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Whistleblower Blog

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

IR-2007-25, Feb. 2, 2007
WASHINGTON – The Internal Revenue Service today named Stephen A. Whitlock as director of its new Whistleblower Office, where he will be responsible for administering the program designed to receive information that helps uncover tax cheating and to provide appropriate rewards to whistleblowers.

“This is an important new office at the IRS, and Steve brings a strong background in ethics and tax issues to help get this program off to a good start,” said IRS Commissioner Mark W. Everson. “Under Steve’s leadership, we will meet expectations from Sen. Grassley and other supporters to run a robust program.”
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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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Latest IRAQ FRAUD Report by Special Inspector General for Iraq Reconstruction

We saw yesterday’s quarterly audit report on Iraq fraud, published by the Special Inspector General for Iraq Reconstruction (SIGIR), Stuart Bowen Jr. The message is sobering:

“The security situation in Iraq continues to deteriorate, hindering progress in all reconstruction sectors and threatening the overall reconstruction effort,” in the words of the Inspector General.

We all have already seen reports of how the United States is being exploited by dishonest and incompetent contractors in Iraq. This IG Report discusses not only poor security, but also
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Government Joins Whistleblower Case Against Pharmaceutical Firm for Overcharging on Generic Drugs

We saw another significant whistleblower case against a drug company hit the news wire this week.

The government announced that it was joining a qui tam lawsuit under the False Claims Act against the company Boehringer Ingelheim Roxane, Inc. The Complaint alleges overcharging on pharmaceutical products.

In joining this lawsuit, the United States has alleged that the drug company engaged in a “scheme to report fraudulent and inflated prices for several pharmaceutical products, knowing that federal health care programs established reimbursement rates based on those reported prices.”

We have reprinted the government’s announcement of why it is joining this qui tam whistleblower lawsuit below (from the U.S. Department of Justice press release):

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Progress with the New IRS Rewards Program for Tax Whistleblower Cases

We have been working with the IRS to bring information about large tax cheating to the IRS’s attention, so that clients can participate in the new IRS Whistleblower rewards. The IRS officials sound excited to have this new tool at their disposal, and we are happy to help our whistleblower clients obtain the new rewards. Our latest one deals with fraud in the Hurricane Katrina relief effort, where the public and government have been cheated out of what appears to be many millions of
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Hurricane Katrina Fraud: The Government’s Inspectors General Continue to Investigate Fraud and Whistleblower Reports

We all remember how Hurricane Katrina and Hurricane Rita left the Gulf Coast devastated. As government agencies began to provide disaster relief with public dollars, dishonest contractors saw a huge opportunity for fraud against the government. Too many FEMA contracts have been the targets of dishonest contractors.

The “watchdogs” of the federal government agencies–the various Inspectors General of the many agencies involved in Katrina relief–have combined their efforts and sent hundreds of auditors to the Gulf region to examine fraud and mismanagement of Katrina

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New IRS Whistleblower Rewards Statute

We hear from many lawyers and clients that they are not aware of the new IRS Whistleblower Rewards Program. The new provisions took effect on December 20, 2006, and yet so far they are locate on the web.

We hope it is helpful to you to find the new IRS Whistleblower Rewards amendments here, in the amended version of the statute:

26 U.S.C. § 7623.

(a) In general.–The Secretary, under regulations prescribed by the Secretary, is authorized to pay such sums as he deems necessary for–

(1) detecting underpayments of tax, or
(2) detecting and bringing to trial and punishment persons guilty of violating the internal revenue laws or conniving at the same,

in cases where such expenses are not otherwise provided for by law. Any amount payable under the preceding sentence shall be paid from the proceeds of amounts collected by reason of the information provided, and any amount so collected shall be available for such payments.
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Why States Are Passing Their Own Qui Tam Whistleblower Laws

I looked into the experiences that states have had with their own False Claims Acts, because almost every state is considering passing its own. I have tried to provide a brief summary that I hope is useful to you.

