Qui Tam Cases: If You Are Thinking About Blowing the Whistle, Follow These Tips

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

At The Health Law Firm, we have represented many clients that were involved in qui tam cases brought because of false claims under the Medicare False Claims Act (FCA).  We have defended health facilities and health professionals, but we have also brought whistle blower cases against health facilities and health professionals, representing the whistle blower.  If you are thinking about blowing the whistle on any type of fraud or unlawful conduct by your current or former employer, there are important facts that you should know.

Filing a qui tam (whistle blower) case can be complicated, complex, and time consuming.  It’s important to seek experienced legal counsel to guide you through the difficult process. It is crucial that a whistle blower’s attorney have a good working relationship with the U.S. Attorney’s Office and the State Attorney’s Office, as well.
Based on years of experience with these types of cases, from both sides, here are some key tips to remember if you are thinking about filing a qui tam or whistle blower suit:

1.     You Are Doing the Right Thing.  It is important to remember in qui tam cases that you are doing the right thing. Qui tam whistle blowers often save taxpayers millions of dollars and help the government recover stolen funds by coming forward with cases of fraud or unlawful conduct.  Additionally, they help to put an end to fraudulent activities and illegal conduct that may harm patients.

2.     Choose an Experienced Attorney.  Because filing a qui tam suit under the False Claims Act (FCA) can be a difficult and complicated task, choosing an attorney with the proper experience is very important. Litigation of whistle blower cases, either prosecuting them or defending them, is a highly complex, technical area of law and not all attorneys have the experience to make the process easier, let alone be successful.

3.     Don’t Drag Your Feet If You Have Evidence of Fraud.  Once you have evidence of fraud, you need to act quickly or you may lose your opportunity to receive a monetary award. The FCA limits the time in which a suit can be filed. Generally, a qui tam suit must be filed within six years of the date the fraud was committed. Most qui tam laws, including the FCA also have a “first to file” rule. This means that a qui tam whistle blower must be the first to file a case in order to be eligible to receive an award.  Additionally, if the fraud becomes public knowledge or the government discovers the fraud on its own, it is too late for the whistle blower.

4.     Whistleblowers Are Legally Protected from Retaliation by the False Claims Act.  One concern clients have when filing a qui tam suit, is the effect it might have on their future professional career as well as their personal life.
First, because the case is filed under seal, there is no record of any kind that even shows a case has been filed, much less the name of the person filing it.  The U.S. Attorney and its investigators (including the FBI and the OIG Special Agents) will know, but they ain’t telling.  It often takes several years before the court will order the case unsealed. Second, the False Claims Act contains a provision that prohibits any type of retaliation against the whistle blower. The act  makes it unlawful for any employer to retaliate against you for exercising your rights as a whistle blower.  Additionally, if it occurs, you will have a separate right to sue an employer just for the retaliation.  I saw a whistle blower case recently which the court dismissed because there wasn’t specific information contained in the complaint about any false claim being submitted.  However, because the employer had retaliated against the whistle blower, the court did not dismiss the whistle blower’s claim for wrongful retaliation against the employer.  This was a big mistake by the employer.

5.     Silence is Golden in Qui Tam Cases. Do not discuss your case with anyone but your lawyer. Do not tell your friends. Do not tell your family. Do not even disclose that you are thinking of filing a lawsuit. Public discussions can be detrimental to your case. Qui tam suits are filed under the “seal” provision of the FCA, which prohibits the disclosure of any aspect of the case to anyone without prior court approval.

6.    Most Important, Documentation of Actual False Claims is Required. Recent court cases have strictly emphasized the requirement that you must have documented proof of actual false claims being submitted to the government.  Whether these are copies of claims, copies of superbills, copies of explanations of benefits (EOBs), copies of ledgers, copies of book keeping documents or whatever, you must have several actual claims that are false that were submitted for payment.  You must be able to specifiy these by patient name, date of service, CPT code billed, amount billed, etc.  Internal memos, policies and procedures, billing guidance and instructions, medical record entries, and other documents that show the employer’s intent to defraud the government are useful in showing a conspiracy, or organized scheme to falsely bill. However, you must also have copies of false claims documentation, as well.

