Outcome Health to pay $70m after fraud investigation

Outcome Health, privately held by ContextMedia Health, admitted in resolution documents that from 2012 to 2017, former executives and employees of the company perpetrated a scheme to defraud its clients—most of which were pharmaceutical companies—by selling advertising inventory that it did not have.

The payout will be $70 million to victims of the fraud scheme, that targeted clients, lenders and investors.

According to a statement from the Justice Department, the resolution was based on a number of factors, including Outcome and Outcome Parent’s ongoing cooperation with the United States and for taking extensive remedial measures.

For example, Outcome no longer employs the executives or employees who were involved in the wrongdoing, and Outcome and Outcome Parent made significant improvements to address and improve the reliability of reporting on advertising campaign delivery, including hiring third parties to audit all of their advertising campaigns.

“Outcome Health deceived its lenders and investors, and overbilled its clients, by fraudulently misrepresenting both the quality and quantity of its advertising services and concealing those misrepresentations from auditors,” said Principal Deputy Assistant Attorney General John P. Cronan said in a statement. “Today’s resolution demonstrates the Criminal Division’s unyielding commitment to making whole victims of fraud.”

Outcome admitted that as a result of its practice of selling clients inventory it did not have, it under-delivered on its advertising campaigns. Despite these under-deliveries, the company still invoiced its clients as if it had delivered in full.

To conceal the under-deliveries, Outcome employees at the time falsified affidavits and proofs of performance to make it appear the company was delivering advertising content to the number of screens in its clients’ contracts.

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“Outcome’s payment of $70 million is an appropriate resolution for the corporate entity given the misconduct of executives and employees acting on its behalf,” said Assistant U.S. Attorney Brian Hayes, Chief of the Criminal Division for the Northern District of Illinois. “This resolution demonstrates that there are significant consequences for businesses whose executives and employees engage in fraud.”

Outcome executives and employees during that time also inflated patient engagement metrics regarding how frequently patients engaged with Outcome’s devices. The judgement also says, an Outcome executive at the time altered a number of studies presented to clients to make it appear that the campaigns were more effective than they actually were.

“For five years, employees of Outcome Health purposely failed to deliver on advertising campaigns and engaged in a pattern of misrepresentations to conceal their fraud,” said Special Agent in Charge Emmerson Buie Jr. of the FBI’s Chicago Field Office. “This resolution demonstrates the FBI’s commitment to working with its prosecutorial and investigative partners to ensure that justice is done.”

Outcome further admitted that its under-delivery on advertising campaigns resulted in a material overstatement of its revenue for the years 2015 and 2016. The company’s outside auditor signed off on the 2015 and 2016 revenue numbers because executives and employees at the time fabricated data to conceal the under-deliveries from the auditor.

“Today’s agreement holds a healthcare technology company accountable for systematically committing fraudulent business practices for financial gain over many years,” said Inspector General Jay N. Lerner of the Federal Deposit Insurance Corporation’s Office of Inspector General (FDIC-OIG). “The FDIC-OIG is committed to investigating such corporate corruption which harms lending institutions, investors, customers, and competitors. We remain dedicated to working with our law enforcement partners to investigate those who commit such misconduct.”

Outcome used the inflated revenue figures in its 2015 and 2016 audited financial statements to raise $110 million in debt financing in April 2016, $375 million in debt financing in December 2016, and $487.5 million in equity financing in early 2017, it admitted.

The Department and Outcome entered into a non-prosecution agreement (NPA) to resolve this matter. Outcome’s obligations under the agreement will have a term of three years, unless the term is modified by the government. Under the terms of the NPA, Outcome and its current parent company, Outcome Health LLC (Outcome Parent), committed to compensating the pharmaceutical client victims in the amount of $70 million, approximately $65.5 million of which has already been made through a combination of cash payments and in-kind services, and to set aside an additional $4.5 million to compensate any additional pharmaceutical clients who have not yet been made whole.

Since its inception, Outcome has had a troubled past. The company was investigated for fraud in 2018. Co-founders, Rishi Shah and Shradha Agarwal no longer had an ownership stake in the Chicago company since May of 2019. Finally, Matt McNally, an advertising-industry veteran, was hired as CEO and has been trying to rebuild the company.

Seems McNally will now have his work cut out for him.

Read the full judgment here.

SOURCE: Justice Department