Articles Posted in Recent Developments

We are pleased to see yet another state–Oklahoma–realize how effective qui tam whistleblower laws are by passing a state False Claims Act this week.

The Oklahoma legislature has passed the Oklahoma Medicaid False Claims Act (SB 889). The bill’s primary author was Cox Crain.

The new whistleblower law appears to be modelled on the federal False Claims Act. As we have written about often on this whistleblower lawyer blog, states that pass such laws with qui tam whistleblower provisions that are at least as effective as the federal False Claims Act qualify for a 10 point increase in the state’s share of Medicaid fraud recoveries.

Health care cases remain busy this week. The Justice Department on April 26 announced that it is joining whistleblowers in pursuing three qui tam lawsuits against HealthEssentials Solutions Inc. (HES) that allege false claims were submitted to Medicare.

The cases involve allegations of upcoding — improperly using a diagnosis code that is not supported by the medical record, for the purpose of obtaining greater reimbursement–and billing for medically unnecessary services.

The three cases were filed separately in the U.S. District Court in Louisville, Ky., by former employees of HES.

Another state whistleblower law, with qui tam provisions that follow the federal False Claims Act, was born today. The Georgia Senate passed the “State False Medicaid Claims Act” today, and it goes to Governor Sonny Perdue for his signature.

We have been writing about this and other new state whistleblower statutes. Representative Edward Lindsey deserves credit for his sponsorship of the bill.

Our firm was fortunate enough to have been part of the legislative effort. Rep. Lindsey asked Michael A. Sullivan (one of this whistleblowerlawyerblog co-authors) to testify and explain the whistleblower law three times, before the House Judiciary Committee and the Senate Insurance and Labor Committee. There were no dissenting votes in any of the committee votes.

New York also recently approved a state False Claims Act, and many other states are considering them.

We look forward to following the progress in other states that are considering state False Claims Acts, so that they take advantage of the financial incentives Congress created in the Deficit Reduction Act.
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A new qui tam whistleblower law has cleared another hurdle toward passage. Georgia’s Senate Insurance and Labor Committee unanimously approved the new “State False Medicaid Claims Act” this afternoon. As we have written about previously on this whistleblower lawyer blog, the new whistleblower law has already passed the Georgia House.

After an introduction by Senator Seth Harp, the bill’s sponsor, Rep. Edward Lindsey, asked Inspector General Doug Colburn of the Department of Community Health and attorney Michael A. Sullivan (co-author of this whistleblower lawyer blog) of Finch McCranie, LLP to join him in testifying about how the new whistleblower law would work. Rep. Lindsey explained the incentives that Congress has provided to states to enact their own qui tam whistleblower laws, and then asked Sullivan to explain how the law would function.

Sullivan testified about the successes of the federal False Claims Act in not only recovering money from those who have defrauded the government, but also serving as a deterrent to those who might otherwise cheat the public. He explained how the funds recovered have increased dramatically since the 1986 Amendments that created the modern False Claims Act, especially in the health care area. Sullivan also described other states’ successes with their own whistleblower statutes, as well as the strict review of state false claims statutes by the Office of Inspector General of the Department of Health and Human Services.

We have had many calls this week from potential clients in our IRS Whistleblower practice, probably because msn.com featured an article about the IRS Whistleblower program on Monday that linked to our whistleblower lawyer blog.

As I have explained to many whistleblower clients, the new regulations for the IRS Whistleblower Rewards Program are in the works, but have not been issued. We have been pursuing IRS Whistleblower claims under the new program and have found the IRS agents to be excited about it.

Adding to the mix for those seeking a whistleblower attorney is that Congress is considering amendments to the law that established the new IRS Whistleblower Program in December 2006. Among the possible changes/additions are a provision opening up the Whistleblower Program to more claims by setting a different threshold for the amount of money in question, which could allow more whistleblowers to qualify for a reward.

Another provision would appropriate funds for the IRS Whistleblower Office, some of which might help defray expenses incurred by the whistleblower’s legal representative. Yet another provision addresses the confidentialty of whistleblowers in Tax Court proceedings.

These proposed changes are part of HB 2, the “minimum wage” bill, which passed the Senate in February.