Remember: Those who file qui tam cases under the FCA are valuable and important for our nation’s health care system. They help stop health care fraud and help the government recover billions of dollars. They prevent the theft or waste of millions of dollars that could be spent on actual, needed health care.  They also help prevent harm that may be caused to patients from receiving substandard treatment, unnecessary procedures and treatments or no treatment. Through qui tam lawsuits, whistle blowers have stopped harmful practices that endanger the health and lives of Medicare, Medicaid, Tricare and VA patients.

For more information, read my prior blog on whistleblowers who report fraud.

Contact an Experienced Health Law Attorney to Assist in Whistle blower/Qui Tam Cases.

If you have knowledge of false claims being filed against Medicare, Medicaid, TRICARE/CHAMPUS or any other type of government program, please contact us, and we will be happy to assist you. Our law firm represents health professionals and health care organizations almost exclusively. Yet, we have been involved in a number of whistle blower/qui tam cases, in which we represent the person who files the claim.
To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: False Claims Act, FCA defense attorney, legal representation for FCA violations, legal representation for Medicare false claims, legal representation for false billing, Medicare fraud defense attorney, legal representation for Medicare fraud, legal representation for Medicare audit, whistle blower attorney, complex health care litigation defense attorney, whistle blower defense attorney, whistle blower defense lawyer, legal representation for whistle blower suits, legal representation for qui tam suits, qui tam relator attorney, qui tam relator lawyer, qui tam relator legal counsel, health care fraud defense attorney, complex health care litigation defense lawyer, legal representation for health care professionals, health law defense attorney, The Health Law Firm attorney reviews, reviews of The Health Law Firm, whistle blower plaintiff attorney, health care professionals defense counsel, health care professional defense lawyer, health care professional defense lawyer, medical professionals defense counsel, medical professionals defense lawyer, medical professional defense lawyer

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.Copyright © 2018 The Health Law Firm. All rights reserved.

By |2024-03-14T10:01:33-04:00May 15, 2018|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Qui Tam Cases: If You Are Thinking About Blowing the Whistle, Follow These Tips
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Florida Federal Judge Triples Award to $347 Million in Rare Whistleblower Case

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

On March 1, 2017, a Florida federal judge tripled a $115 million damages award for the government to $347 million after a jury found that the operators of 53 nursing facilities submitted false claims to Medicare and Medicaid. U.S. District Judge, Steven D. Merryday, upheld the jury’s $115 award affirming that the operators of the 53 nursing facilities had violated the False Claims Act (FCA). The case is U.S. ex rel. Ruckh v. CMC II LLC et al., case number 8:11-cv-01303, in the U.S. District Court for the Middle District of Florida.

The whistleblower in the case, Angela Ruckh, a former nurse at two of the facilities, brought the allegations against four defendants that they had submitted false claims and fraudulent records to the government. The four defendants in the case are CMC II LLC, Salus Rehabilitation LLC, 207 Marshall Drive Operations LLC and 803 Oak Street Operations LLC.

Details of the Case.

On February 15, 2017, the jury found that the four defendants had falsely increased the amount of resources needed for their patients needed, in order to get more money from Medicare and Medicaid. In the jury’s verdict, the four defendants were ordered to pay $115 million in damages for violating the FCA. Click here to read the jury’s verdict in full.

Treble Damages for FCA.

This rare FCA case that both went to trial and received a jury verdict, called for treble damages. The four defendants received penalties proportionate to the jury’s allocated findings. Sea Crest Health Care Management, L.L.C. and CMC II, LLC were ordered to pay $291,160,608 to the U.S. government and $39,897,291 to the Florida government. Salus Rehabilitation LLC was required to pay $484,000 to the U.S. government. 207 Marshall Drive Operations L.L.C. incurred $6,266,424 of damages owed to the federal government and 803 Oak Street Operations, LLC was penalized $10,055,961 to be paid back to the U.S. government. Click here to read the order from this case in full.

To learn more about FCA violations and cases of fraud involving a relator or whistleblower, click here to read one of our prior blogs.

Nurses and Other Employees Are Often Whistle Blowers in These Big Cases.

It is often a nurse or other health professional employed by the facility that is the whistle blower in such cases. They are in a position to know whether or not services are being provided and whether or not they are medically necessary. They are often in a position to see if false bills are being submitted for the patients.

In a case such as this one, where the U.S. did not intervene to take the case forward and the whistleblower and her attorneys did, she can receive an award of up to thirty percent (30%) of the recovery or $104,100,000.

