Whistleblower Blog Archives - Page 13 of 36

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Oklahoma Joins Nationwide Movement of States That Are Passing False Claims Acts with Qui Tam Whistlblower Provisions

May 3, 2007
Michael Sullivan

We are pleased to see yet another state–Oklahoma–realize how effective qui tam whistleblower laws are by passing a state False Claims Act this week.

The Oklahoma legislature has passed the Oklahoma Medicaid False Claims Act (SB 889). The bill’s primary author was Cox Crain.

The new whistleblower law appears to be modelled on the federal False Claims Act. As we have written about often on this whistleblower lawyer blog, states that pass such laws with qui tam whistleblower provisions that are at least as effective
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“Heathcare Auditing Strategies” Quotes Whistleblowerlawyerblog Author on State Whistleblower Statutes

May 1, 2007
Michael Sullivan

To understand why states are passing their own “False Claims Acts” with qui tam whistleblower provisions, the heath care compliance newsletter Heathcare Auditing Strategies called on one of the authors of this whistleblower lawyer blog, Michael A. Sullivan.

The May 2007 edition of this heath care compliance publication discusses the results of our efforts in this blog to explain these new state statutes, and to report on how these state statutes have fared when reviewed by the Office of Inspector General of HHS.
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Whistleblower Lawsuit Against California Hospital Accused of Overbilling is Settled

April 30, 2007
Michael Sullivan

In a whistleblower lawsuit settlement, the Loma Linda Behavioral Science Center agreed to pay more than $2 million to resolve allegations of overbilling.

This False Claims Act whistleblower case was filed by a former employee of Healthcare Financial Advisors (HFA), a consulting firm that advises hospitals in preparing cost reports. The lawsuit alleges that HFA assisted its clients in seeking reimbursement for unallowable costs from Medicare and Medi-Cal.

Justice Department Announces It Joins Qui Tam Health Care Fraud Cases Against HealthEssentials Solutions Inc.

April 26, 2007
Michael Sullivan

Health care cases remain busy this week. The Justice Department on April 26 announced that it is joining whistleblowers in pursuing three qui tam lawsuits against HealthEssentials Solutions Inc. (HES) that allege false claims were submitted to Medicare.

The cases involve allegations of upcoding — improperly using a diagnosis code that is not supported by the medical record, for the purpose of obtaining greater reimbursement–and billing for medically unnecessary services.

The three cases were filed separately in the U.S. District Court in Louisville, Ky., by
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Another State Qui Tam Whistleblower Law is Born–Georgia Bill Passes Senate and Goes to Governor for Signature

April 13, 2007
Michael Sullivan

Another state whistleblower law, with qui tam provisions that follow the federal False Claims Act, was born today. The Georgia Senate passed the “State False Medicaid Claims Act” today, and it goes to Governor Sonny Perdue for his signature.

We have been writing about this and other new state whistleblower statutes. Representative Edward Lindsey deserves credit for his sponsorship of the bill.

Our firm was fortunate enough to have been part of the legislative effort. Rep. Lindsey asked Michael A. Sullivan (one of this whistleblowerlawyerblog co-authors) to testify and explain the whistleblower law three times, before the House Judiciary Committee and the Senate Insurance and Labor Committee. There were no dissenting votes in any of the committee votes.

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New Qui Tam Whistleblower Law Clears Senate Committee in Georgia

April 9, 2007
Michael Sullivan

A new qui tam whistleblower law has cleared another hurdle toward passage. Georgia’s Senate Insurance and Labor Committee unanimously approved the new “State False Medicaid Claims Act” this afternoon. As we have written about previously on this whistleblower lawyer blog, the new whistleblower law has already passed the Georgia House.

After an introduction by Senator Seth Harp, the bill’s sponsor, Rep. Edward Lindsey, asked Inspector General Doug Colburn of the Department of Community Health and attorney Michael A. Sullivan (co-author of this
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Amendments to New IRS Whistleblower Law Considered

April 5, 2007
Michael Sullivan

We have had many calls this week from potential clients in our IRS Whistleblower practice, probably because msn.com featured an article about the IRS Whistleblower program on Monday that linked to our whistleblower lawyer blog.

As I have explained to many whistleblower clients, the new regulations for the IRS Whistleblower Rewards Program are in the works, but have not been issued. We have been pursuing IRS Whistleblower claims under the new program and have found the IRS agents to be excited about it.

Adding to the mix for those seeking a whistleblower attorney is that Congress is considering amendments to the law that established the new IRS Whistleblower Program in December 2006. Among the possible changes/additions are a provision opening up the Whistleblower Program to more claims by setting a different threshold for the amount of money in question, which could allow more whistleblowers to qualify for a reward.