We will continue to keep up with any developments affecting the IRS Whistleblower Program, which we believe promises to be a great success. If you have any questions about the IRS Whistleblower program, feel free to email me here.

The current section of the proposed HB 2 that applies to the IRS Whistleblower Program is below:
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A subsidiary of the drug manufacturer Pfizer has agreed to plead guilty in a kickback scheme and to pay a criminal fine of $19.68 million, according to the U.S. Attorney for the District of Massachusetts, Michael J. Sullivan (not to be confused with Michael A. Sullivan, one of the authors of this whistleblower lawyer blog).

The government’s announcement was that Pharmacia & Upjohn Company, Inc., a subsidiary of Pfizer, Inc., was charged with offering a kickback in connection with the administration and distribution of its human growth hormone, Genotropin. Another Pfizer subsidiary, Pharmacia & Upjohn Company LLC entered into a Deferred Prosecution Agreement with the Government for what the government described as illegally promoting Genotropin for “off-label” uses as anti-aging, cosmetic use and athletic performance enhancement. The result is that the companies will pay a total amount of $34.7 million.

The New York legislature has become the latest state to agree to the enactment of a State False Claims Act, when it approved passage of such a whistleblower law as part of approving the state budget. The Buffalo Times reported on this encouraging development.

We have written before about why states are passing their own whistleblower laws to protect taxpayer money. Congress has created significant financial incentives for states that pass their own state false claims acts, with whistleblower provisions that are at least as effective as the federal False Claims Act.

States whose whistleblower laws are approved by the Office of Inspector General are entitled to a 10% increase in their share of Medicaid fraud recoveries. OIG recently approved the whistleblower laws of Hawaii and Virginia, which now join Illinois, Massachusetts, and Tennessee as having whistleblower laws that qualify the state for the extra funds. OIG has disapproved the whistleblower laws of seven other states, California, Florida, Louisiana, Indiana, Michigan, Nevada, and Texas, which can still strengthen their laws to make them as effective as the federal False Claims Act.

We have been writing about why states are passing their own whistleblower laws, with qui tam provisions that are at least as effective as the federal False Claims Act. Georgia’s legislature took a giant step forward when its House of Representatives today passed the State False Medicaid Claims Act–by an overwhelming margin of 164-2!

As we have mentioned before on this whistleblower lawyer blog, when the House Judiciary Committee met to discuss and approve the new whistleblower statute, two witnesses were invited to explain the new law: the Inspector General of the Department of Community Health, and this whistleblower blog author. We at Finch McCranie, LLP are proud to be part of this effort to protect taxpayer dollars in the Medicaid program.

States are figuring out how to pass whistleblower laws with effective “qui tam” provisions, so that they qualify to receive more money from Medicaid fraud settlements. The Office of Inspector General of the Department of Health and Human Services has announced that, unlike 7 of the 10 state whistleblower laws that OIG had previously reviewed, the whistleblower laws of Hawaii and Virginia pass muster under the Deficit Reduction Act of 2005.

We have previously discussed why states are passing or improving their own whistleblower laws with qui tam provisions–Congress creative large financial incentives because effective qui tam whistleblower laws are essential to preventing fraud against the government. We applaud Hawaii and Virginia for making their whistleblower law provisions as effective as those of the federal False Claims Act!

Whistleblowers and whistleblower attorneys may consider Senator Charles Grassley of Iowa as the “patron saint” of protecting taxpayer money from fraud against the government. Sen. Grassley continues his great work as he testifies today before the Senate Judiciary Committee about Iraq contractor profiteering and fraud.

The Senator already claimed another recent victory by spearheading passage of the new IRS Whistleblower Rewards Program. Sen. Grassley saw how cost-effective the False Claims Act has been in recovering more than $20 billion for the government–largely because of the improved qui tam whistleblower enhancements enacted in 1986. (Sen. Grassley and Rep. Howard Berman were sponsors of the landmark 1986 amendments to the False Claims Act.)

Sen. Grassley was to testify that the False Claims Act whistleblower statute should be strengthened to deal with contractors such as Halliburton. He mentioned trying to recover $60 billion for meals not provided to the military by the defense contractor.

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