Qui Tam 101 » whistleblower

U.S. Sen. Grassley Works to Strengthen False Claims Act

Nolan and Auerbach — Fri, 30 Apr 2010 14:03:07 +0000

In May 2009, the President signed the Fraud Enforcement Recovery Act, sponsored by Senator Chuck Grassley and Senators Patrick Leahy and Ted Kaufman, made major changes to strengthen the federal False Claims Act by removing liability loopholes and addressing statutory confusion. Additional related, though less extensive changes, were made as part of the Patient Protection and Affordable Care Act enacted in March 2010, Grassley is now working to make sure that the recent changes made to the federal False Claims Act are recognized and incorporated by the 14 states that already have OIG-approved state False Claims Acts.

Consistency by a state with the Federal False Claims Act, is a requirement for a large federal incentive afforded to the state, when Medicaid dollars are successfully recovered in a Federal False Claims Act lawsuit. The federal incentive allows states to receive an additional 10% of the Medicaid recoveries if they allow whistleblower/qui tam lawsuits in their state False Claims Acts, as long as the state False Claims Acts afford the same rights to whistleblowers as the federal False Claims Act does.

In an April 28, 2010 press release , Grassley asked the Inspector General for the Department of Health and Human Services and the Attorney General to review existing state False Claims Acts, to make sure they are in compliance with recent changes to the federal False Claims Act; and to issue appropriate guidance for any state interested in the federal incentive.. In addition to the 14 states which have already qualified for this incentive (and are now subject to this review), six states applied for it but did not meet the requirements.

For the full press release, go to: http://www.iowapolitics.com/index.iml?Article=194624. For more information about qui tam law and health care fraud, contact Nolan & Auerbach, PA.

New Poll: Nearly Two Thirds of Business Professionals Expect Uptick in Recovered Government Funds

Nolan and Auerbach — Thu, 28 Jan 2010 01:45:33 +0000

Sixty-four percent of business professionals polled during a recent Deloitte webcast think the Fraud Enforcement and Recovery Act will be effective in increasing the total dollar amount the government will recover under the False Claims Act, according to a Jan. 27 Deloitte press release.

Respondents indicated their greatest concerns under the Fraud Enforcement and Recovery Act’s enforcement changes are: an expanded universe of companies potentially liable for FCA violations (24 percent); increased consequences of failing to return overpayments to the government (13 percent); extended whistleblower protections to non-employees (12 percent); and revived government ability to use Civil Investigative Demands (11 percent).

Approximately two-thirds (66 percent) of respondents were unaware that private qui tam plaintiffs — or whistleblowers — can bring suits under the FCA on behalf of the U.S. government against companies misusing government funds and keep a share of recovered funds.

Respondents expect that the financial services (44 percent) and health care and life sciences (23 percent) industries will see the highest increase in litigation resulting from increased Fraud Enforcement and Recovery Act, as well as FCA enforcement activity.

More than 800 business professionals from the banking and securities, consumer and industrial products, energy, resources and power, financial services, health care and life sciences, public sector technology, media and telecommunications and manufacturing industries responded to the online polling questions during an October 2009 Deloitte webcast.

For the full release, go to: http://www.prnewswire.com/news-releases/deloitte-poll-nearly-two-thirds-of-business-professionals-expect-uptick-in-recovered-government-funds-82784237.html.

For more information about qui tam law and health care fraud, contact Nolan and Auerbach, PA. at http://www.whistleblowerfirm.com/.

Supreme Court Hears Argument to Decide Whether Fraud Allegations in State Reports are Public Disclosures

Nolan and Auerbach — Wed, 02 Dec 2009 13:58:58 +0000

On November 30, the US Supreme Court heard oral argument in Graham County Soil & Water Conservation District v. United States ex rel. Wilson, No. 08-304 (“Graham County II”), concerning the “public disclosure” provision in Section 3730(e)(4)(A) of the False Claims Act. The public disclosure provision and the “original source” provision of the False Claims Act is intended to define the statutory bar against copycat whistleblowers who merely repeat what they have read or heard in public arenas, without having first-hand information of such information. The issue in Graham County was whether fraud publicly disclosed in a state (as opposed to a federal) administrative investigation or audit report are “publicly disclosed” for purposes of the FCA. Counsel for the Relator and for the the Government (from the Solicitor General’s Office) urged the Court to restrict the term “administrative to federal sources because of a “likelihood” that Congress believed that federal authorities would focus upon strictly federal sources. At oral argument, it seemed that the Justices were of the opinion that the statutory language was far from clear, and that the legislative history on the specific phrase is non-existent. Therefore it may be that the issue will be decided upon policy grounds taking into account the purposes of the False Claims Act as intended by its drafters.

