False Claims Act lawyer

Home/Tag: False Claims Act lawyer

Hospital Countersues Whistleblower for Failing to Report Conduct Internally First

George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On March 13, 2019, a West Virginia hospital facing a whistleblower lawsuit countersued a former employee who filed the False Claims Act (FCA) lawsuit against the health system. Wheeling Hospital alleges that the former executive, who is the whistleblower/relator in the lawsuit, breached his fiduciary duty to the company by failing to report the unlawful conduct internally, first. Instead, he used the information as the basis for his whistleblower claim. In the countersuit filed in the U.S. District Court for the Northern District of West Virginia, the Hospital accuses the former executive-turned-whistleblower of attempting to ‘extort a settlement’ and filing the FCA whistleblower suit as an act of revenge.

The Whistleblower’s Complaint.

The whistleblower, a former accountant, and senior executive at Wheeling Hospital, was discharged in August 2015. In December 2017, he filed a complaint under the qui tam provisions of the False Claims Act (FCA). He alleged the hospital violated the federal Anti-Kickback Statute (AKS) by paying kickbacks to physicians for patient referrals to the Hospital. Based on this, it is alleged, the claims for the services the hospital provided to the referred patients were false claims, subject to recoupment by the government.

The Hospital’s Countersuit.

In an unusual strategy, the Hospital filed a counter-suit against the whistleblower, alleging that he breached his fiduciary duty to the Hospital and abused the legal process. The Hospital’s case asserts that instead of carrying out his duty to the Hospital, instead, he capitalized on his alleged knowledge of the conduct to “extort a settlement” through a “false and frivolous” FCA suit as an act of revenge.

Additionally, the Hospital alleges that “at no time during his employment, or in his role as a partner at Deloitte, did he report any suspicions of fraud or violations of federal regulations to Wheeling Hospital’s compliance officer.”

You can read Wheeling Hospital’s countersuit against the whistleblower on our website in full.

The Significance of This Case: Unique Defense Strategy for Defending a Whistleblower Suit.

This case shows a unique, but legally valid, defense strategy that might be used in other future whistleblower cases. Often the information about false claims is produced by a high-ranking hospital or institutional employees whose job duties may have required them to report what they knew to the company as part of their job. The company should then have the opportunity to investigate and correct any improper billing or other misconduct that an errant employee might be carrying out on his own. By failing to do this, the employee may breach his duties to the company, may violate his employment contract, and may be subject to a suit or counter-suit over this. To the extent that the actions of the ex-employee cause the employer damages, the employer may be entitled to indemnification from the ex-employee.

However, the other side of the story is when an employee does make his or her superiors aware of suspected misconduct and false claims within the company and the company does nothing about it. This is often the case that we have when potential blowers contact us about filing a False Claims Act case. Often the whistleblower attempts to do the right thing by reporting it within the company and is stymied by his or her superiors. To us, this opens the door to legitimate whistleblower suits.

To read one of my prior blogs about South Florida Hospital reaching a settlement for similar FCA
claims, click here.

Click here to learn more about who can file a whistleblower/qui tam lawsuit and the reward programs for coming forward with a false claim.

Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.

Attorneys with The Health Law Firm represent physicians, nurses and other health professionals who desire to file a False Claims Act (whistleblower or qui tam) case. However, the attorneys of The Health Law Firm also defend physicians, medical groups and health facilities that have been sued in False Claims Act (whistleblower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Pearlman, Steve and Freeman, Meika. “Top 10 Whistleblowing And Retaliation Events Of The Year.” Law360. (December 20, 2019). Web.

Goldberg, Pinchos. “Hospital Sues Whistleblower for Failing to Report Information And Choosing Instead to Use As Basis for Claim.” JD Supra. (May 8, 2019). Web.

Commins, John. “HOSPITAL COUNTERSUES FALSE CLAIMS WHISTLEBLOWER.” Health Leaders. (May 9, 2019). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida area.  www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620.

