The
Department of Justice and Whistleblowers have been
cracking down on Fraud that is being committed against
the United States including Medicare Fraud, Tricare
Fraud, Nursing Home Fraud, Hospice Fraud, Health Care
Fraud, Off Label Drug Fraud,
Pharmaceutical Marketing Fraud, Defense Contractor
Fraud, Road Construction Fraud. This Federal False
Claims Act web site is designed to provide information
on the Federal False Claims Act and Qui Tam
Whistleblower Actions.
If you are aware of a defense
contractor, highway contractor, large health care
company, or other large contractor or subcontractor that
is defrauding the United States Government out of
millions or billions of dollars, please blow the whistle
on that fraudulent actor. If you have a question on
this web site or a specific fraudulent activity, feel
free to contact
Qui Tam Whistleblower Lawyer Jason Coomer.
History of Qui Tam Whistleblower
Claims (Lincoln's Law and Battling Corrupt War
Profiteers)
During
the Civil War, corrupt military contractors were
defrauding the United States Army out of hundreds of
thousands of dollars and putting troops at risk by
supplying troops with defective products and faulty war
equipment. Illegal price gouging was a common practice
and the armed forces of the United States suffered. In
response, Abraham Lincoln enacted the Federal Civil
False Claims Act. A key provision of the act was known
as qui tam.
The abbreviation is from Latin and
refers to "a person who files a suit for the king as for
himself". Qui tam laws have existed for centuries as
deceptive government contractors have been around as
long as government contracting has. Qui tam actions
allow a private citizen to file a lawsuit on behalf of
the U.S. government in an effort to recover losses
caused by fraud against the government. The law is an
incentive for civilians who know of individuals or
companies making false claims for profit to come forward
with information. In reward, the "whistleblower" (also
known as the relator) shares in any federal revenue
recovered.
Successful Qui Tam Whistleblower
Claims (The Department of Justice Reclaims Billions
of Dollars and Pays Realtors Hundreds of Millions of
Dollars through Qui Tam Actions)
The Department of Justice has been
cracking down on Fraud and False Claims including
Medicare Fraud, Tricare Fraud, Nursing Home Fraud,
Hospice Fraud, and other Health Care Fraud. Below is
are just a few of the recent successful recoveries that
have been obtained by Whistleblowers and the Department
of Justice.
Pfizer to pay record $2.3B penalty
over promotions Repeat offender Pfizer paying record
$2.3B settlement for illegal drug promotions By
Devlin Barrett, Associated Press Writer On Wednesday
September 2, 2009, 3:47 pm EDT
"WASHINGTON (AP) -- Federal
prosecutors hit Pfizer Inc. with a record-breaking $2.3
billion in fines Wednesday and called the world's
largest drug maker a repeating corporate cheat for
illegal drug promotions that plied doctors with free
golf, massages, and resort junkets."
Announcing the penalty as a warning
to all drug manufacturers, Justice Department officials
said the overall settlement is the largest ever paid by
a drug company for alleged violations of federal drug
rules, and the $1.2 billion criminal fine is the largest
ever in any U.S. criminal case. The total includes $1
billion in civil penalties and a $100 million criminal
forfeiture.
More Than $1 Billion Recovered
by Justice Department in Fraud and False Claims in
Fiscal Year 2008
WASHINGTON – The United States
secured $1.34 billion in settlements and judgments in
the fiscal year ending Sept. 30, 2008, pursuing
allegations of fraud against the federal government, the
Justice Department announced today. This brings total
recoveries since 1986, when Congress substantially
strengthened the civil False Claims Act, to more than
$21 billion.
"Now, more than ever, it is crucial
that taxpayer dollars aren't lost to fraud," said
Gregory G. Katsas, Assistant Attorney General for the
Department’s Civil Division. "The billion dollars
collected this year is only part of the story. By
rooting out fraud and vigorously pursuing it, the
Department, with the help of concerned citizens who
report fraud in hotline calls and in qui tam complaints,
undoubtedly saves the country many times that amount in
aborted schemes and misconduct."
Assistant Attorney General Katsas
also paid tribute to Senator Charles Grassley of Iowa
and Representative Howard L. Berman of California who
sponsored the 1986 amendments to the False Claims Act,
the government's primary weapon to fight government
fraud. "Without this important legislation strengthening
the Act and, in particular, the qui tam provisions which
encourage private citizens to uncover government fraud,
such recoveries would not have been possible."
Almost 78 percent of this year’s
recoveries are associated with suits initiated by
private citizens (known as "relators") under the False
Claims Act's qui tam provisions. These provisions
authorize relators to file suit on behalf of the United
States against those who have falsely or fraudulently
claimed federal funds. Such cases run the gamut of
federally funded programs from Medicare and Medicaid to
defense procurement contracts, disaster assistance loans
and agricultural subsidies. Persons who knowingly make
false claims for federal funds are liable for three
times the government’s loss plus a civil penalty of
$5,500 to $11,000 for each claim.
Relators recover 15 to 25 percent of
the proceeds of a successful suit if the United States
intervenes in the qui tam action, and up to 30 percent
if the government declines and the relator pursues the
action alone. In fiscal year 2008, relators were awarded
$198 million. (This figure does not include relator
shares awarded after Sept. 30, 2008.)
