Posted on

Tennessee False Claims Attorney Explores Medicaid Fraud Reporting by Whistleblowers

Tennessee false claims act

Tennessee, 28 other states and the federal government are expected to receive $4.1 million as a result of the actions of a Medicaid fraud whistleblower. Earlier in September 2015, a whistleblower and his Tennessee false claim attorney fought another Medicaid fraud forcing Louisville-based PharMerica Healthcare to pay $1.3 million. It was accused of billing TennCare for more drugs than used. In one of the largest Medicaid fraud recovery, Florida-based Adventist Health System, which also has clinics in Tennessee, settled a 2012 whistleblower Medicaid fraud lawsuit for $118.7 million. Last year, home healthcare agency CareAll made a similar settlement for $25 million after a healthcare false claim lawsuit filed by a whistleblower and his Tennessee false claims attorney.

How To Report Medicaid Fraud?

The Tennessee Medicaid False Claims Act of 1993 allows anyone, a resident of the state or not, to report a Medicaid or healthcare fraud. However, he or she must have ample evidence to showcase embezzlement of funds and claims should not be more than three-year old.

A Medicaid fraud whistleblower should hire a false claims attorney in Tennessee to prepare and file a lawsuit. First, the claim is presented to the court or appropriate authorities “under seal.” The whistleblower may be interviewed by officials empowered to investigate Medicaid fraud and take a decision on joining the lawsuit. The relator is free to continue his or her Tennessee false claim lawsuit even if the state or federal authorities do not back the claim.

What is qui tam lawsuit?

A qui tam lawsuit is the paperwork filed in the court by whistleblowers. A civil lawsuit of this type has been instrumental in recovering more than $16 billion Medicaid funds embezzled through false billing practices. It allows a private individual to sue an entity, individual or business on the behalf of government for Medicaid fraud. The plaintiff’s identity and lawsuit details are kept secret until an investigation by authorities into the genuineness of the claim.  If there is a recovery, the “relator” will share in the recovery.

What a whistleblower can report?

  • Any false claim, action or practice leading to Medicaid fraud
  • False claims for Medicaid fund payments
  • Medicaid billing upcoding
  • Falsifying Medicaid record to seek a higher payment
  • Conspiracy to defraud Medicaid money
  • Avoiding payment of Medicaid-related amount to the state
  • Acting in an ignorant manner despite being aware of false payments
  • Deliberate ignorance of the false Medicaid payment
  • Any fraudulent act by individual, entity, trust, business or agency that cause Medicaid fraud

What type of benefits and protection a whistleblower is granted in Tennessee?

A Tennessee Medicaid fraud whistleblower is provided with several incentives and protective measures as a mean of encouragement. There are legal provisions to ensure safety of whistleblowers from ant retaliation, backlash, harm or loss of job.

The financial award for a whistleblower and his Tennessee false claims attorney amounts to 15 to 25 percent of total money recovered, including fines, when state or federal authorities joins the claim. Fighting on your own leads to a higher award, usually between one-third and one-fourth of the recovery. The plaintiff may also claim reimbursement of attorney fees and legal costs.

For free whistleblower case evaluation, please call on 1-800-632-1404 to consult our Medicaid false claims attorney in Tennessee.

Posted on

Tennessee Whistleblower Fights “Retaliation” by Morgan Stanley

Tennessee Whistleblower Attorney

FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

A Knoxville financial adviser has accused Morgan Stanley of retaliation following his action as a whistleblower. He was terminated on allegations of receiving kickback after the employer came to know about his actions in exposing SOW violations and insider trading, claims the Tennessee false claims attorney representing the whistleblower. The state law assures protection to the whistleblowers from any kind of reprisal.

Filed in February, the Tennessee whistleblower lawsuit cites several instances where John Verble helped the Securities and Exchange Commission with information about insider trading by some of his colleagues. The whistleblower also claims that he is the “Confidential Human Source 1,” as mentioned in the FBI records, who helped the investigators probing discrepancies in a fuel fraud scheme known as the Pilot Flying J investigation in May 2011.