Contact an Experienced Health Law Attorney to Assist in Whistleblower/Qui Tam Cases.

If you have knowledge of false claims being filed against Medicare, Medicaid, TRICARE/CHAMPUS or any other type of government program, please contact us, and we will be happy to assist you. Our law firm represents health professionals and health care organizations almost exclusively. Yet, we have been involved in a number of whistleblower/qui tam cases, in which we represent the person who files the claim.

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

Sources:

Smith, Mara. “Florida Judge Trebles Award to $347 Million in Whistleblower Case.” AHCA. (March 1, 2017). Web.

Bolado, Carolina. “Judge Triples Nursing Home Cos.’ Fraud Penalty To $347M.” Law360. (March 6, 2017). 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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: False Claims Act (FCA) violations, FCA defense attorney, Medicare and Medicaid fraud defense attorney, Medicare false claims, legal representation for FCA violations, legal representation for overbilling Medicare and Medicaid, legal representation for submitting false claims to the government, Legal representation for Medicare fraud, legal counsel for Medicare audit, legal representation for whistleblower, qui taim, qui tam suits, qui tam relator, whistleblower defense attorney, Medicare fraud defense attorney, Medicaid fraud defense attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

By |2024-03-14T10:01:34-04:00May 15, 2018|Categories: Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , |2 Comments
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Qui Tam Cases: If You Are Thinking About Blowing the Whistle, Follow These Tips

8 Indest-2008-5By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

At The Health Law Firm, we have represented many clients that were involved in qui tam cases brought because of false claims under the Medicare False Claims Act (FCA).  We have defended health facilities and health professionals, but we have also brought whistle blower cases against health facilities and health professionals, representing the whistle blower.  If you are thinking about blowing the whistle on any type of fraud or unlawful conduct by your current or former employer, there are important facts that you should know.

Filing a qui tam (whistle blower) case can be complicated, complex, and time consuming.  It’s important to seek experienced legal counsel to guide you through the difficult process. It is crucial that a whistle blower’s attorney have a good working relationship with the U.S. Attorney’s Office and the State Attorney’s Office, as well.
Based on years of experience with these types of cases, from both sides, here are some key tips to remember if you are thinking about filing a qui tam or whistle blower suit:

1.     You Are Doing the Right Thing.  It is important to remember in qui tam cases that you are doing the right thing. Qui tam whistle blowers often save taxpayers millions of dollars and help the government recover stolen funds by coming forward with cases of fraud or unlawful conduct.  Additionally, they help to put an end to fraudulent activities and illegal conduct that may harm patients.

2.     Choose an Experienced Attorney.  Because filing a qui tam suit under the False Claims Act (FCA) can be a difficult and complicated task, choosing an attorney with the proper experience is very important. Litigation of whistle blower cases, either prosecuting them or defending them, is a highly complex, technical area of law and not all attorneys have the experience to make the process easier, let alone be successful.

3.     Don’t Drag Your Feet If You Have Evidence of Fraud.  Once you have evidence of fraud, you need to act quickly or you may lose your opportunity to receive a monetary award. The FCA limits the time in which a suit can be filed. Generally, a qui tam suit must be filed within six years of the date the fraud was committed. Most qui tam laws, including the FCA also have a “first to file” rule. This means that a qui tam whistle blower must be the first to file a case in order to be eligible to receive an award.  Additionally, if the fraud becomes public knowledge or the government discovers the fraud on its own, it is too late for the whistle blower.

4.     Whistleblowers Are Legally Protected from Retaliation by the False Claims Act.  One concern clients have when filing a qui tam suit, is the effect it might have on their future professional career as well as their personal life.
First, because the case is filed under seal, there is no record of any kind that even shows a case has been filed, much less the name of the person filing it.  The U.S. Attorney and its investigators (including the FBI and the OIG Special Agents) will know, but they ain’t telling.  It often takes several years before the court will order the case unsealed. Second, the False Claims Act contains a provision that prohibits any type of retaliation against the whistle blower. The act  makes it unlawful for any employer to retaliate against you for exercising your rights as a whistle blower.  Additionally, if it occurs, you will have a separate right to sue an employer just for the retaliation.  I saw a whistle blower case recently which the court dismissed because there wasn’t specific information contained in the complaint about any false claim being submitted.  However, because the employer had retaliated against the whistle blower, the court did not dismiss the whistle blower’s claim for wrongful retaliation against the employer.  This was a big mistake by the employer.