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Guilty Plea in Pharmaceutical Fraud Case

April 4, 2007
Michael Sullivan

A subsidiary of the drug manufacturer Pfizer has agreed to plead guilty in a kickback scheme and to pay a criminal fine of $19.68 million, according to the U.S. Attorney for the District of Massachusetts, Michael J. Sullivan (not to be confused with Michael A. Sullivan, one of the authors of this whistleblower lawyer blog).

The government’s announcement was that Pharmacia & Upjohn Company, Inc., a subsidiary of Pfizer, Inc., was charged with offering a kickback in connection with the administration and distribution
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New York Becomes Latest State to Agree to Enact a State False Claims Act

April 3, 2007
Michael Sullivan

The New York legislature has become the latest state to agree to the enactment of a State False Claims Act, when it approved passage of such a whistleblower law as part of approving the state budget. The Buffalo Times reported on this encouraging development.

We have written before about why states are passing their own whistleblower laws to protect taxpayer money. Congress has created significant financial incentives for states that pass their own state false claims acts, with whistleblower provisions that are at
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New Medicaid Whistleblower Law Passes House in Georgia

March 27, 2007
Michael Sullivan

We have been writing about why states are passing their own whistleblower laws, with qui tam provisions that are at least as effective as the federal False Claims Act. Georgia’s legislature took a giant step forward when its House of Representatives today passed the State False Medicaid Claims Act–by an overwhelming margin of 164-2!

As we have mentioned before on this whistleblower lawyer blog, when the House Judiciary Committee met to discuss and approve the new whistleblower statute, two witnesses were invited
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State False Claims Acts Must Be Updated to Include New False Claims Act Changes, Grassley Warns

April 30, 2010
Michael Sullivan

Senator Chuck Grassley is making sure that the States take advantage of important, recent improvements to the federal False Claims Act–with the help of financial incentives. In doing so, Grassley highlighted a defect in Oklahoma’s False Claims Act that should disqualify any state with a similar defect from these financial incentives.

As we have discussed at length, in the Deficit Reduction Act of 2005, Congress recognized how effective the False Claims has been in recovering money for fraud against the government, by creating financial incentives for states that enact equally effective versions of the federal False Claims Act.

“Weaker” state versions of the False Claims Act do not qualify for the incentives, however. The Inspector General for the Department of Health and Human Services must approve a state’s False Claims Act before the incentives are available. So far, the IG has approved fourteen state FCAs, while disapproving six other state acts.

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IRS Whistleblower Office Announces Important Changes, New Procedures for IRS Whistleblower Program

April 28, 2010
Michael Sullivan

IRS Whistleblower Office Director Steve Whitlock announced important, long-awaited developments in the new IRS Whistleblower Program yesterday at the Second Annual “IRS Whistleblower Boot Camp” in Washington.

First, Director Whitlock finally announced how the IRS will share information that will allow whistleblowers to understand the Whistleblower Office’s decisions about what awards are made to whistleblowers.

A year ago in my interview with the IRS Whistleblower Office Director, Mr. Whitlock discussed the need to solve the vexing question of how the IRS can share this information with whistleblowers and their attorneys, while also complying with legal requirements for confidentiality of taxpayer information under section 6103 of the Internal Revenue Code.

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New IRS Whistleblower Program Developments Discussed This Week at “IRS Whistleblower Boot Camp”

April 25, 2010
Michael Sullivan

On Tuesday, April 27, 2010, the Second Annual “IRS Whistleblower Boot Camp” will convene in Washington, D.C., sponsored by Taxpayers Against Fraud.

Representatives of the IRS Whistleblower Office will discuss the latest developments in the IRS Whistleblower Program, though which tax whistleblowers can receive up to 30% of recoveries by the IRS. Other IRS and DOJ representatives will take part as well, as they analyze what lawyers representing IRS whistleblowers should know in pursuing these claims.

Like last year’s program, this one is a sell-out. I am looking forwarding once again to moderating a panel discussion, this time on “Protecting IRS Whistleblowers from Criminal and Civil Liability.”

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SEC Charges Goldman Sachs With Fraud in Synthetic CDO Tied to Subprime Mortgages

April 16, 2010
Michael Sullivan

As Congress finally works to establish a more meaningful SEC whistleblower program, the SEC has just announced that it has charged Goldman Sachs and one of its vice presidents with fraud, in connection with a “financial product tied to subprime mortgages, as the U.S. housing market was beginning to falter.”

Often maligned for failing to protect investors before the recent financial crisis, the SEC now charges that Goldman structured and marketed a “synthetic collateralized debt obligation” (CDO) like those that “contributed to the recent financial crisis by magnifying losses associated with the downturn in the United States housing market,” and then violated the federal securities laws in connection with that product.