Verble has claimed to expose criminal activity at Knoxville office of Morgan Stanley that he joined in 2006 and “wear a wire for more than a year to record conversations with a Pilot employee.”

Morgan Stanley, on the other hand, has termed his allegations as “rhetoric and misplaced whistleblower aspirations aside” and justified his termination on the ground that he took “six-figure kickbacks” from a sports agent. Verble’s Tennessee whistleblower lawyer says it was “gift for his daughter.”

The whistleblower was interrogated by his superiors in May 2013 about his cooperation with federal investigators after a colleague spotted him meeting with FBI agents, according the lawsuit.

TN Whistleblower Complaint Leads to Investigation

A Tennessee false claim lawsuit has led to investigations against road-building major Jones Brothers. Filed in 2012 by a former employee, the whistleblower lawsuit alleged the company and its affiliates used fraudulent means and false representations to get “projects that would not have been awarded to such primary contractors or alternatively no federal funding would have been provided for the project” between 2007 and 2012.

The FBI investigation came after the court set the latest deadline by June. The defendant “named a minority-owned firm in its contract, but instead did work the subcontractor (G&M Associates) was supposed to do, even going as far as to cover the company logo on their trucks with the minority-owned contractor’s logo and the primary contractors obtained various contracts fraudulently, aided and abetted by G&M,” says the FBI warrant.

The Tennessee false claim lawsuit came at a time when the federal government is has been strict in punishing those involved in procurement fraud. If proved, Jones Brothers may be directed to deposit three-time more money than such alleged fraudulent contracts involve along with a penalty of $11,000 for each instance of deceit.

Court Sets Disclosure Bar for TN False Claim Lawsuits

The Sixth Circuit has delineated the extent of public disclosure of information for use to file false claim lawsuits in Tennessee. In 2006, a whistleblower complaint accused Erlanger Medical Center of fraudulent Medicare and Medicaid billings. The hospital refunded $500,000 to close the federal investigation against it in 2008.

A qui tam lawsuit was initiated two years later based on internal administrative reports. The hospital moved court seeking its dismissal on the ground of already being a public disclosure. Even the government refused to participate. The plaintiff continued with his Tennessee false claims attorney.

The circuit court ruled that “the FCA does not bar jurisdiction over qui tam actions based on disclosures of allegations or transactions to the government.” It held that internal government disclosures arrived at through prior probe did not amount to public disclosure and allowed the complainant to proceed with his lawsuit.

The judgment came within six months of a federal court in Tennessee allowing use of statistical sampling to determine overall damage and liability in false claim lawsuits.

For false claims free case evaluation, please call on 1-800-632-1404 to consult our expert false claims attorney in Tennessee.

Contact a Tennessee False Claims Act Attorney

We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

CALL 1-800-632-1404

or fill out this form below for a free initial consultation.

    Your Name (required)

    Your Email (required)

    Your Phone Number (required)

    Case Details

    captcha

    Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

    Posted on

    FBI Probes Memphis VA After Tennessee Whistleblower Red Flagged Purchases

    Tennessee Whistleblower Attorney

    FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

    A Tennessee whistleblower complaint led to the FBI investigating the alleged fraudulent purchases at Memphis Department of Veterans Affairs Medical Center.  Sean Higgins, a former employee at the hospital, reported suspicious bogus purchases of equipment in March. The whistleblower is also free to file a lawsuit with adequate evidence and even go alone with his Tennessee false claims attorney if the state refuses to be a party to the proceedings. A settlement or court verdict assures him up to a third of recovered amount as award.

    The whistleblower accused another former employee of making fake purchases orders for of certain equipment that went to his partner outside the department. While the order was not officially approved, these equipment were allegedly resold causing over a million dollar loss to the VA.

    The claim goes back to November 2013 when VaproQuip bed bug decontamination machines or “RayPods” were bought for $1.5 million apiece. An email by the TN whistleblower claimed that these machines were ineffective. Similarly, $290,000-worth Magnet Resonance Imaging machine was purchased from the University of Tennessee than the original Swiss supplier by a researcher affiliated with the institution. When Higgins brought these discrepancies to the notice of the logistics head, the order was “straightened out” and the complainant received a Special Recognition award.

