Articles Tagged with relator

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false claims act

Qui Tam Whistleblower

One thing we cannot stress enough as attorneys for relators in False Claims Act cases is to respect the seal.  As you may know from reading this blog, the False Claims Act requires that any case filed by a qui tam whistleblower has to remain under seal for at least 60 days to give the government an opportunity to investigate the claims and decide whether it wants to intervene and run the case on its own.  As we have previously explained, violations of the seal are serious, and if the relator (or his or her attorney) discloses the existence of the lawsuit to a third party, that individual could face sanctions, including dismissal or contempt of court.

False Claims Act

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Anyone reading this blog probably knows that we represent whistleblowers who file so-called “qui tam” cases under the False Claims Act.  The term “qui tam” is a Latin term derived from the longer and ancient legal expression “qui tam pro domino rege quam pro se ipso in hac parte sequitur,” meaning one “who pursues this action on our Lord the King’s behalf as well as his own.”  In short hand, that means an action brought by a private citizen on the government’s behalf, whereby the government and the individual will share in any of the money recovered.  The False Claims Act is one of the few provisions in federal law that allows a private citizen to file a case on behalf of the government.

Qui Tam Cases

Because qui tam actions are brought on behalf of the government, the government is the “real” plaintiff in the case, and the whistleblower or “relator,” is functioning more like a private attorney general.  As a result, the False Claims Act requires that the government have a shot at pursuing the case on its own.  To give the government this opportunity, when a relator files a case, it must be filed “under seal” for a period of at least 60 days.  That means that the existence of the case remains secret and cannot be disclosed without the court’s permission to anyone other than (a) the relator, (b) the court, and (c) the government.

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If you are considering blowing-the-whistle on government fraud, you are probably wondering what happens once you file a qui tam lawsuit under the False Claims Act. The False Claims Act, 31 U.S.C. § 3729 et seq., contains a very detailed process for bringing a whistleblower case.

Steps involved in a qui tam case

Before the qui tam complaint is filed, the whistleblower (also called the “relator”) must make a “pre-filing disclosure” to the government through his or her attorney.  The pre-filing disclosure contains substantially all of the evidence that is known to the relator about the fraud.  The pre-filing disclosure is not filed with any court and is not available to the defendant.

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According to the Department of Justice, the federal government has filed a consolidated complaint intervening in three whistleblowers’ qui tam lawsuits alleging that HCR ManorCare and its affiliates violated the False Claims Act.  The Justice Department alleges that the medical providers engaged in systematic overbilling of Medicare and TRICARE, the healthcare program for U.S. military members and their families, for therapy services.  The government’s complaint names HCR ManorCare, Inc., owned by The Carlyle Group; Manor Care Inc.; HCR ManorCare Services, LLC; and Heartland Employment Services, LLC (collectively “ManorCare”) as defendants.

According to ManorCare’s website, it employees over 55,000 people and operates 280 skilled nursing facilities and rehabilitation centers nationwide under the names Heartland, ManorCare Health Services and Arden Courts.

According to the Consolidated Complaint in Intervention, the whistleblowers, also known as relators, are three former employees of three Heartland entities.  Relator Christine Ribik, a licensed occupational therapist, initiated the first lawsuit against ManorCare under the qui tam provisions of the False Claims Act in 2009 in the Eastern District of Virginia. Relator Patrick Gerard Carson, a physical therapy assistant, filed his qui tam action in 2011.  The third relator, Marie Slough, is a physical therapist who brought her qui tam suit in 2014.   All three of the whistleblower’s actions were consolidated by the Court in November 2014.

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According to the South Florida Business Journal, a California judge has approved the $68.5 million settlement of a whistleblower’s case against Office Depot alleging violations of the California False Claims Act.

Office supply giant Office Depot, headquartered in Boca Raton, Florida, was named in a whistleblower’s lawsuit filed under the qui tam provision of the California False Claims Act.  The whistleblower, David Sherwin, initially filed the qui tam complaint against Office Depot in March 2009, prior to its 2013 merger with Office Max.  The City of Los Angeles intervened in the lawsuit in 2012.

Pursuant to the First Amended Complaint-in-Intervention of the City of Los Angeles (“Complaint”), relator David Sherwin was a Florida resident and a former account manager for Office Depot.   The South Florida Business Journal reported that the whistleblower passed away in March 2014, but his estate continued to pursue this matter after his death.

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Halifax Hospital Medical Center (“Halifax”) in Central Florida has tentatively agreed to settle certain allegations in a whistleblower’s qui tam lawsuit that it violated the Stark Law, but the remaining allegations of violations of the False Claims Act will be heard at a jury trial set for July.

According to the Orlando Sentinel, Halifax and the Department of Justice reached a tentative agreement to settle the claims relating to the payment of illegal kickbacks in violation of the Stark Law, just as jury selection was set to begin.  The Orlando Sentinel reported that a source close to the case said the settlement amount was $85 million.  If that figure is correct, it will be the largest amount paid for a Stark Law violation in history.

In 2009, a former compliance officer for Halifax, Elin Baklid-Kunz, filed the whistleblower litigation under the qui tam provisions of the False Claims Act.  The whistleblower’s complaint alleged that Halifax violated the Stark Law and False Claims Act.  The whistleblower alleged that the violations occurred when Halifax submitted false claims to government healthcare programs for hospital admissions and procedures that were not medically necessary, and billed for services provided as a result of referrals from physicians with whom Halifax had improper financial relationships.