5.     Silence is Golden in Qui Tam Cases. Do not discuss your case with anyone but your lawyer. Do not tell your friends. Do not tell your family. Do not even disclose that you are thinking of filing a lawsuit. Public discussions can be detrimental to your case. Qui tam suits are filed under the “seal” provision of the FCA, which prohibits the disclosure of any aspect of the case to anyone without prior court approval.

6.    Most Important, Documentation of Actual False Claims is Required. Recent court cases have strictly emphasized the requirement that you must have documented proof of actual false claims being submitted to the government.  Whether these are copies of claims, copies of superbills, copies of explanations of benefits (EOBs), copies of ledgers, copies of book keeping documents or whatever, you must have several actual claims that are false that were submitted for payment.  You must be able to specifiy these by patient name, date of service, CPT code billed, amount billed, etc.  Internal memos, policies and procedures, billing guidance and instructions, medical record entries, and other documents that show the employer’s intent to defraud the government are useful in showing a conspiracy, or organized scheme to falsely bill. However, you must also have copies of false claims documentation, as well.

Remember: Those who file qui tam cases under the FCA are valuable and important for our nation’s health care system. They help stop health care fraud and help the government recover billions of dollars. They prevent the theft or waste of millions of dollars that could be spent on actual, needed health care.  They also help prevent harm that may be caused to patients from receiving substandard treatment, unnecessary procedures and treatments or no treatment. Through qui tam lawsuits, whistle blowers have stopped harmful practices that endanger the health and lives of Medicare, Medicaid, Tricare and VA patients.

For more information, read my prior blog on whistleblowers who report fraud.

Contact an Experienced Health Law Attorney to Assist in Whistle blower/Qui Tam Cases.

If you have knowledge of false claims being filed against Medicare, Medicaid, TRICARE/CHAMPUS or any other type of government program, please contact us, and we will be happy to assist you. Our law firm represents health professionals and health care organizations almost exclusively. Yet, we have been involved in a number of whistle blower/qui tam cases, in which we represent the person who files the claim.
To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: False Claims Act, FCA defense attorney, legal representation for FCA violations, legal representation for Medicare false claims, legal representation for false billing, Medicare fraud defense attorney, legal representation for Medicare fraud, legal representation for Medicare audit, whistle blower attorney, complex health care litigation defense attorney, whistle blower defense attorney, whistle blower defense lawyer, legal representation for whistle blower suits, legal representation for qui tam suits, qui tam relator attorney, qui tam relator lawyer, qui tam relator legal counsel, health care fraud defense attorney, complex health care litigation defense lawyer, legal representation for health care professionals, health law defense attorney, The Health Law Firm attorney reviews, reviews of The Health Law Firm, whistle blower plaintiff attorney, health care professionals defense counsel, health care professional defense lawyer, health care professional defense lawyer, medical professionals defense counsel, medical professionals defense lawyer, medical professional defense lawyer

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.Copyright © 2018 The Health Law Firm. All rights reserved.

By |2024-03-14T10:01:36-04:00May 15, 2018|Categories: Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Qui Tam Cases: If You Are Thinking About Blowing the Whistle, Follow These Tips
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Florida Federal Judge Triples Award to $347 Million in Rare Whistleblower Case

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

On March 1, 2017, a Florida federal judge tripled a $115 million damages award for the government to $347 million after a jury found that the operators of 53 nursing facilities submitted false claims to Medicare and Medicaid. U.S. District Judge, Steven D. Merryday, upheld the jury’s $115 award affirming that the operators of the 53 nursing facilities had violated the False Claims Act (FCA). The case is U.S. ex rel. Ruckh v. CMC II LLC et al., case number 8:11-cv-01303, in the U.S. District Court for the Middle District of Florida.

The whistleblower in the case, Angela Ruckh, a former nurse at two of the facilities, brought the allegations against four defendants that they had submitted false claims and fraudulent records to the government. The four defendants in the case are CMC II LLC, Salus Rehabilitation LLC, 207 Marshall Drive Operations LLC and 803 Oak Street Operations LLC.

