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You have a right to sue for improper claims for payment.


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warner mendenhall - Fri Jul 25, 2014 @ 09:52AM
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Although Relator Shares are supposed to be between 15-30% of the overall award the reality is they usually are below the statutory guidelines.  

Percentage of Recovery going to awards for Relators from DOJ statistics for 2013:

Intervened cases -- 13%

Non-intervened cases -- 12.4%

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warner mendenhall - Sat Dec 18, 2010 @ 11:14AM
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This article is a good overview of the changes for whistleblowers in the PPACA. 

1. Antikickback statute and false claims:  “a claim that includes items or services resulting from a violation [of the Anti-Kickback Statute] constitutes a false or fraudulent claim for purposes of [the FCA].”

2. Public Disclosure: A whistleblower suit cannot be barred unless “substantially the same allegations or transactions were publicly disclosed” in: (1) “a Federal criminal civil or administrative hearing in which the government or its agent was a party;” (2) “a congressional, [GAO], or other Federal report, hearing, audit, or investigation,” or (3) “from the news media.”

3. Original Source: “original source” was broadened to include any individual who has knowledge that is “independent of and materially adds to the publicly disclosed allegations or transactions, and who voluntarily provided the information to the government” before filing the suit.

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warner mendenhall - Wed Dec 08, 2010 @ 06:22AM
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warner mendenhall - Tue Dec 07, 2010 @ 02:54PM
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DOJ WASHINGTON —   Abbott Laboratories Inc., B. Braun Medical Inc. and Roxane Laboratories Inc. n/k/a Boehringer Ingelheim Roxane Inc. and affiliated entities have agreed to pay $421 million to settle False Claims Act allegations, the Justice Department announced today. These settlements resolve claims by the United States that the defendants engaged in a scheme to report false and inflated prices for numerous pharmaceutical products knowing that federal healthcare programs relied on those reported prices to set payment rates.  The actual sales prices for the products were far less than what defendants reported.



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warner mendenhall - Wed May 07, 2008 @ 02:25PM
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A large group of whistleblowers, including a number of successful qui tam relators, have joined forces to organize a series of events in D.C. for the week of May 11th. All whistleblowers are invited!
If your clients are in D.C. that week, please encourage them to attend. However, the organizers of the event stress that folks need to register ASAP at this site:

Of particular note, I direct your attention to Tuesday's events at the Washington Court Hotel:
8:00   Breakfast & Sign In
9:00   Office of Special Counsel Forum (GAP and OSC Watch co-sponsored)
10:00  Judicial Oversight (Mike McCray and Zena Crenshaw)
11:00  False Claims Act: Protecting Those Who Fight Fraud (TAF Sponsored)
12:00  Lunch & Keynote Speakers (General Charles Henry & Mike Behn)
1:10   Mentoring Initiative Dr. Janet Chandler and James H. Holzrichter Sr.
2:00   Life After Whistleblowing (Joint Presentation by Patrick Burns & Tom Devine)
3:00   The Good the Bad and the Ugly (Ethical Solutions John Schilling and Kevin McDounagh)
5:00   Book signing by John Schilling
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warner mendenhall - Wed Dec 19, 2007 @ 01:33PM
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Interesting IRS Press release today on its qui tam provisions. Caution is always in order in filing one of these. Make sure your house is in order first. You will be the first audited and then your target gets audited.

Procedure Unveiled for Reporting Violations of the Tax Law,

Making Reward Claims

IR-2007-201, Dec. 19, 2007

WASHINGTON— The Internal Revenue Service today outlined ways informants can

report violations of the tax law and possibly claim a reward based on the amount of

additional tax, penalties and interest that is owed.

“Since Congress enacted new procedures increasing award amounts last year,

informants have come forward with information on alleged tax noncompliance

amounting to tens of millions of dollars, and in some cases hundreds of millions of

dollars,” said Stephen Whitlock, Director of the Whistleblower Office.

Since the Whistleblower Office was created in December 2006, the IRS has received

about 80 claims, half of those submitted in just the last two and a half months. To make

a claim, an informant must file new Form 211, Application for Award for Original

Information, which asks informants to provide an estimate of the tax owed, the pertinent

facts in the case and an explanation of how the informant obtained the information.

The IRS’ Whistleblower Office will make the final determination about whether an award

will be paid and the amount of the award for claims that it processes. Awards will be

paid in proportion to the value of information furnished voluntarily with respect to

proceeds collected.

Under the new procedures, the amount of award will be at least 15%, but no more than

30%, of the collected proceeds in cases in which the IRS determines that the

information submitted by the informant substantially contributed to the collection of tax.

The award percentage may be reduced in some circumstances, which are described in

IRS guidance.

To be eligible for an award under the new procedures, the tax, penalties, interest,

additions to tax, and additional amounts in dispute must exceed $2 million for any

taxable year and, if the taxpayer is an individual, the individual’s gross income must

exceed $200,000 for any taxable year in question.

All awards will be subject to normal tax reporting and withholding requirements.

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warner mendenhall - Tue Dec 11, 2007 @ 03:36PM
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http://www.usdoj.gov/usao/nj/press/files/pdffiles/hips0927.rel.pdfOur new site is up and running. Currently looking at a number of false claims issues. I am getting very interested in medical device sales and installation practices. It seems to me that the sales pressure may lead to unnecessary implantation of medical devices. Tens of thousands of dollars are at stake in each operation and billions nationally as medical device manufacturers vie for your doctor's business. It erodesour trust of our physicians and surgeons when they are under pressure from their hospitals and medical groups to install expensive devices in our bodies. Drug sales can build similar pressures by the way. Some states have recently examined sales practices and are recognizing the conflicts of interest that can be created when physician education, junkets, research is sponsored by companies interested in selling their products. Although these activities are supposed to be delinked from sales, it appears that the opposite is occuring.

Kickbacks in exchange for implants? From a recent U.S. DOJ Press Release

NEWARK - Five companies that account for nearly 95 percent of the lucrative market in hip and knee surgical implants have avoided criminal prosecution over financial
inducements paid to surgeons to use their products by agreeing to new corporate
compliance procedures and federal monitoring under 18-month agreements with the Department of Justice, U.S. Attorney Christopher J. Christie announced today.
Zimmer, Inc., Depuy Orthopaedics, Inc., Biomet Inc., and Smith & Nephew, Inc., have
executed Deferred Prosecution Agreements (DPAs), which will expire in 18 months if they meet all of their respective reform requirements. Criminal Complaints were also filed today against those four companies, charging them with conspiring to violate the federal anti-kickback statute. Those Complaints will be dismissed at the conclusion of the DPAs if the companies comply with their terms.:

The criminal Complaints accuse the four companies of using consulting agreements with orthopedic surgeons as inducements to use a particular company's artificial hip and knee reconstruction and replacement products. The investigation revealed that this was a common practice by the companies from at least 2002 through 2006. Surgeons who had agreements with the companies were typically paid tens to hundreds of thousands of dollars per year for consulting contracts and were often lavished with trips and other expensive perquisites.


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