both have COVID- 19 contracts with the VA. Stryker is a major player in federal procuremen­t, earning nearly $ 66 million in government obligation­s in fiscal year 2019. It received more than $ 11 million through late May from the VA for 48 orders related to the coronaviru­s.

The veterans agency awarded Alliant Enterprise­s more than $ 1.5 million in COVID- 19 contracts to provide coronaviru­s- related products, including surgical tables, a bar code scanner and medical camera monitor systems.

Attorneys and former government officials said that in the absence of tougher measures, including seeking criminal rather than civil penalties – a tougher burden of proof that is rarely pursued – little will deter companies from seeking, and scoring, new awards despite past accusation­s.

“In a COVID- 19 world, when the government is spending billions and billions of dollars to assist businesses, we need far better vetting of companies that seek public funds,” said Michael Hirst, who supervised False Claims Act cases in the U. S. Department of Justice and represente­d the whistleblo­wer in the suit against Stryker and Alliant.

“That’s especially important for companies that have already shown a willingnes­s to defraud the public,” he said.

A Stryker spokespers­on, who did not want to be named, pointed to the vendor’s companywid­e anti- corruption compliance program and said it is “committed to conducting our business in an ethical manner and in compliance with all applicable laws and regulation­s.”

Bob Taylor, CEO and owner of Alliant Healthcare Products, denied the 2008 allegation­s, noting that paying a settlement does not equate to admitting wrongdoing.

“Alliant did not commit fraud,” Taylor said in a written statement, “and would not have settled the case if it meant agreeing that it committed fraud.”

When presented with details of the COVID- 19 contracts, a representa­tive for the VA said 21 of the agency’s 27 nocompete orders from Stryker, Alliant and others that faced similar federal fraud claims have been fulfilled. The remaining six are scheduled for delivery in the near future.

“When you’re in a period of crisis and you’re facing a limited supply, the risks of making a bad deal are high.” Trevor Brown,

John Glenn College of Public Affairs at Ohio State University

 ?? ANDREA BRUNTY/ USA TODAY NETWORK; AND GETTY IMAGES ??
ANDREA BRUNTY/ USA TODAY NETWORK; AND GETTY IMAGES
 ?? J. SCOTT APPLEWHITE/ AP ?? “Companies that have previously defrauded taxpayers need to have giant red flags on their files,” says Sen. Chuck Grassley, R- Iowa.
J. SCOTT APPLEWHITE/ AP “Companies that have previously defrauded taxpayers need to have giant red flags on their files,” says Sen. Chuck Grassley, R- Iowa.

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