Keywords: Florida health law attorney, whistleblower attorney, whistleblower defense lawyer, Florida health law defense attorney, whistleblower defense attorney, whistleblower defense legal counsel, legal representation for whistleblower cases, qui tam lawyer, health law attorney, qui tam defense lawyer, qui tam plaintiff lawyer, whistleblower legal representation, False Claims Act lawyer, False Claims Act attorney, False Claims Act legal counsel, The Health Law Firm, DOJ defense lawyer, Office of Inspector General (OIG) defense counsel, Office of Inspector General (OIG) defense attorney, Office of Inspector General (OIG) legal representation, medcila legal defense attorney, health care fraud attorney, health care fraud lawyer, attorney legal representation for qui tam cases, Anti-Kickback Statute (AKS) attorney, Anti-Kickback Statute (AKS) lawyer, Anti-Kickback Statute (AKS) defense counsel, Medicare fraud defense lawyer attorney, Medicare fraud legal representation, Medicaid fraud defense lawyer attorney, legal representation for Medicare and Medicaid fraud, legal representation for Stark Law violations, healthcare fraud defense attorney, whistle blower lawyer attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Florida qui tam whistle blower lawyer attorney, Colorado qui tam whistle blower lawyer attorney, Louisiana qui tam whistle blower lawyer attorney, Kentucky qui tam whistle blower lawyer attorney, Virginia qui tam whistle blower lawyer attorney, District of Columbia (D.C.) qui tam whistle blower lawyer attorney, civil monetary penalties lawyer attorney, Colorado False Claims Act (FCA) and civil monetary penalties lawyer, Louisiana False Claims Act (FCA) and civil monetary penalties attorney, Kentucky False Claims Act (FCA) and civil monetary penalties lawyer attorney legal counsel, Virginia False Claims Act (FCA) and civil monetary penalties lawyer attorney, Virginia whistleblower lawyer attorney, District of Columbia (D.C.) False Claims Act (FCA) and civil monetary penalties lawyer attorney, civil monetary penalties lawyer attorney

The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2020 The Health Law Firm. All rights reserved

By |2019-12-30T21:22:42-05:00March 16th, 2020|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Hospital Countersues Former Employee for Failing to Report Information Internally in FCA Suit

George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On March 13, 2019, a West Virginia hospital facing a whistleblower lawsuit countersued a former employee who filed the False Claims Act (FCA) lawsuit against the health system. Wheeling Hospital alleges that the former executive, who is the whistleblower/relator in the lawsuit, breached his fiduciary duty to the company by failing to report the unlawful conduct internally, first. Instead, he used the information as the basis for his whistleblower claim. In the countersuit filed in the U.S. District Court for the Northern District of West Virginia, the Hospital accuses the former executive-turned-whistleblower of attempting to ‘extort a settlement’ and filing the FCA whistleblower suit as an act of revenge.

The Whistleblower’s Complaint.

The whistleblower, a former accountant, and senior executive at Wheeling Hospital, was discharged in August 2015. In December 2017, he filed a complaint under the qui tam provisions of the False Claims Act (FCA). He alleged the hospital violated the federal Anti-Kickback Statute (AKS) by paying kickbacks to physicians for patient referrals to the Hospital. Based on this, it is alleged, the claims for the services the hospital provided to the referred patients were false claims, subject to recoupment by the government.

The Hospital’s Countersuit.

In an unusual strategy, the Hospital filed a counter-suit against the whistleblower, alleging that he breached his fiduciary duty to the Hospital and abused the legal process. The Hospital’s case asserts that instead of carrying out his duty to the Hospital, instead, he capitalized on his alleged knowledge of the conduct to “extort a settlement” through a “false and frivolous” FCA suit as an act of revenge.

Additionally, the Hospital alleges that “at no time during his employment, or in his role as a partner at Deloitte, did he report any suspicions of fraud or violations of federal regulations to Wheeling Hospital’s compliance officer.”

You can read Wheeling Hospital’s countersuit against the whistleblower on our website in full.

The Significance of This Case: Unique Defense Strategy for Defending a Whistleblower Suit.

This case shows a unique, but legally valid, defense strategy that might be used in other future whistleblower cases. Often the information about false claims is produced by a high-ranking hospital or institutional employees whose job duties may have required them to report what they knew to the company as part of their job. The company should then have the opportunity to investigate and correct any improper billing or other misconduct that an errant employee might be carrying out on his own. By failing to do this, the employee may breach his duties to the company, may violate his employment contract, and may be subject to a suit or counter-suit over this. To the extent that the actions of the ex-employee cause the employer damages, the employer may be entitled to indemnification from the ex-employee.

However, the other side of the story is when an employee does make his or her superiors aware of suspected misconduct and false claims within the company and the company does nothing about it. This is often the case that we have when potential blowers contact us about filing a False Claims Act case. Often the whistleblower attempts to do the right thing by reporting it within the company and is stymied by his or her superiors. To us, this opens the door to legitimate whistleblower suits.