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SEC Whistleblower Program–The SEC Inspector General’s Report

April 5, 2010
Michael Sullivan

Post-Madoff, we have followed the legislative efforts to help establish an effective SEC whistleblower program. We know that the Senate Banking Committee in particular has worked hard in attempting to devise the best overall arrangement to encourage and reward whistleblowers who report fraud within the SEC’s jurisdiction.

Shortly before Congress authorized the first meaningful IRS Whistleblower Program in December 2006, the Treasury Inspector General for Tax Administration issued its report on many of the changes needed for the IRS to use whistleblowers effectively.

Now, the SEC’s Inspector General David Kotz has issued his report, “Assessment of the SEC Bounty Program.” No one is surprised that it concludes that the SEC has not effectively encouraged, used, or rewarded whistleblowers over the past decades. Perhaps this report will pave the way for something meaningful–like the TIGTA report that preceded the now-promising IRS Whistleblower Program, which rewards whistleblowers with 15-30% of the government’s tax recoveries.

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Well Worth a Read: SEC Whistleblower Harry Markopolos’ “No One Would Listen: A True Financial Thriller”

April 5, 2010
Michael Sullivan

After meeting with the Department of Justice in Washington recently to discuss another whistleblower case, I picked up Harry Markopolos’ recent book, “No One Would Listen: A True Financial Thriller.” It is a fun and engrossing read, with humor that I did not expect to find in this subject.

We have written previously to applaud Harry Markopolos’ work in figuring out Bernie Madoff’s Ponzi scheme, and then in trying to get the SEC’s attention for years. In an era when fraud is being exposed in so many industries through the courage of whistleblowers, his book shows just how paper-thin our government’s resources can be in recognizing and stopping the next huge fraud scheme.

Neither I nor my law firm has any financial interest in recommending this book, and no one has asked me to mention it, but I do believe that any thinking person will enjoy it.

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New Health Care Law Arrives With Announcement of $12 Million Recovery in Qui Tam Whistleblower Case Under False Claims Act

March 26, 2010
Michael Sullivan

The major new “health care” law that the President signed this week, the Patient Protection and Affordable Care Act (Public Law 111-148), includes increased efforts to combat health care fraud and abuse, especially fraud in the Medicare and Medicaid programs.

It was significant that, on the very same day that this law took effect, an outstanding group of government prosecutors and investigators brought to an efficient conclusion a $12 million recovery of funds in a qui tam whistleblower case alleging health care fraud in violation of the False Claims Act. The case was brought by our firm, Finch McCranie, LLP, the Simpson Firm, LLC, and James G. Gustino, P.A..

The next day, after a meeting in Washington with the Department of Justice on another False Claims Act case, I sat in on the Senate debate of amendments to the new health care law. Whatever differing views may exist about many of the new law’s provisions, all taxpayers agree that stopping fraud in health care is an essential step to preserving scarce health care dollars.

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Greatest Impact of 2009 False Claims Act Amendments–“Civil Investigative Demands”

March 17, 2010
Michael Sullivan

Among the many 2009 changes to strengthen the False Claims Act is one whose impact is about to be experienced: greater use of “civil investigative demands” to gather evidence.

Civil investigative demands allow to government to require any person believed to have documents or information relevant to a False Claims Act investigation to do the following:

(A) to produce such documentary material for inspection and copying,

(B) to answer in writing written interrogatories with respect to such documentary material or information,

Bank CEO’s Alleged TARP Fraud Results in First Reported Criminal Charges For Misuse of TARP Funds

March 16, 2010
Michael Sullivan

We have written previously about how the “Troubled Asset Relief Program” (TARP) that began with the financial meltdown in 2008 would undoubtedly beget fraud that may be actionable under the False Claims Act. The qui tam provisions of the False Claims Act, the country’s major whistleblower law, allow whistleblowers (“relators”) who report fraud or false claims to share in the government’s recovery of damages.

Yesterday, the first TARP fraud criminal charges appeared. Federal prosecutors in New York’s Southern District announced the arrest of Charles J. Antonucci, Sr., former President and Chief Executive Officer of The Park Avenue Bank.

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Iraq Reconstruction Fraud Continues to Fuel Investigations by Office of the Special Inspector General for Iraq Reconstruction

March 13, 2010
Michael Sullivan

As if the nation’s expenditures to rebuild Iraq were not enough, fraud that steals taxpayer dollars continues to infect the Iraq reconstruction program. This fraud often results in qui tam whistleblower cases under the False Claims Act, which allows those reporting the fraud to receive a a share of the government’s recovery of money.

Today’s New York Times piece by James Glanz reports on the more than 50 new fraud investigations in the past six months alone in the Iraq reconstruction effort.

The Office of the Special Inspector General for Iraq Reconstruction is responsible for these investigations. “Chaos, weak oversight and wide use of cash payments in the reconstruction program in Iraq allowed many more Americans who took bribes or stole money to get off scot-free,” in Mr. Glanz’s words.

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