To encourage states to enact their own False Claims statutes with qui tam whistleblower provisions that are at least as effective as the federal Act, Congress created a large financial incentive when it passed the Deficit Reduction Act of 2005. States that have or enact such acts become eligible as of January 1, 2007, for a 10% increase in the state’s share of Medicaid fraud recoveries.

Many states, therefore, will consider whether to follow suit by enacting their own False Claims Act as early as 2007. Thus, it is important to consider other states’ experiences with their own state statutes governing false claims.

Most qui tam cases filed under the state statutes have been related to health care. Many are “global” Medicaid cases that were first developed in federal courts as Medicare and Medicaid fraud cases and that concerned a nationwide fraud which had been investigated by multiple federal and state jurisdictions.

Texas recovered $45.5 million in 2004 from pharmaceutical companies based on their allegedly overstating the price of prescription brand-name and generic-brand drugs. The Texas Attorney General stated that neither the lawsuit nor the settlement would have been possible had the state not enacted a qui tam provision.

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New IRS Whistleblower Director Says IRS Rewards Program Is Off to a Strong Start

The head of the new IRS Whistleblower Office, Stephen Whitlock, reports that the new IRS Whistleblower Rewards Program is off to a strong start.

Today’s Wall Street Journal quotes Mr. Whitlock as saying that the claims submitted to the IRS Whistleblower Office to date appear to have credibility and have evidence to support them.

Since the new IRS Whistleblower program was authorized by Congress in December, our firm has been working with the IRS in pursuing whistleblower claims in the Midwest,
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Whistleblower Case Victory in D.C. Bid-Rigging Trial

A qui tam whistleblower and his lawyer are very happy as a result of a $102 million jury verdict–to be shared by the whistleblower–in a False Claims Act trial that ended on May 14.

The defendants in this whistleblower case included Bill Harbert International Construction Inc.; Harbert Construction Services; Bilhar International Establishment; Harbert Corp.; and Harbert International. The case alleged bid-rigging on three U.S. government-funded construction contracts in Egypt in the 1980s and 1990s.

The jury found that defendants violated the False Claims Act and awarded $34 million in damages, which are “trebled” under the False Claims Act.

The Department of Justice lawyer, Carolyn Mark, is a veteran prosecutor. She handled one of my first cases under the False Claims Act in the late 1980s–another bid-rigging case against electrical contractors, one of whom I was defending (in my former life, before I represented whistleblowers). I sent Carolyn a note of congratulations today.

AUSA Keith Morgan also deserves kudos, as does Robert Bell, who represented whistleblower Richard Miller.

Two of my favorite D.C. federal judges presided over the case. Initially, the late Judge William Bryant had it, and it was later transferred to Judge Royce Lamberth.
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“Lessons from Health Care Fraud in Medicare and Medicaid” to Begin on This Whistleblower Lawyer Blog

Because health care fraud in the Medicare and Medicaid programs is such a huge problem, this week our whistleblower lawyer blog writers (former federal prosecutors who are now whistleblower attorneys) begin a series of posts on “Lessons from Health Care Fraud in Medicare and Medicaid.”

We will discuss how whistle blowers in the medical services profession have been important resources in revealing and stopping health care fraud in hospitals, nursing homes, physicians’ practices, and the pharmaceutical or drug industry. We also discuss how the
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Texas Upgrades Its Qui Tam Whistleblower Statute–and Considers An Even Better Whistleblower Law

Just after Georgia, New York, and Oklahoma have passed new whistleblower laws similar to the federal False Claims Act to protect at least state Medicaid funds, Texas is poised to do even more.

We were pleased to see that, on May 4, Texas upgraded its already successful Texas Medicaid Fraud Prevention Act. The changes were designed to allow Texas to receive a greater share of Medicaid fraud recoveries, as we have written about previously on this whistleblowerlawyerblog. The Deficit Reduction Act of 2005 creates
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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.

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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.

New York also recently approved a state False Claims Act, and many other states are considering them.

We look forward to following the progress in other states that are considering state False Claims Acts, so that they take advantage of the financial incentives Congress created in the Deficit Reduction Act.
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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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