To read one of my prior blogs about South Florida Hospital reaching a settlement for similar FCA
claims, click here.

Click here to learn more about who can file a whistleblower/qui tam lawsuit and the reward programs for coming forward with a false claim.

Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.

Attorneys with The Health Law Firm represent physicians, nurses and other health professionals who desire to file a False Claims Act (whistleblower or qui tam) case. However, the attorneys of The Health Law Firm also defend physicians, medical groups and health facilities that have been sued in False Claims Act (whistleblower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Pearlman, Steve and Freeman, Meika. “Top 10 Whistleblowing And Retaliation Events Of The Year.” Law360. (December 20, 2019). Web.

Goldberg, Pinchos. “Hospital Sues Whistleblower for Failing to Report Information And Choosing Instead to Use As Basis for Claim.” JD Supra. (May 8, 2019). Web.

Commins, John. “HOSPITAL COUNTERSUES FALSE CLAIMS WHISTLEBLOWER.” Health Leaders. (May 9, 2019). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida area.  www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620.

Keywords: Florida health law attorney, whistleblower attorney, whistleblower defense lawyer, Florida health law defense attorney, whistleblower defense attorney, whistleblower defense legal counsel, legal representation for whistleblower cases, qui tam lawyer, health law attorney, qui tam defense lawyer, qui tam plaintiff lawyer, whistleblower legal representation, False Claims Act lawyer, False Claims Act attorney, False Claims Act legal counsel, The Health Law Firm, DOJ defense lawyer, Office of Inspector General (OIG) defense counsel, Office of Inspector General (OIG) defense attorney, Office of Inspector General (OIG) legal representation, medcila legal defense attorney, health care fraud attorney, health care fraud lawyer, attorney legal representation for qui tam cases, Anti-Kickback Statute (AKS) attorney, Anti-Kickback Statute (AKS) lawyer, Anti-Kickback Statute (AKS) defense counsel, Medicare fraud defense lawyer attorney, Medicare fraud legal representation, Medicaid fraud defense lawyer attorney, legal representation for Medicare and Medicaid fraud, legal representation for Stark Law violations, healthcare fraud defense attorney, whistle blower lawyer attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Florida qui tam whistle blower lawyer attorney, Colorado qui tam whistle blower lawyer attorney, Louisiana qui tam whistle blower lawyer attorney, Kentucky qui tam whistle blower lawyer attorney, Virginia qui tam whistle blower lawyer attorney, District of Columbia (D.C.) qui tam whistle blower lawyer attorney, civil monetary penalties lawyer attorney, Colorado False Claims Act (FCA) and civil monetary penalties lawyer, Louisiana False Claims Act (FCA) and civil monetary penalties attorney, Kentucky False Claims Act (FCA) and civil monetary penalties lawyer attorney legal counsel, Virginia False Claims Act (FCA) and civil monetary penalties lawyer attorney, Virginia whistleblower lawyer attorney, District of Columbia (D.C.) False Claims Act (FCA) and civil monetary penalties lawyer attorney, civil monetary penalties lawyer attorney

The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2020 The Health Law Firm. All rights reserved

By |2019-12-30T21:18:07-05:00February 24th, 2020|Categories: Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Hospital Countersues Whistleblower for Failing to Report Information Internally in FCA Suit

George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On March 13, 2019, a West Virginia hospital facing a whistleblower lawsuit countersued a former employee who filed the False Claims Act (FCA) lawsuit against the health system. Wheeling Hospital alleges that the former executive, who is the whistleblower/relator in the lawsuit, breached his fiduciary duty to the company by failing to report the unlawful conduct internally, first. Instead, he used the information as the basis for his whistleblower claim. In the countersuit filed in the U.S. District Court for the Northern District of West Virginia, the Hospital accuses the former executive-turned-whistleblower of attempting to ‘extort a settlement’ and filing the FCA whistleblower suit as an act of revenge.

The Whistleblower’s Complaint.

The whistleblower, a former accountant, and senior executive at Wheeling Hospital, was discharged in August 2015. In December 2017, he filed a complaint under the qui tam provisions of the False Claims Act (FCA). He alleged the hospital violated the federal Anti-Kickback Statute (AKS) by paying kickbacks to physicians for patient referrals to the Hospital. Based on this, it is alleged, the claims for the services the hospital provided to the referred patients were false claims, subject to recoupment by the government.

