Michael Sullivan

Where Is the Oversight?

Just before Christmas I read an article about a case in Texas where a doctor was sentenced to a lengthy prison term for a scheme to defraud Medicare and Medicaid in excess of $25 million. The doctor had been approached by individuals offering to pay him a kickback for supplying Certificates of Medical Necessity (CMN) approving a beneficiary to receive a motorized wheelchair. I have been watching TV and seeing these adds for sometime about scooters for disabled individuals and I was wondering how so

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The Most Significant Recent Qui Tam Whistleblower Cases Under the False Claims Act

This is the final section of my article. It discusses the most significant recent qui tam cases under the False Claims Act (as of December 2006).

B. Recent Significant Recoveries Under the False Claims Act:

1. Health Care Industry

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The Growing Importance of the Qui Tam Whistleblower Cases Under the False Claims Act

This is part 4 of my article on the False Claims Act. This part discusses the huge increase in federal dollars recovered in the past few years:

IV. Recent Recoveries and Other Developments In Qui Tam Litigation

A. An Explosion of Federal Dollars Recovered Since 1986, Under the False Claims Act

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How the Modern False Claims Act Works in Qui Tam Whistleblower Cases

This is part 3 of my article on how the False Claims Act works:

III. Brief Overview of How the Modern False Claims Act Works

A. Conduct Prohibited

The federal False Claims Act imposes civil liability under several different theories:

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History of the False Claims Act

This is the second part of my article explaining the False Claims Act–it addresses the history of the Act:

II. Background of the False Claims Act
While the False Claims Act may be the best known qui tam statute, it is far from being the first. Qui tam actions date back to English law in the 13th and 14th Centuries. This tradition took root in the American colonies and, by 1789, states and the new federal government had authorized qui tam actions in various contexts.7
According to one writer, “[i]n the early years of the Nation, the qui tam mechanism served a need at a time when federal and state governments were fairly small and unable to devote significant resources to law enforcement. As the role of the Government expanded, the utility of private assistance in law enforcement did not diminish. If anything, changes in the role and size of Government created a greater role for this method of law enforcement.” 8

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Introduction to the False Claims Act and Qui Tam Whistleblower Cases

I wrote this article for a seminar to explain the False Claims Act to those who may not know about it. I hope it may be useful to those who are interested in the Act. I have divided it into several sections–this is the first section, summarizing how the False Claims Act came to be in the time of Abraham Lincoln, and how it has evolved since then:

I. Introduction

Fraud is perhaps so pervasive and, therefore, costly to the Government due to a lack of deterrence. GAO concluded in its 1981 study that most fraud goes undetected due to the failure of Governmental agencies to effectively ensure accountability on the part of program recipients and Government contractors. The study states:

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Part II: IRS Tax Whistleblower Officials Explain Details of New IRS Whistleblower Rewards Program

This is Part II of this whistleblower lawyer blog’s description of how IRS Tax Whistleblower officials have explained many of the long-awaited details of the new IRS Whistleblower Rewards Program to whistleblower attorneys at the annual Taxpayers Against Fraud Conference in Washington, a national organization of whistleblower lawyers who represent whistleblowers under the False Claims Act, the state False Claims Acts, and the new IRS Whistleblower Rewards Program for tax whistleblowers. Both parts summarize information provided by IRS Whistleblower officials at this Conference, at which I had the pleasure of participating in a panel discussion with the Director of the IRS Whistleblower Office, Stephen Whitlock, and later spending time with other IRS officials from the IRS group responsible for the Financial Services industry (including hedge funds), Large and Mid-Sized Business Division, Stuart Mann and Nicole Cammarota.

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IRS Whistleblower Officials Explain Details of New IRS Whistleblower Rewards Program

IRS officials explained long-awaited details of how the new IRS Whistleblower Rewards Program will work to whistleblower attorneys gathered last week at the annual Taxpayers Against Fraud Conference in Washington.

This whistleblower lawyer blog author had the pleasure of appearing with the Director of the new IRS Whistleblower Office, Stephen Whitlock, in a panel discussion on the new IRS Whistleblower Program. I enjoyed spending time with Director Whitlock and with the other participants, Professor Dennis Ventry of American University’s Washington College of
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Whistleblower Law Attorneys to Gather for Symposium on False Claims Act, State False Medicaid Claims Act, and New IRS Whistleblower Rewards Program

Some of the country’s leading attorneys in qui tam whistleblower cases and IRS Whistleblower cases will gather for the “First Annual Whistleblower Law Symposium,” which will take place at the Georgia State Bar Headquarters on Thursday, September 20, beginning at 9:00 a.m. (See Agenda below). This Whistleblower Law Symposium is organized and co-chaired by the authors of this whistleblower lawyer blog, Michael A. Sullivan and Richard W. Hendrix.

