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The DOJ's Assistant Attorney General Tony West realizes that healthcare fraud is a serious issue that can't be fought alone. Since 2009, he has led DOJ's Civil Division and is requesting help from Congress to combat healthcare fraud. We applaud Assistant Attorney General Tony West for his efforts in admitting that the DOJ needs help. This is a first step in making progress. Earlier this week, Senator's Ted Kaufman (D-Del.) and Arlen Specter (D-Pa.) and Senator Patrick Leahy (D-Vt.) introduced... Posted on October 30, 2009 at 01:30 am

Pfizer Inc has agreed to pay a record settlement of $2.3 billion to resolve a qui tam case and to settle federal and criminal probes. According to the DOJ and several published reports, this involves the alleged Medicare/Medicaid fraud, and the illegal use off-label marketing of multiple drugs. The fines in this case are $1.3 billion, which are the largest settlement ever paid for a health care fraud claim and a criminal case. In addition to Pfizer, Pharmacia & Upjohn Co, a Pfizer... Posted on September 3, 2009 at 04:29 am

Former UBS Banker, Bradley C. Birkenfeld was recently sentenced to 3 years and 4 months in prison for assisting a client at UBS to evade taxes. However, due to Mr. Birkenfield's assistance, the government was successful in reaching the February settlement of UBS agreeing to pay $780 million in fines, penalties, and restitution relating to tax fraud. In response to the sentencing of Bradley Birkenfeld, Qui tam Attorney Brian F. LaBovick, Esq. stateted the following: "This is a major issue within... Posted on August 26, 2009 at 02:34 am

We have followed with great interest the IRS Voluntary Disclosure Program, especially after the UBS settlement created fear of discovery in many U.S. taxpayers with offshore accounts. IRS Commissioner Doug Shulman announced that the IRS Voluntary Disclosure Program was flooded with submissions by more than 14,000 taxpayers, according to the Wall Street Journal. IRS Whistleblower cases have been impacted--and in some cases probably pre-empted--by the submissions of recalcitrant taxpayers to the... Posted on November 17, 2009 at 03:09 pm

Since the Madoff and Stanford schemes proved ruinous to so many investors, many have asked why the SEC has no meaningful "whistleblower" program to expose wrongdoing, a topic we have written about previously. Perhaps Harry Markopolis' voice is finally being heard, albeit faintly. Last week, the House Financial Services Committee approved legislation that would expand both whistleblower rewards and whistleblower protections, among other things. Still, past experience with the False Claims Act... Posted on November 9, 2009 at 02:47 pm

The battle against those who steal taxpayer dollars through Medicare fraud and other health care fraud took a step forward this week. The Senate is now considering the "Health Care Fraud Enforcement Act," which will enhance the government's tools used to investigate and remedy Medicare and Medicaid fraud. After a Senate Judiciary Committee hearing Wednesday on "Effective Strategies for Preventing Health Care Fraud," Senators Leahy, Kaufman, Specter, Kohl, Schumer, and Klobuchar sponsored the... Posted on October 30, 2009 at 03:28 pm

On November 18th, the Ninth Circuit issued an opinion reversing and remanding a WD Washington decision that had precluded a biotechnology company from seeking recovery against a third party for contractual indemnity claims relating to a qui tam action. The qui tam defendant, Cell Therapeutics, Inc. (CTI), had hired the Lash Group to provide Medicare reimbursement consulting services. CTI alleged that Lash Group had advised it that off-label uses of CTI's cancer drug were reimbursable by... Posted on November 20, 2009 at 09:53 pm by admin

At a press conference today, Civil Division Assistant Attorney General Tony West announced DOJ's FCA recoveries for the fiscal year which ended on September 30. According to the DOJ press release, the US recovered $2.4 billion under the False Claims Act, bringing to more than $24 billion the total recoveries since the 1986 amendments which revitalized the FCA. Some highlights: $2 billion, or 83% of the recovery, came from qui tam suits Relators received $255 million (12.75%) in awards... Posted on November 19, 2009 at 04:35 am by Ben Vernia

DOJ announced on November 18 that it had reached a settlement, of $3.02 million plus interest, with Trinitas Regional Medical Center in Elizabeth, New Jersey, and that it was intervening against Brookhaven Memorial Hospital in East Patchogue, New York. The qui tam suit, brought in 2005 by relator Tony Kite, alleged that the hospitals had inflated their costs, and sought and received outlier payments (supplemental reimbursements made to hospitals and other health care providers in cases where... Posted on November 18, 2009 at 11:36 pm by Ben Vernia

The Congressional Research Service has released a report on the False Claims Act, Qui Tam: The False Claims Act and Related Federal Statutes. CRS is a department within the Library of Congress that provides policy and legal analysis to Congressional committees and members. The report summarizes the history of the law, including the 2009 amendments. It outlines key provisions of the law: who may be liable, who may bring and action, basis for liability, penalties and awards, and procedure.... Posted on October 7, 2009 at 12:28 pm by Qui Tam

Six hospitals in Indiana and Alabama will pay the United States more than $8 million to settle a whistleblower lawsuit brought under the qui tam provisions of the False Claims Act, the U.S. Dept. of Justice announced on September 22. The settlement resolves allegations that, from 2000 to 2008, patients who went to these hospitals for a certain type of spinal surgery known as "kyphoplasty" were unnecessarily kept overnight at the hospital and then classified as inpatient cases to boost the... Posted on October 7, 2009 at 06:32 am by Qui Tam

The U.S. Dept. of Justice announced that Pfizer Inc. will pay $2.3 billion in civil False Claims Act damages and criminal fines to resolve allegations that the company illegally promoted a number of its drugs for off-label uses. Six separate whistleblower suits were filed against the company in this matter. The bulk of the settlement, $1.8 billion, is due to the company's off-label marketing of Bextra. John Kopchinski, the whistleblower in that suit, was represented by Erika Kelton of Phillips... Posted on September 3, 2009 at 06:09 am by Qui Tam