    Tennessee False Claims Lawsuit: Erlanger Saga Continues

    A Tennessee false claims lawsuit filed against Erlanger Medical Center alleging Medicare and TennCare fraud continue to make news. In 2005, it paid $40 million to settle referral kickback accusation that reported committed between 1995 and 2003. The Justice Department initiated an investigation after a whistleblower reported violation of Ethics in Patients Referrals Act. At the time of the settlement, the hospital agreed to refrain any such wrongdoing.

    However, a Tennessee false claims attorney representing another whistleblower, a former consultant and care management director at the hospital, filed a fraud petition in 2006. It reported about the practice of “submitting false or fraudulent claims for reimbursement to federally funded healthcare programs.”

    In 2009, Erlanger returned $477,140.42 following an audit by the government. The defendant made it a basis to seek dismissal of the Tennessee whistleblower lawsuit. However, the Sixth Circuit Court of Appeals restored the litigation ruling that “government audit or investigation did not constitute public disclosure under the False Claim Act.”

    Medtronic Makes Third Settlement

    Medical device manufacturer Medtronic has settled the “country of origin false claim lawsuit” filed against it in Tennessee for $4.4 million. This is the third such settlement by the third-biggest medical device maker in the last two months. In February, it settled two overbilling and Medicare fraud claims for $1.25 million and $2.8 million.

    The Tennessee false claims lawsuit was filed by three Memphis whistleblowers. Filed in 2012, it accused the Irish company of supplying “medical devices to the American military as made in Memphis.” The federal law requires only supply of US-made medical devices to the military. But these devices were procured from China and Malaysia before relabeled and repackaged at a Memphis distribution center, according to the Tennessee false claims lawyer representing the trio.

    One of the three whistleblowers was also instrumental in filing a TN false claims lawsuit against Smith & Nephew for supplying similar relabeled foreign-made medical devices. The claim ended with a $11.3 million settlement in 2014.

    For free case evaluation of whistleblower actions, please call on 1-800-632-1404 to consult our expert false claims attorney in Tennessee.

    Contact a Tennessee False Claims Act Attorney

    We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

    CALL 1-800-632-1404

    or fill out this form below for a free initial consultation.

      Your Name (required)

      Your Email (required)

      Your Phone Number (required)

      Case Details

      captcha

      Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

      Posted on

      Tennessee Whistleblower Fights “Retaliation” by Morgan Stanley

      Tennessee Whistleblower Attorney

      FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

      A Knoxville financial adviser has accused Morgan Stanley of retaliation following his actions as a whistleblower. He was terminated on allegations of receiving kickback after the employer came to know about his actions in exposing SOW violations and insider trading, claims the Tennessee false claims attorney representing the whistleblower. The state law assures protection to the whistleblowers from any kind of reprisal.

      Filed in February, the Tennessee whistleblower lawsuit cites several instances where John Verble helped the Securities and Exchange Commission with information about insider trading by some of his colleagues. The whistleblower also claims that he is the “Confidential Human Source 1,” as mentioned in the FBI records, who helped the investigators probing discrepancies in a fuel fraud scheme known as the Pilot Flying J investigation in May 2011.

      Verble has claimed to expose criminal activity at Knoxville office of Morgan Stanley that he joined in 2006 and “wear a wire for more than a year to record conversations with a Pilot employee.”

      Morgan Stanley, on the other hand, has termed his allegations as “rhetoric and misplaced whistleblower aspirations aside” and justified his sacking on the ground that he took “six-figure kickbacks” from a sports agent. Verble’s Tennessee whistleblower lawyer says it was “gift for his daughter.”

      The whistleblower was interrogated by his superiors in May 2013 about his cooperation with federal investigators after a colleague spotted him meeting with FBI agents, according the lawsuit.

      Tennessee Whistleblower Complaint Leads to Complaint Against Construction Company Jones Brothers

      A Tennessee false claims act lawsuit has led to investigations against road-building major Jones Brothers. Filed in 2012 by a former employee, the whistleblower lawsuit alleged the company and its affiliates used fraudulent means and false representations to get “projects that would not have been awarded to such primary contractors or alternatively no federal funding would have been provided for the project” between 2007 and 2012.