The Hospital’s Countersuit.

In an unusual strategy, the Hospital filed a counter-suit against the whistleblower, alleging that he breached his fiduciary duty to the Hospital and abused the legal process. The Hospital’s case asserts that instead of carrying out his duty to the Hospital, instead, he capitalized on his alleged knowledge of the conduct to “extort a settlement” through a “false and frivolous” FCA suit as an act of revenge.

Additionally, the Hospital alleges that “at no time during his employment, or in his role as a partner at Deloitte, did he report any suspicions of fraud or violations of federal regulations to Wheeling Hospital’s compliance officer.”

You can read Wheeling Hospital’s countersuit against the whistleblower on our website in full.

The Significance of This Case: Unique Defense Strategy for Defending a Whistleblower Suit.

This case shows a unique, but legally valid, defense strategy that might be used in other future whistleblower cases. Often the information about false claims is produced by a high-ranking hospital or institutional employees whose job duties may have required them to report what they knew to the company as part of their job. The company should then have the opportunity to investigate and correct any improper billing or other misconduct that an errant employee might be carrying out on his own. By failing to do this, the employee may breach his duties to the company, may violate his employment contract, and may be subject to a suit or counter-suit over this. To the extent that the actions of the ex-employee cause the employer damages, the employer may be entitled to indemnification from the ex-employee.

However, the other side of the story is when an employee does make his or her superiors aware of suspected misconduct and false claims within the company and the company does nothing about it. This is often the case that we have when potential blowers contact us about filing a False Claims Act case. Often the whistleblower attempts to do the right thing by reporting it within the company and is stymied by his or her superiors. To us, this opens the door to legitimate whistleblower suits.

To read one of my prior blogs about South Florida Hospital reaching a settlement for similar FCA
claims, click here.

Click here to learn more about who can file a whistleblower/qui tam lawsuit and the reward programs for coming forward with a false claim.

Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.

Attorneys with The Health Law Firm represent physicians, nurses and other health professionals who desire to file a False Claims Act (whistleblower or qui tam) case. However, the attorneys of The Health Law Firm also defend physicians, medical groups and health facilities that have been sued in False Claims Act (whistleblower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Pearlman, Steve and Freeman, Meika. “Top 10 Whistleblowing And Retaliation Events Of The Year.” Law360. (December 20, 2019). Web.

Goldberg, Pinchos. “Hospital Sues Whistleblower for Failing to Report Information And Choosing Instead to Use As Basis for Claim.” JD Supra. (May 8, 2019). Web.

Commins, John. “HOSPITAL COUNTERSUES FALSE CLAIMS WHISTLEBLOWER.” Health Leaders. (May 9, 2019). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida area.  www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620.

Keywords: Florida health law attorney, whistleblower attorney, whistleblower defense lawyer, Florida health law defense attorney, whistleblower defense attorney, whistleblower defense legal counsel, legal representation for whistleblower cases, qui tam lawyer, health law attorney, qui tam defense lawyer, qui tam plaintiff lawyer, whistleblower legal representation, False Claims Act lawyer, False Claims Act attorney, False Claims Act legal counsel, The Health Law Firm, DOJ defense lawyer, Office of Inspector General (OIG) defense counsel, Office of Inspector General (OIG) defense attorney, Office of Inspector General (OIG) legal representation, medcila legal defense attorney, health care fraud attorney, health care fraud lawyer, attorney legal representation for qui tam cases, Anti-Kickback Statute (AKS) attorney, Anti-Kickback Statute (AKS) lawyer, Anti-Kickback Statute (AKS) defense counsel, Medicare fraud defense lawyer attorney, Medicare fraud legal representation, Medicaid fraud defense lawyer attorney, legal representation for Medicare and Medicaid fraud, legal representation for Stark Law violations, healthcare fraud defense attorney, whistle blower lawyer attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Florida qui tam whistle blower lawyer attorney, Colorado qui tam whistle blower lawyer attorney, Louisiana qui tam whistle blower lawyer attorney, Kentucky qui tam whistle blower lawyer attorney, Virginia qui tam whistle blower lawyer attorney, District of Columbia (D.C.) qui tam whistle blower lawyer attorney, civil monetary penalties lawyer attorney, Colorado False Claims Act (FCA) and civil monetary penalties lawyer, Louisiana False Claims Act (FCA) and civil monetary penalties attorney, Kentucky False Claims Act (FCA) and civil monetary penalties lawyer attorney legal counsel, Virginia False Claims Act (FCA) and civil monetary penalties lawyer attorney, Virginia whistleblower lawyer attorney, District of Columbia (D.C.) False Claims Act (FCA) and civil monetary penalties lawyer attorney, civil monetary penalties lawyer attorney