As in the last several years, health
care accounted for the lion's share of fraud settlements
and judgments–$1.12 billion. This number includes both
qui tam claims and those initiated by the United States.
The Department of Health and Human Services reaped the
biggest recoveries, largely attributable to its Medicare
program and the federal/state Medicaid program which
funds health care for the needy. Recoveries were also
made by the Office of Personnel Management which
administers the Federal Employees Health Benefits
Program, the Department of Defense for its TRICARE
insurance program, the Department of Veterans Affairs
and others.
The largest health care recoveries
came from pharmaceutical companies and related entities.
Settlements with Cephalon Inc., Merck & Co. and CVS
Caremark Corp. accounted for more than $640 million. In
addition to federal recoveries, these pharmaceutical
fraud cases returned $430 million to state Medicaid
programs.
The Civil Division’s investigation of
the pharmaceutical industry is part of a Department-wide
effort. Typical allegations include "off-label"
marketing, which is the illegal promotion of drugs or
devices that are billed to Medicare and other federal
health care programs, for uses that were neither found
safe and effective by the Food and Drug Administration
nor supported by the medical literature; paying
kickbacks to physicians, wholesalers and pharmacies to
induce drug or device purchases; establishing inflated
drug prices knowing that federal health care programs
use these prices to reimburse providers, then marketing
the "spread" between the federal reimbursement and the
provider’s lower cost to induce drug purchases; and
knowingly failing to report the company’s true "best
price" for a drug to reduce rebates owed to the Medicaid
program.
Lilly Pharmaceuticals - $438 million
under the False Claims Act In January of 2009, Eli Lilly
agreed to pay a total of $1.4 billion to resolve
Federal, state and criminal charges in relation to the
off-label marketing of the drug Zyprexa. Of this sum,
$438 million went to satisfy Federal False Claims Act
charges, $361 million was divided among the states, and
$515 million was paid as a criminal fine.
Recent History of Qui Tam Claims
In 1986 as a result of increased
government contractor fraud, Congress amended the False
Claims Act in order to make it easier for whistleblowers
to file claims against fraudulent corporations and
individuals.
The 1986
Amendment defines a "claim" as:
"...any
request or demand which is made to a contractor,
grantee, or other recipient if the United States
Government provides any portion of the money or property
which is requested or demanded, or if the government
will reimburse such contractor, grantee, or other
recipient for any portion of the money or property which
is requested or demanded."
The whistleblower's share of recovery
is a maximum of 30 percent and the government's prior
knowledge of fraud now does not necessarily bar a
whistleblower from collecting lost revenue. If the
government took over the lawsuit, the relator can
"continue as a party to the action." The defendant is
also required to pay for the relator's attorney fees.
The whistleblower is also protected from retaliatory
actions by his or her employer. As a result or the
amendment, qui tam lawsuits increased dramatically.
Though the amendment was first made fore corrupt defense
contractors, the amendment has uncovered billions of
dollars in health care fraud.
Anyone who defrauds the government
out of revenue can be held accountable under the False
Claims Act. Common defendants include defense
contractors, health care providers, other government
contractors & subcontractors, state and local government
agencies, and private universities. Whistleblowers
often include current and former employees of the
defrauding company, competitors of government
contractors and public interest groups.
The False Claims Act was enacted to
encourage private citizens to assist the government in
the fight against fraud. Often the whistleblower faces
an uphill battle as large, powerful corporations or
individuals are usually named as defendants. An
experienced attorney in qui tam claims may help you gain
a percentage of stolen government funds.
There are several types of Qui Tam claims
covered under the False Claims Act:
Potential heroes that blow the whistle on
government fraud and corruption include employees, former
employees, high-level executives, sub contractors, general
contractors, and people working with major defense
contractors, telecommunications companies, and large health
care organizations.
If you are a Health Care Administrator,
Hospital Administrator, Nursing Home Administrator, Doctor,
Coder, Benefit Coordinator, Nurse, Chief Financial Officer,
or other health care professional that has knowledge and
evidence of a Health Care Provider, Hospice Provider,
Nursing Home, Hospital, Medical Supply Company, or other
health care contractor or subcontractor that is defrauding
Tricare, Medicare, or the United States Government out of
millions or billions of dollars, it is important to gather
evidence of the fraud and blow the whistle on the fraud.
In blowing the whistle on government
contractor fraud, subcontractor fraud, defense contractor
fraud, off label drug fraud, patent fraud, health care
fraud, Medicare fraud, Tricare fraud, VA fraud, or other
fraud against the government, it is typically best to
contact a Federal Government Contractor Fraud, Medicare
Fraud, Tricare Fraud, and Hospice Fraud Qui Tam Claim Lawyer
like
Jason S. Coomer and the firms that he works with to
help investigate the fraud and pull together a disclosure
and complaint to file.
For information on this web site or Qui
Tam Whistle Blower Litigation, feel free to contact Medicare
Fraud, Tricare Fraud, and Hospice Fraud Qui Tam Claim
Lawyer,
Jason S. Coomer.