Details of the Case.

On February 15, 2017, the jury found that the four defendants had falsely increased the amount of resources needed for their patients needed, in order to get more money from Medicare and Medicaid. In the jury’s verdict, the four defendants were ordered to pay $115 million in damages for violating the FCA. Click here to read the jury’s verdict in full.

Treble Damages for FCA.

This rare FCA case that both went to trial and received a jury verdict, called for treble damages. The four defendants received penalties proportionate to the jury’s allocated findings. Sea Crest Health Care Management, L.L.C. and CMC II, LLC were ordered to pay $291,160,608 to the U.S. government and $39,897,291 to the Florida government. Salus Rehabilitation LLC was required to pay $484,000 to the U.S. government. 207 Marshall Drive Operations L.L.C. incurred $6,266,424 of damages owed to the federal government and 803 Oak Street Operations, LLC was penalized $10,055,961 to be paid back to the U.S. government. Click here to read the order from this case in full.

To learn more about FCA violations and cases of fraud involving a relator or whistleblower, click here to read one of our prior blogs.

Nurses and Other Employees Are Often Whistle Blowers in These Big Cases.

It is often a nurse or other health professional employed by the facility that is the whistle blower in such cases. They are in a position to know whether or not services are being provided and whether or not they are medically necessary. They are often in a position to see if false bills are being submitted for the patients.

In a case such as this one, where the U.S. did not intervene to take the case forward and the whistleblower and her attorneys did, she can receive an award of up to thirty percent (30%) of the recovery or $104,100,000.

Contact an Experienced Health Law Attorney to Assist in Whistleblower/Qui Tam Cases.

If you have knowledge of false claims being filed against Medicare, Medicaid, TRICARE/CHAMPUS or any other type of government program, please contact us, and we will be happy to assist you. Our law firm represents health professionals and health care organizations almost exclusively. Yet, we have been involved in a number of whistleblower/qui tam cases, in which we represent the person who files the claim.

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

Sources:

Smith, Mara. “Florida Judge Trebles Award to $347 Million in Whistleblower Case.” AHCA. (March 1, 2017). Web.

Bolado, Carolina. “Judge Triples Nursing Home Cos.’ Fraud Penalty To $347M.” Law360. (March 6, 2017). 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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: False Claims Act (FCA) violations, FCA defense attorney, Medicare and Medicaid fraud defense attorney, Medicare false claims, legal representation for FCA violations, legal representation for overbilling Medicare and Medicaid, legal representation for submitting false claims to the government, Legal representation for Medicare fraud, legal counsel for Medicare audit, legal representation for whistleblower, qui taim, qui tam suits, qui tam relator, whistleblower defense attorney, Medicare fraud defense attorney, Medicaid fraud defense attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

By |2024-03-14T10:01:37-04:00May 15, 2018|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , |Comments Off on Florida Federal Judge Triples Award to $347 Million in Rare Whistleblower Case
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Judge Refuses to Dismiss Whistleblower’s False Research Data Suit Against Duke University and Two Faculty Members

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

On April 27, 2017, a federal judge in North Carolina refused to dismiss a False Claims Act (FCA) lawsuit against Duke University and some of its faculty. The suit alleges that Duke knowingly falsified medical research data in order to get federal grants. According to the judge, the whistleblower in the suit had adequately stated his case against the defendants.

The case was originally filed in West Virginia but was later transferred to a federal district court in North Carolina. The full case caption is United States of America, ex rel. Joseph M. Thomas, Plaintiff, vs. Duke University, Duke University Health System, Inc., William M. Foster, Ph.D., and Erin N. Potts-Kant, U.S. Dist. Ct. Middle Dist. N.C., Case No. 1:17-cv-276.

Click here for a copy of the Amended Complaint filed on November 13, 2015.

Denied Motion For Dismissal.

In a three-page order, U.S. District Judge Catherine C. Eagles denied dismissal motions by Duke and two defendants. Judge Eagles did not elaborate on her decision beyond saying that plaintiff and whistleblower Joseph M. Thomas had brought claims upon which relief could be granted.

To read the order for this case in full, click here.

The Whistleblower Suit.