The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2020 The Health Law Firm. All rights reserved

By |2019-12-30T21:07:39-05:00February 3rd, 2020|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Hospital Countersues FCA Whistleblower for Failing to Report Information Internally

George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On March 13, 2019, a West Virginia hospital facing a whistleblower lawsuit countersued a former employee who filed the False Claims Act (FCA) lawsuit against the health system. Wheeling Hospital alleges that the former executive, who is the whistleblower/relator in the lawsuit, breached his fiduciary duty to the company by failing to report the unlawful conduct internally, first. Instead, he used the information as the basis for his whistleblower claim. In the countersuit filed in the U.S. District Court for the Northern District of West Virginia, the Hospital accuses the former executive-turned-whistleblower of attempting to ‘extort a settlement’ and filing the FCA whistleblower suit as an act of revenge.

The Whistleblower’s Complaint.

The whistleblower, a former accountant, and senior executive at Wheeling Hospital, was discharged in August 2015. In December 2017, he filed a complaint under the qui tam provisions of the False Claims Act (FCA). He alleged the hospital violated the federal Anti-Kickback Statute (AKS) by paying kickbacks to physicians for patient referrals to the Hospital. Based on this, it is alleged, the claims for the services the hospital provided to the referred patients were false claims, subject to recoupment by the government.

The Hospital’s Countersuit.

In an unusual strategy, the Hospital filed a counter-suit against the whistleblower, alleging that he breached his fiduciary duty to the Hospital and abused the legal process. The Hospital’s case asserts that instead of carrying out his duty to the Hospital, instead, he capitalized on his alleged knowledge of the conduct to “extort a settlement” through a “false and frivolous” FCA suit as an act of revenge.

Additionally, the Hospital alleges that “at no time during his employment, or in his role as a partner at Deloitte, did he report any suspicions of fraud or violations of federal regulations to Wheeling Hospital’s compliance officer.”

You can read Wheeling Hospital’s countersuit against the whistleblower on our website in full.

The Significance of This Case: Unique Defense Strategy for Defending a Whistleblower Suit.

This case shows a unique, but legally valid, defense strategy that might be used in other future whistleblower cases. Often the information about false claims is produced by a high-ranking hospital or institutional employees whose job duties may have required them to report what they knew to the company as part of their job. The company should then have the opportunity to investigate and correct any improper billing or other misconduct that an errant employee might be carrying out on his own. By failing to do this, the employee may breach his duties to the company, may violate his employment contract, and may be subject to a suit or counter-suit over this. To the extent that the actions of the ex-employee cause the employer damages, the employer may be entitled to indemnification from the ex-employee.

However, the other side of the story is when an employee does make his or her superiors aware of suspected misconduct and false claims within the company and the company does nothing about it. This is often the case that we have when potential blowers contact us about filing a False Claims Act case. Often the whistleblower attempts to do the right thing by reporting it within the company and is stymied by his or her superiors. To us, this opens the door to legitimate whistleblower suits.

To read one of my prior blogs about South Florida Hospital reaching a settlement for similar FCA
claims, click here.

Click here to learn more about who can file a whistleblower/qui tam lawsuit and the reward programs for coming forward with a false claim.

Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.

Attorneys with The Health Law Firm represent physicians, nurses and other health professionals who desire to file a False Claims Act (whistleblower or qui tam) case. However, the attorneys of The Health Law Firm also defend physicians, medical groups and health facilities that have been sued in False Claims Act (whistleblower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Pearlman, Steve and Freeman, Meika. “Top 10 Whistleblowing And Retaliation Events Of The Year.” Law360. (December 20, 2019). Web.

Goldberg, Pinchos. “Hospital Sues Whistleblower for Failing to Report Information And Choosing Instead to Use As Basis for Claim.” JD Supra. (May 8, 2019). Web.

Commins, John. “HOSPITAL COUNTERSUES FALSE CLAIMS WHISTLEBLOWER.” Health Leaders. (May 9, 2019). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida area.  www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620.