      The FBI investigation came after the court set the latest deadline by June. The defendant “named a minority-owned firm in its contract, but instead did work the subcontractor (G&M Associates) was supposed to do, even going as far as to cover the company logo on their trucks with the minority-owned contractor’s logo and the primary contractors obtained various contracts fraudulently, aided and abetted by G&M,” says the FBI warrant.

      The Tennessee false claim lawsuit came at a time when the federal government is has been strict in punishing those involved in procurement fraud. If proved, Jones Brothers may be directed to deposit three-time more money than such alleged fraudulent contracts involve along with a penalty of $11,000 for each instance of deceit.

      Court Sets Disclosure Bar for Tennessee False Claim Lawsuits

      The Sixth Circuit has delineated the extent of public disclosure of information for use to file false claim lawsuits in Tennessee. In 2006, a whistleblower complaint accused Erlanger Medical Center of fraudulent Medicare and Medicaid billings. The hospital refunded $500,000 to close the federal investigation against it in 2008.

      A qui tam lawsuit was initiated two years later based on internal administrative reports. The hospital moved court seeking its dismissal on the ground of already being a public disclosure. Even the government refused to participate. The plaintiff continued with his Tennessee false claims attorney.

      The circuit court ruled that “the FCA does not bar jurisdiction over qui tam actions based on disclosures of allegations or transactions to the government.” It held that internal government disclosures arrived at through prior probe did not amount to public disclosure and allowed the complainant to proceed with his lawsuit.

      The judgment came within six months of a federal court in Tennessee allowing use of statistical sampling to determine overall damage and liability in false claim lawsuits.

      For false claims free case evaluation, please call on 1-800-632-1404 to consult our expert false claims attorney in Tennessee.

      Contact a Tennessee False Claims Act Attorney

      We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

      CALL 1-800-632-1404

      or fill out this form below for a free initial consultation.

        Your Name (required)

        Your Email (required)

        Your Phone Number (required)

        Case Details

        captcha

        Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

        Posted on

        Tennessee False Claims Attorney Explores Healthcare Whistleblower Lawsuits of 2014

        Tennessee Whistleblower Attorney

        FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

        2014 was indeed a great year for whistleblowers, says a Tennessee false claims attorney. The year saw the recovery of millions of dollars of Medicare/Medicaid/TennCare monies and other state and federal funds misappropriated through fraud, upcoding, and false billing.  It is estimated that federal and state authorities close to $60 billion taxpayers’ money because of “fraud, waste, and abuse” every year. And here the role of whistleblower and their lawyers in recovering the public money defrauded is nothing less than national heroes.  Over $25 billion were recovered nationwide, including $16 billion health-care funds, in the last five years preceding 2015.

        The last year began with settlement of a Tennessee false claim lawsuit filed against a state cardiologist. Dr. Elie H. Korban paid $1.15 million to settle allegations of unnecessary cardiac stent placements raised in a qui tam claim. Whistleblower Dr. Wood M. Deming accused the Delta Clinic, owned by Dr. Korban, of performing “cardiac procedures that were not necessary or appropriate” between 2005 and 2008 with a motive to inflated medical bill patients reimbursed from federal health-care funding.

        In November, CareAll Management LLC, a leading home health agency, agreed to pay $25 million to settle fasle billing allegation brought against it by a whistleblower. The Tennessee false claims attorney representing the qui tam plaintiff accused the service provider of “overstating the severity of patients’ conditions to increase billings and billed for services that were not medically necessary and rendered to patients who were not homebound.” The recovered Medicare and Medicaid money were misappropriated between 2006 and 2013. Toney Gonzales, the whistleblower, was awarded $3.9 million for his initiative in the recovery.

        The month of August saw the biggest Tennessee false claims lawsuit settlement of the year. Community Health Systems, headquartered in Franklin, settled false claim allegations against it for $98 million. A number of whistleblower lawyers initiated multiple litigations against CHS in Tennessee, Illinois, and three other states. The allegations include “fraudulently billing Medicare and Medicaid between 2005 and 20110 for the unnecessary hospital stays, including admitting patients to emergency rooms that didn’t need to be hospitalized.”

