Category Archives: Qui Tam/Whistleblower
Whistleblower Client Defeats National Pharmacy Chain’s Motion to Dismiss Medicare Fraud Claims Alleging Medication Therapy Management Consultations Were “Worthless Services”
Representing their whistleblower client (“Relator”) in a qui tam case in which the federal government declined to intervene, RKJ attorneys Adam Rabin, Havan Clark, and Andrew Abreu, together with co-counsel Rosalyn Sia Baker-Barnes, prevailed in defeating a national pharmacy chain’s motion to dismiss the Second Amended Complaint (“Complaint”), as detailed in U.S. District Judge… Read More »
Florida Contractors and Owner Agree to Pay $7.7M to Resolve False Claims Act Allegations
On June 29, 2023, the United States Department of Justice (“DOJ”) announced it reached an agreement with “HX5 LLC and its owner and Chief Executive Officer, Margarita Howard, located in Fort Walton Beach, Florida, and an affiliated joint venture HX5 Sierra LLC, located in Cleveland, Ohio” (collectively, “HX5 Parties”) whereby the HX5 Parties would… Read More »
GCI Communications Corp. and U.S. Department of Justice Settle False Claims Act Case for $40M
On May 11, 2023, the United States Department of Justice (“DOJ”) announced it reached a settlement with GCI Communications Corp. (“GCI”) whereby GCI agreed to pay $40,242,546 to resolve allegations that it violated the False Claims Act (“Act”).[1] Under the Act, a private individual who has knowledge of past or present fraud on the… Read More »
History of the Public Disclosure Bar in the Eleventh Circuit and Determining a Proper Burden-Shifting Framework
In 1986, Congress amended the False Claims Act (the “Act”) by adding the public disclosure bar.[1] Congress enacted this bar with the goal of balancing the prevention of parasitic actions based on publicly available information and the encouragement of individuals bringing qui tam actions.[2] The original version of the public disclosure stated: (A) No… Read More »
If I Blow the Whistle on My Employer, Can My Employer Sue Me For Breach of My Nondisclosure Agreement?
When weighing whether to blow the whistle on an employer engaging in fraud upon the Government, an employee or former employee (“Employee”) must consider if doing so would violate the Employee’s nondisclosure agreement. In particular, the Employee must weigh whether providing company documents to the Government will expose the Employee to liability. The short… Read More »
Can a Whistleblower in an Existing Qui Tam Case Add A Co-Whistleblower to the Action?
In the life cycle of a qui tam case, it is common for a whistleblower (also referred to as a “relator”) to learn that another whistleblower has brought a qui tam action against the same defendant for the same or a substantially similar fraudulent scheme. For the second-filed (or third-filed, and so on) case,… Read More »
HEALTHCARE WITH A SIDE OF HAIRCARE: IMPROPER INCENTIVES TO MEDICARE PATIENTS
Offering free gifts with purchase is not a new marketing concept. Many businesses use it as an effective tool for customer retention and soliciting new customers. When the customers are paying with government funds, however, free gifts can be a big no-no. Especially when the free gifts offered to Medicare beneficiaries have no relation… Read More »
Tax Fraud Costs the Government up to $1 Trillion Per Year
On April 9, 2021, the Commissioner of the Internal Revenue Service, Charles Rettig, testified before the Senate Finance Committee regarding the so-called “tax gap,” which represents the shortfall between the amount of taxes that should be paid each year versus the amount actually collected. Rettig estimated the current the tax gap could be as… Read More »
Medicare Advantage Audit Shows $197 Million in Over-Payments
In April 2021, the Department of Health and Human Services, Office of Inspector General (HHS-OIG) released a report regarding a Medicare Advantage Compliance Audit of one of the country’s major Medicare Advantage Organizations, Humana, Inc. The audit covered only one year, 2015, and one particular contract. The audit selected a random sampling of 200… Read More »
Blowing the Whistle on Money Laundering
South Florida is the money laundering capital of the world. Each year, crooked banks, bankers and criminal enterprises move millions of dollars of illicit funds through South Florida banks. In the process, they convert unusable criminal proceeds into seemingly “clean” laundered cash. As whistleblower lawyers, we have received numerous calls over the years from… Read More »