The whistleblower, Joseph Thomas, was a laboratory research analyst in the Pulmonary, Asthma and Critical Care Division of Duke University Health Systems during the alleged violations. He originally filed his complaint in the Western District of Virginia in May of 2013. He accused the defendants of violating the FCA by faking data in an effort to get money from various federal agencies, including the U.S. Environmental Protection Agency and the National Institutes of Health.

One of the defendants was a clinical research coordinator in that same division and is charged with directly manipulating the research in question. The second defendant, a research professor of medicine, was her direct supervisor.

Repercussions of Clinical Research Fraud and Misconduct.

An accusation, even if later proven to be unfounded, may unfairly tarnish the personal and professional reputation of the researcher and institution. Findings of research misconduct can result in exclusion from grants, termination of employment, and possible civil and criminal penalties. Obtaining an experienced attorney at the earliest stages of an investigation can help the researcher to avoid many pitfalls and mistakes that can harm or even give up defense opportunities the researcher may have. At the very least, legal guidance can assist in presenting the researcher’s side of the case in an effective and organized manner that does not compromise a legal defense.

Going out and retaining an aggressive trial attorney who is unfamiliar with such matters can often be counter-productive and actually lessen the chances of a researcher coming out of an investigation unscathed.

To learn more on this topic, watch our informational video blog here.

To learn how The Health Law Firm can assist if you find yourself facing accusations of research fraud or misconduct, read one of my prior blogs here.

Don’t Wait Until It’s Too Late, Contact Health Law Attorneys Experienced in Clinical Research Fraud and Misconduct.

The Health Law Firm and its attorneys have experience in representing researchers, investigators, academicians and clinicians who are the subject of clinical research fraud and misconduct. The Health Law Firm and its attorneys also have experience in representing students, employees, researchers, investigators and “whistle blowers” who report such matters including those who become the victim or reprisals and retaliation by the person against whom the report is made. Don’t wait. Obtain the advice and counsel of experienced attorneys who are familiar with such matters and can assist you before it is too late.

If you are facing research misconduct or research fraud accusations, please visit our website for more information at www.TheHealthLawFirm.com or call The Health Law Firm at (407) 331-6620 or (850) 439-1001.

Sources:

Kennedy, John. “Duke Can’t Drop Whistleblower’s False Research Data Suit.” Law360. (April 27, 2017). Web.

Hofstra, Patricia. “Research Misconduct False Claims Act Lawsuit Upheld.” Duane Morris Law Firm. (April 27, 2017). 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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for medical research fraud, legal representation for clinical research fraud, clinical research fraud defense attorney, medical research fraud defense attorney, legal representation for allegations of clinical research fraud, legal representation for clinical research misconduct, clinical research misconduct defense attorney, legal representation for medical and clinical researcher investigation, legal counsel for falsifying research data, legal counsel for clinical trials and research, legal representation for manipulating data, whistleblower defense attorney, legal representation for whistblowers, legal counsel for whistleblower suits, whistleblower attorney, False Claims Act (FCA) defense attorney, legal representation for FCA violations, legal representation for allegations of FCA violations, health law defense attorney, reviews of The Health Law Firm attorneys, The Health Law Firm reviews
“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

By |2024-03-14T10:01:48-04:00May 15, 2018|Categories: Medical Education Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , |Comments Off on Judge Refuses to Dismiss Whistleblower’s False Research Data Suit Against Duke University and Two Faculty Members
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Qui Tam Cases: If You Are Thinking About Blowing the Whistle, Follow These Tips

Headshot of The Health Law Firm's attorney George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

At The Health Law Firm, we have represented many clients that were involved in qui tam cases brought because of false claims under the Medicare False Claims Act (FCA).  We have defended health facilities and health professionals, but we have also brought whistle blower cases against health facilities and health professionals, representing the whistle blower.  If you are thinking about blowing the whistle on any type of fraud or unlawful conduct by your current or former employer, there are important facts that you should know.

Filing a qui tam (whistle blower) case can be complicated, complex, and time consuming.  It’s important to seek experienced legal counsel to guide you through the difficult process. It is crucial that a whistle blower’s attorney have a good working relationship with the U.S. Attorney’s Office and the State Attorney’s Office, as well.
Based on years of experience with these types of cases, from both sides, here are some key tips to remember if you are thinking about filing a qui tam or whistle blower suit:

1.     You Are Doing the Right Thing.  It is important to remember in qui tam cases that you are doing the right thing. Qui tam whistle blowers often save taxpayers millions of dollars and help the government recover stolen funds by coming forward with cases of fraud or unlawful conduct.  Additionally, they help to put an end to fraudulent activities and illegal conduct that may harm patients.