        The first lawsuit filed by a Tennessee whistleblower lawyer in 2011 reads “CHS has engaged in a systematic scheme [to] increase its revenues by making or causing to be made false claims for payment and/or approval to Medicare, and likely other third-party government payors as well, such as Medicaid, TriCare and government employee health plans.”

        With Healthcare fraud continuing to be the most focused subject of suits filed by a Tennessee false claims attorney, many other recoveries were also made in 2014. Meridian Surgical Partners paid $5.12 million following fraud allegations. The company reportedly “offer and pay kickbacks to certain doctors in exchange for the doctor’s promise to secure patient referrals to its ambulatory surgical centers.” A reward of close to $1 million was awarded to the whistleblower.

        In September, another Tennessee whistleblower lawsuit resulted in $11.3 million settlement. Medical device manufacturer Smith & Nephew was accused by one of its employees of supplying products rebranded with made-in-US tags. These supplies were originally procured from Malaysia. The whistleblower received $2.3 million in award in addition to $3 million for his Tennessee false claims attorney.

        A Tennessee false claims act lawsuit provides for a reward ranging from 15 to 33 percent of the recovered amount for the whistleblower. It remains between 15 and 25 percent when the state joins the prosecution. The compensation goes up to a third of the total amount settled for, if the plaintiff proceeds without state support.

        If you are aware of any type of fraud targeting Medicare or Medicaid funds, you have a chance to play the role of a hero and help in the recovery of the taxpayers’ money. To encourage whistleblower, the Tennessee False Claim Act allows the first filing relator a share of the total recovery or settlement as reward to them. For false claims free case evaluation, please call on 1-800-632-1404 to consult our expert false claims attorney in Tennessee.

        Contact a Tennessee False Claims Act Attorney

        We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

        CALL 1-800-632-1404

        or fill out this form below for a free initial consultation.

          Your Name (required)

          Your Email (required)

          Your Phone Number (required)

          Case Details

          captcha

          Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

          Posted on

          Tennessee Whistleblower: Know Your Rights

          Tennessee Whistleblower Attorney

          FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

          A Tennessee whistleblower allegation has led to prosecution of a former Knox County trustee under the state false claim law. Mike Lowe has been charged in a Tennessee false claims lawsuit initiated by a “ghost employee” of siphoning taxpayers’ money. The accused reportedly paid salary to ghost employees and bonus to those did not deserve the compensation and was also involved in false billing. A jury indicted Lowe in April 2012 that paved the way for his trial on six felony theft charges.

          The Tennessee false claims act attorney leading the prosecution has also submitted documents showing how the former trustee paid almost five-time more to his friend’s firm for a contract involving preparation of property titles. He paid $250 per title search and abstract compared to $50 the vendor paid to each lawyer. In many cases, payments were done even though the work is not performed.

          The TN false claim lawsuit names Lowe and two of his companions for using the public funds as “piggy bank.”  While Lowe held the position for 13 years, the allegations were based on payments made between 2004 and 2008.

          In another incident, a Tennessee whistleblower has revealed that modified guard rail devices are designed and manufactured in violation of the Federal Highway Administration specifications. The discloser came after 27 lives lost and 324 injured seriously in over 1,400 guard rail crashes.

          What Are Inferred Rights of a Tennessee Whistleblower?

          • Right to disclose anything that leads to misappropriation of public funds, violate laws, or threaten public interest.
          • Right to be protected against retaliation by his employer or defendants.
          • Right to compensation from a part of the total recovery subject to the state law.
          • Right to fight his claim and hire a Tennessee whistleblower lawyer if the state declines to participate in the prosecution.

          What Are Whistleblower Laws?

          The federal False Claims Act came into existence in 1863 to “protect the government from unscrupulous contractors.” It was extensively revised in 1986 offering safeguard to whistleblowers against unfair dismissal and encouraging qui tam lawsuits through an award from recovered funds.

          The Tennessee False Claim Act provides the very basis for the whistleblowers and their attorneys to act. Expanded in 2001, it lays down details of damages to be recovered from the convicted party and compensation for the qui tam plaintiff.

