Whistleblower Blog

Comments–Whistleblower Lawyers, Other Attorneys, and Clients on the Whistleblower Lawyer Blog

Since we began the Whistleblower Lawyer Blog to discuss topics of interest to attorneys, potential whistleblowers and others about developments in the new IRS Whistleblower Rewards Program, in qui tam litigation under the False Claims Act, and other whistleblower developments that might be of interest to other lawyers or whistleblowers, we have received some very positive feedback.

We have discussed not only how the IRS Whistleblower Program and the False Claims Act work, but we have also tried to highlight specific
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New Whistleblower Protections Approved by House Committee

Recognizing how important whistleblowers are to stopping fraud, the U.S. House Oversight and Government Reform Committee today approved the Whistleblower Protection Enhancement Act (H.R. 985).

The new whistleblower protections would apply to federal employees and government contractors. The law would establish whistleblower protections for scientific, intelligence and transportation security employees. It would also apparently mean that officials would investigate whether security clearances are revoked as retribution for a whistleblower’s reporting allegations of waste, fraud or abuse.

Congressman Henry Waxman (D-Cal.) introduced the bill last week. Additional amendments would strengthen the effectiveness of the whistleblower provisions.

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Medicare Fraud Indictments in Los Angeles

We find it staggering to read about how blatant Medicare fraud can be, which often provokes a whistleblower to step forward. Today’s L.A. Times reports on a shameless scheme to defraud Medicare:

Elderly and mentally ill patients allegedly were offered doughnuts, candy and other gifts to lure them into more than $12 million worth of unnecessary respiratory treatments that were fraudulently billed to Medicare, according to the Indictment. Doctors and administrators were charged, according to this report.

What can you say about such criminality,
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State Whistleblower Act Is a Powerful Tool in Texas–But Could Produce Even More Medicaid Fraud Recoveries

Whistleblower suits that reveal Medicaid fraud in Texas have grabbed the attention of the Texas Legislature–which apparently recognizes how powerful state False Claims Acts can be.

Today’s Houston Chronicle reports that Texas is working through a “backlog” of Medicaid fraud cases, the top 20 of which could bring another $700 million to the State (and presumably a significant amount to whistleblowers).

Whistleblower cases have been so effective that the legislators asked what more could be accomplished with more resources provided to pursue these fraud
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Watching the New IRS Whistleblower Procedures Take Shape

We are excited to see the new IRS Whistleblower Office’s procedures being developed. We obtained a copy of a recent letter from IRS Commissioner Mark W. Everson, describing how the new Whistleblower procedures are taking shape, to Senator Charles Grassley.

Senator Grassley has been instrumental in pushing for effective whistleblower laws, both in qui tam litigation under the False Claims Act, and now in the new IRS Whistleblower Program. Here is an excerpt of Commisioner Everson’s January 29, 2007 letter describing the implementation of the new IRS Whistleblower Program:

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Potential Whistleblowers: IRS Offers Program for Employers “Back-Dating” Stock Options

We are encouraged that the IRS is taking action in response to the fraudulent practice of “back-dating” of stock options. Potential whistleblowers may wish to see the IRS’ description of its program to deal with an aspect of this problem.

Here is an excerpt from the IRS’ announcement of how it is permitting employers to “step forward” and pay a penalty, and a related IRS Release can be read here:

(From IRS Release:)

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Lincoln’s Law and Whistleblower Claims

Taxpayers every day lose money because of fraud against their government. Current examples include government contracting fraud in Iraq, procurement fraud regarding the efforts of the Federal Emergency Management Agency and Hurricane Katrina and numerous false claim schemes under both the Medicare and Medicaid programs. Those who are bent of fraud are usually clever and devious. This is the very reason why President Abraham Lincoln enacted the False Claims Act during the American Civil War in 1863.

During the Civil War, as today, there were
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Iraq Indictments:TheTip of the Iceberg

As former federal prosecutors, it is always of interest to us to read about grand jury indictments involving fraud schemes. We have presented many such indictments to grand juries ourselves and know how the system works. On Tuesday of this week, a grand jury in Washington, D.C., returned an indictment against three Army Reserve Officers and two civilians based on allegations that they steered more than $8.6 million dollars in Iraqi reconstruction funds to a contractor in exchange for a variety of kickbacks and other
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New IRS Whistleblower Office Has First Director

We saw more good news when the IRS announced the first director of the new IRS Whistleblower Office–Stephen A. Whitlock. Mr. Whitlock was formerly in charge of the Office of Professional Responsibility. He also had led anti-fraud and abuse programs at the Defense Department.

The IRS’s press release is reprinted here:

IRS Begins Work on Whistleblower Office; Whitlock Named First Director

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State Enforcement Efforts Disappointing In Combatting Medicaid Fraud

According to a recent report issued by the Inspector General of the Department of Health and Human Services, State enforcement results regarding Medicaid fraud cases have been disappointing. Virtually every state in the country has a State Medicaid Fraud Control Unit whose principle job is to uncover and detect fraud and to prosecute the offenders. Such units are also tasked with the responsibility of attempting to recover monies fraudulently obtained from the Medicaid program. Because Medicaid is approximately twenty (20%) percent of the total federal
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Oklahoma Joins Nationwide Movement of States That Are Passing False Claims Acts with Qui Tam Whistlblower Provisions

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

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

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.

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

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

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

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

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

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

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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