Articles Tagged with Florida

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Book Review: Grisham’s “The Whistler” by Florida Business Attorney Adam Rabin

downloadThe hype is upon us with the release of John Grisham’s new legal thriller, “The Whistler.”   While it feels like yesterday when I was a law student and could not stop turning the pages of “The Firm,” I am particularly excited for Grisham’s new release in a different way.  First, this Grisham novel is set in Florida.  Second, Grisham focuses on one of my firm’s areas of practice: whistleblower law.  Here is how Amazon has summarized the book:

This book may be the “most electrifying novel of the year, a high-stakes thrill ride through the darkest corners of the Sunshine State.”  The book speaks to how our judges are expected to be honest and wise and that their integrity and impartiality are the keys to our judicial system.  The judicial system, however, is shaken when a judge takes a bribe.

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If you are not part of a low-income family with small children, you may not have heard of the Child Care and Development Fund (CCDF).  Similar to the Medicaid program, CCDF is a joint program between the federal government and the states that provides child care subsidies to eligible low-income families so the parent(s) or legal guardian can work or attend school.

In 2015, under the CCDF program, the federal government paid $5.4 billion and the states contributed a combined $2.2 billion to provide child care to 1.5 million children per month.  Of those monies, Florida received nearly $274 million in federal funding and provided child care subsidies to 213,000 eligible children.

As with any government program, there is a potential for fraud.  A report recently issued by the Department of Health and Human Services, Office of Inspector General estimates that in 2015, $311 million in false claims were submitted to the CCDF program.   The potential for fraud includes false claims made by both clients receiving the subsidies and child care providers.

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Baptist Health System, Inc. (“Baptist Health”) will pay $2.5 million to settle allegations by a whistleblower in a qui tam lawsuit that it submitted false claims to Medicare, Medicaid, and TRICARE.  According to its website, Baptist Health was founded in 1955, and is the only locally governed health system in the Jacksonville, Florida area. Baptist Health is the parent company of a network of affiliated hospitals, to wit: Baptist Medical Center Jacksonville, Baptist Medical Center Beaches, Baptist Medical Center Nassau, Baptist Medical Center South and Wolfson Children’s Hospital.

In January 2012, a former patient referral coordinator for the neurology practice at Baptist Medical Center Jacksonville, Verchetta Wells, filed a whistleblower lawsuit against Baptist Health and Dr. Sean Orr under the qui tam provisions of the False Claims Act in the U.S. District Court for the Middle District of Florida.   The whistleblower alleged that Dr. Orr, the former Chief of Neurology at Baptist Medical Center Jacksonville, intentionally misdiagnosed healthy patients with serious neurological conditions like brain lesions and multiple sclerosis in order to bill government health care programs for expensive treatments and medications.  The whistleblower claimed that the submission of bills to government health care programs for treatments that were not medically necessary violated the False Claims Act.

The whistleblower claimed that when Baptist Health discovered Dr. Orr’s alleged fraud against government health care programs, it worked to conceal his conduct rather than report it to the federal and Florida authorities.   According to the Justice Department, Baptist Health uncovered Dr. Orr’s misconduct in or around October 2011, but did not disclose it to the government until September 2012.