Keywords: Florida health law attorney, whistleblower attorney, whistleblower defense lawyer, Florida health law defense attorney, whistleblower defense attorney, whistleblower defense legal counsel, legal representation for whistleblower cases, qui tam lawyer, health law attorney, qui tam defense lawyer, qui tam plaintiff lawyer, whistleblower legal representation, False Claims Act lawyer, False Claims Act attorney, False Claims Act legal counsel, The Health Law Firm, DOJ defense lawyer, Office of Inspector General (OIG) defense counsel, Office of Inspector General (OIG) defense attorney, Office of Inspector General (OIG) legal representation, medcila legal defense attorney, health care fraud attorney, health care fraud lawyer, attorney legal representation for qui tam cases, Anti-Kickback Statute (AKS) attorney, Anti-Kickback Statute (AKS) lawyer, Anti-Kickback Statute (AKS) defense counsel, Medicare fraud defense lawyer attorney, Medicare fraud legal representation, Medicaid fraud defense lawyer attorney, legal representation for Medicare and Medicaid fraud, legal representation for Stark Law violations, healthcare fraud defense attorney, whistle blower lawyer attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Florida qui tam whistle blower lawyer attorney, Colorado qui tam whistle blower lawyer attorney, Louisiana qui tam whistle blower lawyer attorney, Kentucky qui tam whistle blower lawyer attorney, Virginia qui tam whistle blower lawyer attorney, District of Columbia (D.C.) qui tam whistle blower lawyer attorney, civil monetary penalties lawyer attorney, Colorado False Claims Act (FCA) and civil monetary penalties lawyer, Louisiana False Claims Act (FCA) and civil monetary penalties attorney, Kentucky False Claims Act (FCA) and civil monetary penalties lawyer attorney legal counsel, Virginia False Claims Act (FCA) and civil monetary penalties lawyer attorney, Virginia whistleblower lawyer attorney, District of Columbia (D.C.) False Claims Act (FCA) and civil monetary penalties lawyer attorney, civil monetary penalties lawyer attorney

The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2020 The Health Law Firm. All rights reserved

By |2019-12-30T21:01:42-05:00January 13th, 2020|Categories: Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Hospital Countersues FCA Whistleblower for Failing to Report Information Internally

Carole C. SchrieferBy Carole C. Schriefer, R.N., J.D.
On March 13, 2019, a West Virginia hospital facing a whistleblower lawsuit countersued a former employee who filed the False Claims Act (FCA) lawsuit against the health system. Wheeling Hospital alleges that the former executive, who is the whistleblower/relator in the lawsuit, breached his fiduciary duty to the company by failing to report the unlawful conduct internally, first. Instead, he used the information as the basis for his whistleblower claim. In the countersuit filed in the U.S. District Court for the Northern District of West Virginia, the Hospital accuses the former executive-turned-whistleblower of attempting to ‘extort a settlement’ and filing the FCA whistleblower suit as an act of revenge.

The Whistleblower’s Complaint.

The whistleblower, a former accountant, and senior executive at Wheeling Hospital, was discharged in August 2015. In December 2017, he filed a complaint under the qui tam provisions of the False Claims Act (FCA). He alleged the hospital violated the federal Anti-Kickback Statute (AKS) by paying kickbacks to physicians for patient referrals to the Hospital. Based on this, it is alleged, the claims for the services the hospital provided to the referred patients were false claims, subject to recoupment by the government.

The Hospital’s Countersuit.

In an unusual strategy, the Hospital filed a counter-suit against the whistleblower, alleging that he breached his fiduciary duty to the Hospital and abused the legal process. The Hospital’s case asserts that instead of carrying out his duty to the Hospital, instead, he capitalized on his alleged knowledge of the conduct to “extort a settlement” through a “false and frivolous” FCA suit as an act of revenge.

Additionally, the Hospital alleges that “at no time during his employment, or in his role as a partner at Deloitte, did he report any suspicions of fraud or violations of federal regulations to Wheeling Hospital’s compliance officer.”

You can read Wheeling Hospital’s countersuit against the whistleblower on our website in full.

The Significance of This Case: Unique Defense Strategy for Defending a Whistleblower Suit.