2.     Choose an Experienced Attorney.  Because filing a qui tam suit under the False Claims Act (FCA) can be a difficult and complicated task, choosing an attorney with the proper experience is very important. Litigation of whistle blower cases, either prosecuting them or defending them, is a highly complex, technical area of law and not all attorneys have the experience to make the process easier, let alone be successful.

3.     Don’t Drag Your Feet If You Have Evidence of Fraud.  Once you have evidence of fraud, you need to act quickly or you may lose your opportunity to receive a monetary award. The FCA limits the time in which a suit can be filed. Generally, a qui tam suit must be filed within six years of the date the fraud was committed. Most qui tam laws, including the FCA also have a “first to file” rule. This means that a qui tam whistle blower must be the first to file a case in order to be eligible to receive an award.  Additionally, if the fraud becomes public knowledge or the government discovers the fraud on its own, it is too late for the whistle blower.

4.     Whistleblowers Are Legally Protected from Retaliation by the False Claims Act.  One concern clients have when filing a qui tam suit, is the effect it might have on their future professional career as well as their personal life.
First, because the case is filed under seal, there is no record of any kind that even shows a case has been filed, much less the name of the person filing it.  The U.S. Attorney and its investigators (including the FBI and the OIG Special Agents) will know, but they ain’t telling.  It often takes several years before the court will order the case unsealed. Second, the False Claims Act contains a provision that prohibits any type of retaliation against the whistle blower. The act  makes it unlawful for any employer to retaliate against you for exercising your rights as a whistle blower.  Additionally, if it occurs, you will have a separate right to sue an employer just for the retaliation.  I saw a whistle blower case recently which the court dismissed because there wasn’t specific information contained in the complaint about any false claim being submitted.  However, because the employer had retaliated against the whistle blower, the court did not dismiss the whistle blower’s claim for wrongful retaliation against the employer.  This was a big mistake by the employer.

5.     Silence is Golden in Qui Tam Cases. Do not discuss your case with anyone but your lawyer. Do not tell your friends. Do not tell your family. Do not even disclose that you are thinking of filing a lawsuit. Public discussions can be detrimental to your case. Qui tam suits are filed under the “seal” provision of the FCA, which prohibits the disclosure of any aspect of the case to anyone without prior court approval.

6.    Most Important, Documentation of Actual False Claims is Required. Recent court cases have strictly emphasized the requirement that you must have documented proof of actual false claims being submitted to the government.  Whether these are copies of claims, copies of superbills, copies of explanations of benefits (EOBs), copies of ledgers, copies of book keeping documents or whatever, you must have several actual claims that are false that were submitted for payment.  You must be able to specifiy these by patient name, date of service, CPT code billed, amount billed, etc.  Internal memos, policies and procedures, billing guidance and instructions, medical record entries, and other documents that show the employer’s intent to defraud the government are useful in showing a conspiracy, or organized scheme to falsely bill. However, you must also have copies of false claims documentation, as well.

Remember: Those who file qui tam cases under the FCA are valuable and important for our nation’s health care system. They help stop health care fraud and help the government recover billions of dollars. They prevent the theft or waste of millions of dollars that could be spent on actual, needed health care.  They also help prevent harm that may be caused to patients from receiving substandard treatment, unnecessary procedures and treatments or no treatment. Through qui tam lawsuits, whistle blowers have stopped harmful practices that endanger the health and lives of Medicare, Medicaid, Tricare and VA patients.

For more information, read my prior blog on whistleblowers who report fraud.

Contact an Experienced Health Law Attorney to Assist in Whistle blower/Qui Tam Cases.

If you have knowledge of false claims being filed against Medicare, Medicaid, TRICARE/CHAMPUS or any other type of government program, please contact us, and we will be happy to assist you. Our law firm represents health professionals and health care organizations almost exclusively. Yet, we have been involved in a number of whistle blower/qui tam cases, in which we represent the person who files the claim.
To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.Copyright © 2018 The Health Law Firm. All rights reserved.

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“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 © 2022 The Health Law Firm. All rights reserved.
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