For more information about qui tam law and health care fraud, contact Nolan and Auerbach, PA .

SEC Ponders Cash Rewards for Whistleblowers

Nolan and Auerbach — Thu, 12 Mar 2009 14:35:18 +0000

As Bernard Madoff was planning his guilty plea in a history-making fraud case, Securities and Exchange Commission Chairman Mary. L. Schapiro announced that the SEC is considering offering cash rewards to whistleblowers who expose financial wrongdoing, according to a March 12, 2009 Washington Times article. The practice of offering cash bounties to securities fraud whistleblowers would be similar to financial rewards given to people who help to expose insider-trading. Having this power, Schapiro said in the article, would enable the SEC to pursue cases more aggressively.

For the full article, go to: http://washingtontimes.com/news/2009/mar/12/sec-considers-cash-bounties-to-whistleblowers/.

For more about qui tam whistleblower law, contact Nolan and Auerbach, PA.

Weill Medical College of Cornell University to Pay in Excess of $2.6 Millon to Settle Fraud Connected to Research Funding

Nolan and Auerbach — Mon, 09 Mar 2009 16:51:26 +0000

Weill Medical College of Cornell University has agreed to pay $2,606,751 to resolve civil charges that the New York City-based college defrauded the government in connection with federal research funds awarded under grants made by the National Institutes of Health (NIH).

A whistleblower, who filed a qui tam complaint under the False Claims Act, first brought the case to government’s attention.

Weill Medical College made false statements to the NIH and the Department of Defense (DOD) in connection with the school’s federal grant applications. In particular, the principal research investigator who sought funding for the grants failed to disclose to the government the full extent of her various active research projects, according to a March 6, 2009 press release by the U.S. Attorney Southern District of New York.

For the complete release, go to http://www.usdoj.gov/usao/nys/pressreleases/March09/weillmedicalcollegesettlementpr.pdf. For more information about the False Claims Act, contact Nolan and Auerbach, PA .

Hospitals Are Giving Lessons on Blowing the Whistle on Fraud

Nolan and Auerbach — Thu, 27 Dec 2007 14:58:59 +0000

A federal law that takes effect in January 2007 requires the country’s hospitals and nursing homes to educate their employees and officers on how to detect and report fraud. This requirement applies to companies that earn at least $5 million a year in Medicaid business. Under the False Claims Act, whistleblowers have received millions of dollars for disclosing large-scale fraud.

To read more, click here.

Feds Sue Nursing Home Company

Nolan and Auerbach — Mon, 25 Jun 2007 16:29:56 +0000

Cathedral Rock Corporation of Ft. Worth, Texas, which operates five nursing homes in St. Louis, Missouri has to now defend itself against a medicaid fraud lawsuit brought by federal authorities for violations of the False Claims Act. The lawsuit was brought by two whistleblower nurses who complained that patients were being neglected and that the facilities provided “worthless” health care.

To read more on this story click here.