This case shows a unique, but legally valid, defense strategy that might be used in other future whistleblower cases. Often the information about false claims is produced by a high-ranking hospital or institutional employees whose job duties may have required them to report what they knew to the company as part of their job. The company should then have the opportunity to investigate and correct any improper billing or other misconduct that an errant employee might be carrying out on his own. By failing to do this, the employee may breach his duties to the company, may violate his employment contract, and may be subject to a suit or counter-suit over this. To the extent that the actions of the ex-employee cause the employer damages, the employer may be entitled to indemnification from the ex-employee.

However, the other side of the story is when an employee does make his or her superiors aware of suspected misconduct and false claims within the company and the company does nothing about it. This is often the case that we have when potential blowers contact us about filing a False Claims Act case. Often the whistleblower attempts to do the right thing by reporting it within the company and is stymied by his or her superiors. To us, this opens the door to legitimate whistleblower suits.

To read one of my prior blogs about South Florida Hospital reaching a settlement for similar FCA
claims, click here.

Click here to learn more about who can file a whistleblower/qui tam lawsuit and the reward programs for coming forward with a false claim.

Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.

Attorneys with The Health Law Firm represent physicians, nurses and other health professionals who desire to file a False Claims Act (whistleblower or qui tam) case. However, the attorneys of The Health Law Firm also defend physicians, medical groups and health facilities that have been sued in False Claims Act (whistleblower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Pearlman, Steve and Freeman, Meika. “Top 10 Whistleblowing And Retaliation Events Of The Year.” Law360. (December 20, 2019). Web.

Goldberg, Pinchos. “Hospital Sues Whistleblower for Failing to Report Information And Choosing Instead to Use As Basis for Claim.” JD Supra. (May 8, 2019). Web.

Commins, John. “HOSPITAL COUNTERSUES FALSE CLAIMS WHISTLEBLOWER.” Health Leaders. (May 9, 2019). Web.

About the Author: Carole C. Schriefer is an attorney and registered nurse. She practices with The Health Law Firm, which has a national practice. Its regional office is in the Northern Colorado, area. www.TheHealthLawFirm.com The Health Law Firm, 155 East Boardwalk Drive, Fort Collins, Colorado 80525. Phone: (970) 416-7456. Its main office is in the Orlando, Florida area.

Keywords: Florida health law attorney, whistleblower attorney, whistleblower defense lawyer, Florida health law defense attorney, whistleblower defense attorney, whistleblower defense legal counsel, legal representation for whistleblower cases, qui tam lawyer, health law attorney, qui tam defense lawyer, qui tam plaintiff lawyer, whistleblower legal representation, False Claims Act lawyer, False Claims Act attorney, False Claims Act legal counsel, The Health Law Firm, DOJ defense lawyer, Office of Inspector General (OIG) defense counsel, Office of Inspector General (OIG) defense attorney, Office of Inspector General (OIG) legal representation, medcila legal defense attorney, health care fraud attorney, health care fraud lawyer, attorney legal representation for qui tam cases, Anti-Kickback Statute (AKS) attorney, Anti-Kickback Statute (AKS) lawyer, Anti-Kickback Statute (AKS) defense counsel, Medicare fraud defense lawyer attorney, Medicare fraud legal representation, Medicaid fraud defense lawyer attorney, legal representation for Medicare and Medicaid fraud, legal representation for Stark Law violations, healthcare fraud defense attorney, whistle blower lawyer attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Florida qui tam whistle blower lawyer attorney, Colorado qui tam whistle blower lawyer attorney, Louisiana qui tam whistle blower lawyer attorney, Kentucky qui tam whistle blower lawyer attorney, Virginia qui tam whistle blower lawyer attorney, District of Columbia (D.C.) qui tam whistle blower lawyer attorney, civil monetary penalties lawyer attorney, Colorado False Claims Act (FCA) and civil monetary penalties lawyer, Louisiana False Claims Act (FCA) and civil monetary penalties attorney, Kentucky False Claims Act (FCA) and civil monetary penalties lawyer attorney legal counsel, Virginia False Claims Act (FCA) and civil monetary penalties lawyer attorney, Virginia whistleblower lawyer attorney, District of Columbia (D.C.) False Claims Act (FCA) and civil monetary penalties lawyer attorney, civil monetary penalties lawyer attorney

The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2019/2020 The Health Law Firm. All rights reserved

By |2019-12-30T20:53:58-05:00December 30th, 2019|Categories: Colorado Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Nursing Home Chain Reaches Record High False Claims Act Settlement With DOJ

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On October 24, 2016, the U.S. Department of Justice (DOJ) announced that Life Care Centers of America will be paying $145 million to end False Claims Act (FCA) litigation that alleged the company submitted false claims to Medicare for rehabilitation therapy services that were not necessary.  This settlement is a FCA record for the nursing industry and DOJ claims it is the largest in the Department’s history.