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False Claims Act New Amendments Proposed: Senators Grassley and Durbin Introduce Bipartisan Bill to Restore False Claims Act and Its Qui Tam Provisions to Encourage Whistleblowers to Protect Taxpayer Funds Against Fraud

Senators Specter and Leahy to Co-Sponsor Pro-Taxpayer Law to “Correct” Recent Court Decisions That Limited Effectiveness to Government of Qui Tam Whistleblower Law, the False Claims Act

In one of the most potentially significant developments ever discussed on this whistleblower lawyer blog, Senator Charles Grassley (R-Iowa) announced today that he and Senator Dick Durbin (D-Illinois) are co-sponsoring a bipartisan bill designed to restore the government’s primary tool for fighting fraud against taxpayers, the False Claims Act, to its intended effectiveness.
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New IRS Whistleblower Rewards Program Explained at National Conference with Its Director, Stephen Whitlock

Tomorrow in Washington, this whistleblowerlawyerblog author is looking forward to participating in a panel discussion with the Director of the new IRS Whistleblower Office, Stephen Whitlock, to explain how the new IRS Whistleblower Rewards Program works.

We will speak at the Taxpayers Against Fraud Annual Conference in Washington at 6 p.m. on September 9. Leading the panel discussion will be Paul Scott. I am also looking forward to the presentations by Erika Kelton and Professor Dennis Ventry of American University’s Washington
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New State False Claims Act Trend Is Evaluated at Southeastern Health Care Fraud Conference in Atlanta

Yesterday I enjoyed leading a panel discussion of the new State False Claims Acts, at the Southeastern Health Care Fraud Conference in Atlanta. Of particular interest to this audience was the new Georgia State False Medicaid Claims Act that became law in May 2007, which has qui tam whistleblower provisions similar to the federal False Claims Act.

Our audience of health care attorneys heard a detailed account of Florida’s successes with its State False Claims Act by Mark S. Thomas, the Chief
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Confidentiality of IRS Tax Whistleblowers or Informants–Federal Regulation on Keeping Whistleblowers Confidential

Our potential tax whistleblower clients–who call our attorneys about participating in the new IRS Whistleblower Rewards Program–regularly ask before they proceed if the IRS will keep their identities confidential.

Across the country, the IRS Special Agents we have been dealing with in representing our tax whistleblower clients (for example, in New York, Las Vegas, Dallas, and Atlanta, to name a few) have consistently answered the question the same way. Confidentiality is addressed by Treasury Regulations applicable to the IRS, which provide in part
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Whistleblower Lawyer Blog Update: Kickback Allegations Lead IBM and PriceWaterhouseCoopers to Settle False Claims Act Liability

One of the many types of fraud and false claims that whistleblowers can report to whistleblower attorneys is unlawful “kickbacks” paid by companies that do business with the federal government.

The Justice Department has announced a settlement with IBM and PriceWaterhouseCoopers for more than $5.2 million, to resolve allegations that these firms violated the False Claims Act through business arrangements that allegedly constituted unlawful kickbacks. The announcement followed a whistleblower suit under the qui tam provisions of the False Claims Act, which
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Reverse False Claim Act Case Settlment Announced by Justice Department

The Minerals Management Service of the U. S. Department of Interior is responsible for the collection of royalties on federal and Indian leases. Companies who have such leases are required to report to the Department of Interior the value of natural gas produced (or minerals mined) from federal and Indian leases and to pay a percentage to the government as royalties. When the entity that has the duty to pay the royalties files a false report and misstates what the collected revenues were, this is
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Whistleblower Lawyer Update: Medicaid Fraud Investigation Into Fraudulent Pharmacy Billings Produces Recovery in Missouri

Medicaid Fraud Recovery Announced by Missouri Attorney General
False and fraudulent billings were uncovered in a Missouri Medicaid fraud investigation that has produced a recovery by the Missouri Attorney General’s Office’s Medicaid Fraud Control Unit. Billings like this typically violate the False Claims Act or the various state False Claims Acts.

Prescriptions that had not been authorized by physicians were submitted and paid for by the Medicaid program. Once the suspicious activity was reported, the Attorney General’s Office’s investigation followed and produced
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