Inflated Cost Reports Cost California Hospital Over $2 Million to Settle False Claims Act Allegations

Nolan and Auerbach — Mon, 30 Apr 2007 14:57:28 +0000

On April 20, 2007, the Loma Linda Behavioral Medicine Center paid the United States government in excess of $2 million to settle allegations of overbilling from 1992-1996. The settlementis the result of a lawsuit filed by a whistleblower under the False Claims Act. The lawsuit was originally filed in 1998 by a former employee of Healthcare Financial Advisors (HFA), a consulting firm that assists hospitals in preparing cost reports that are submitted to insurers. The lawsuit alleged that Healthcare Financial Advisors prepared for clients two costs reports; one which was inflated and sent to Medicare and another one designed for internal use only, that accurately reflected the amount of reimbursement the hospital should have received from Medicare. It should be noted that seven defendants thus far have settled the HFA whistleblower lawsuit, paying approximately $55 million to the government. (Jackson Memorial Hospital in Miami, Florida more than $14 million; St. Elizabeth Regional Medical Center in Lincoln, Nebraska more than $4 million, Lovelace Health System, a wholly owned subsidiary of Cigna Corp. based in Albuquerque, New Mexico, paid $24.5 million in 2002; St. Joseph’s Hospital in Houston, Texas, paid the government $1.5 million in 2002; Eisenhower Medical Center, located in Rancho Mirage, Calif., paid $8 million in 2005 and HealthSouth Bakersfield Rehabilitation Hospital in Bakersfield, Calif., paid $740,000 in 2005).

To read more click here and here or to learn more on cost report fraud click on this link.

Cost Report Fraud Allegations Cost Baptist Medical and Integris Health $12.2 Million

Nolan and Auerbach — Mon, 04 Dec 2006 15:30:12 +0000

A former contractor of Integris blew the whistle on Integris Health, Inc., alleging that it was submitting inflated claims to Medicare. The complaint stated that Integris sought payment from Medicare for post and non-transplant related costs that Integris knew were not reimbursable under the Medicare program. In addition,the Complaint alleged that Integris claimed Medicare reimbursement for liver and heart organ acquisition costs related to transplant patients who were not Medicare beneficiaries. The whistleblower will receive $2.3 million as a share of the recovery under the False Claims Act. Integris Baptist Medical Center, a not-for-profit health organization, is located in Oklahoma City, Oklahoma and operates the largest Medicare certified Heart, Liver and Kidney transplant program in the state of Texas. Integris Health, Inc. is the parent corporation for Integris Baptist Medical Center.

To read more on this article click here.

Kickbacks in Medical School? Take a Look at New Jersey’s State Medical School

Nolan and Auerbach — Tue, 21 Nov 2006 15:03:08 +0000

Two doctors are being fired and the pay of at least eight others are being reduced in the wake of a federal monitor’s charges that the medical school has been paying kickbacks to cardiologists resulting in bilking Medicare and Medicaid out of tens of millions of dollars. The federal monitor said that the school’s top officials were complicit in the scheme and directly accused the interim university president, Bruce C. Vladeck of “trying to rebut, refute and bury” information. Vladeck released a letter responding to the report which included instructions to the dean of the medical school to fire or reduce the pay of 10 of the 18 physicians named in the monitor’s report. The kickback accusations are the latest in a line of accusations which caused investigators, after reading an article in a New Jersey legal publication which detailed a $2.2 million settlement by the school to a whistleblower, the former chief of the division of cardiology, who had warned the school that he feared these arrangements were probably illegal and to look further into the matter.

For more information please click here.

$48 Million to become $144 Million Verdict Against Amerigroup Corp. For False Claims

Nolan and Auerbach — Fri, 03 Nov 2006 16:52:37 +0000

It may cost Amerigroup Corp, a company that specializes in health care for low-income patients $144 million in damages for discriminating against pregnant women. A federal jury returned a $48 million verdict, which will be tripled under state and federal False Claims Act laws. The whistleblower lawsuit alleged that while marketing its services in Illinois, Amerigroup avoided pregnant women and others likely to run up high doctor bills. State Attorney General Lisa Madigan called the company’s alleged discrimination “unconscionable.”

Visit Nolan Law Firm for more information on the False Claims Act.

For more information about this article click here.

Kellogg, Brown & Root Involved in a Super Fraud?

Nolan and Auerbach — Fri, 22 Sep 2006 15:10:42 +0000

Millions of dollars were charged to the federal government according to a federal whistleblower for a military Super Bowl party that never was…at least not for the troops. According to the lawsuit, Kellogg, Brown & Root used the money for its own football party. The goodies included giant tubs of chicken wings and tacos, a widescreen TV and cheese sticks.

For more information click here.