Who Blew The Whistle?

Tammie Taylor and Glenda Martin, the two whistle blowers and former employees of Life Care, will be splitting the $29 million cut of the payout that they receive as the persons who blew the whistle and filed the initial law suit.  The deal marks the end of two whistle blower cases and a wrongful enrichment suit brought by the DOJ against Forrest L. Preston. Preston is the owner of the Tennessee-based Life Care Center that has over 200 skilled nursing facilities.

$29 million may not be very much money to you, but it is to me.  The False Claims Act and the monetary rewards it authorizes to those who come forward and report fraudulent activities, has now become the primary tool the government has to help stamp out fraud in government programs, in my opinion.

Unnecessary Treatment Alleged.

The government joined the FCA case filed by the whistle blowers in 2012, suspecting that the company was performing excessive treatment of senior patients in order to maximize their Medicare reimbursement.  The company was accused of excessive and unreasonable treatment between January 1, 2006, and February 28, 2013, so that they would qualify for the “Ultra High” reimbursement level Medicare pays.  U.S. Attorney Nancy Stallard Harr stated on Monday that the company’s actions “exploits our most vulnerable citizens.”

According to reports, Preston announced made a statement in connection with the settlement that denied that Life Care engaged in any illegal or improper conduct but was pleased to put the matter behind it.

Big Rewards for Whistle Blowers.

This cause helps show the big monetary rewards that employees and former employees of health care businesses can obtain by coming forward and reporting it when their employer is engaged in submitting false claims to the government.  If managers and supervisors condone or turn a blind eye toward its employees submitting false claims, then this is the same as knowingly committing such violations.  The business is profiting from the false claims.

What is usually missing when an employee or former employee tries to file a whistle blowers law suit is documentation of the companies submission of claims taht are actually false.  Therefore, before an employee or former employee files such a suit, he or she must have copies of the claims that were actually submitted (such as CMS forms 1500, superbills, explanation of benefits (EOBs), etc.) and other documentation.  Without such documentation that shows that false claims were actually submitted for payment, many FCA whistle blower suits are dismissed.

Also, any claims that are paid by state or federally funded healthcare programs can be the subject of such an action.  Most states have a state false claims act that is based on the federal law.  Usually this applies to the state Medicaid program,, but it can also apply to state provided employer health clinics that some cities, counties and agencies provide or to other state funded activities.  Federally funded health care programs that can result in FCA suits include not just Medicare, but also TRICARE, Veterans Administration (VA) funding, Public Health Service (PHS) funding, Indian Health Service (IHS) funding and other government health care programs.  When in doubt, call your friendly whistle blower attorney.

Contact Health Law Attorneys Experienced with Qui Tam, Whistleblower and False Claims Act Cases.

Attorneys with The Health Law Firm also represent health care professionals and health facilities in qui tam or whistleblower cases both in defending such claims and in bringing such claims. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:
Overly, Jeff. “Nursing Home Chain Inks Record $145M FCA Deal With DOJ.” Law360.(October 24, 2016).Web.

“Life Care Centers of America Inc. Agrees to Pay $145 Million to Resolve False Claims Act Allegations Relating to the Provision of Medically Unnecessary Rehabilitation Therapy Services.” Department of Justice. (October 24, 2016). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords:  Whistle blower defense attorney, False Claims Act lawyer, qui tam legal counsel, reviews for the Health Law Firm, skilled nursing facility (SNF) attorney, Health Law Firm reviews, health law, health law firm, The Health Law Firm, False Claims Act whistle blower’s plaintiff attorney, False Claims Act relator’s lawyer, U.S. Department of Justice defense attorney, False Claims Act litigation attorney, False Claims Act defense attorney, consumer reports of Medicare or Medicaid fraud, whistle blower defense attorney, home health care defense attorney, nursing home lawyer, legal representation for home health agencies, attorney for home health agency, legal representation for False Claims Act of whistle blowers, attorneys for VA physicians, Tricare false claims act legal counsel, skilled nursing facility (SNF) defense lawyer, Tricare whistle blower case attorney, nurse reports false claims, defense attorneys on whistle blower, nursing law attorney, nurse attorney, lawyers for nurses

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.