          In 1993, Tennessee Medicaid False Claims Act was implemented to encourage, protect, and compensate whistleblowers disclosing dishonest business practices related to the healthcare funds.

          What Are Safeguards for Tennessee Whistleblowers?

          • “Tennessee Code Ann. § 50-1-304” provides safeguards for whistleblowers and encourages qui tam lawsuits highlighting fraud and misappropriation of state or federal funds as stipulated under the False Claim Act.
          • “Tennessee Codes Ann.§ § 50-3-106(7), 50-3-409” assure protection for whistleblowers revealing violations related to health and safety guidelines by their employers.

          Do I Need a Tennessee False Claims Attorney?

          It is important for a whistleblower to consult with an expert Tennessee false claims attorney. His help is important to prepare the documents and expose the false claim in presentations before the Justice Department. Even plaintiffs go on their own when the government refuses to intervene or party to the prosecution.

          For false claims free case evaluation, please call on 1-800-632-1404 to consult our expert false claims attorney in Tennessee.

          Contact a Tennessee False Claims Act Attorney

          We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

          CALL 1-800-632-1404

          or fill out this form below for a free initial consultation.

            Your Name (required)

            Your Email (required)

            Your Phone Number (required)

            Case Details

            captcha

            Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

            Posted on

            Nursing Provider Settles Tennessee False Claims Lawsuit for $25 Million

            Tennessee whistleblower lawyer for Medicare fraud lawsuit
            Tennessee whistleblower lawyer for Medicare fraud lawsuit

            FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

            CareAll, a leading provider of home-based healthcare and nursing services, has agreed to pay $25 million to settle a Tennessee false claims lawsuit. The Nashville-based company was accused of defrauding Medicare and Medicaid funds by “by submitting false and upcoded home healthcare billings.” Toney Gonzales, the qui tam relator, is expected to receive about $4 million for his efforts to highlight the fraud and false claim.

            Gonzales’s TN false claim attorney accused CareAll of exaggerating “the severity of patients’ conditions to increase billings and billed for services that were not medically necessary and rendered to patients who were not homebound” between 2006 and 2013. Filed in a federal court for the Middle District of Tennessee, it was jointly pursued by the relator, U.S. Attorney’s Office, and the Tennessee Bureau of Investigation.

            A whopping $23.1 billion have been recovered by the Justice Department from false claim litigations filed nationwide in the last five years. About $16 billion of the recovered amount involved false billing and misappropriation of health-care funds. The office of the U.S. Attorney General has made combating health-care fraud a priority, as more than $60 billion meant for patient care is lost every year due to “fraud, waste, and abuse.”

            Tennessee False Claims Lawsuit: The Incentive for Whistleblower

            The justice department has put its weight behind whistleblower lawsuits seeking criminal health-care fraud recoveries. This renewed interest has led to a nationwide upsurge with over 750 false claim lawsuits filed over Medicare fraud last year. In Tennessee, the impact has been massive with whistleblower lawyers and plaintiffs feel incentivized to participate in any such financial recovery. In September, a Tennessee whistleblower won $1.8 million as reward for his role in the recovery of $5 million. Meridian Surgical Partners, the defendant was accused of “misappropriating of $100 million through false billing.”

            A whistleblower initiating a Tennessee false claim lawsuit stands to gain financial incentives, such as

            • reward of 15 to 25 percent of the total recovery from the defendant is awarded to the relator for his contribution in bringing to the notice the Medicare/Medicaid fraud when the state or federal authorities takes over the investigation and prosecution following his disclosure; or
            • reward of up to a third of total money recovered from the defendant is awarded to the qui tam plaintiff for highlighting the Medicare/Medicaid fraud and proceeding on his own with a Tennessee false claim attorney and without state or federal participation in the prosecution; and
            • a separate award by the court asking the defendant to pay for the legal expenses and fees of the attorney in addition to the money recovered.

            The Ambit of Tennessee False Claims Medicare Law

            Any type of fraudulent appropriation of healthcare funds, including false billing, phantom billing, misleading medical procedure, inadequate care, upcoding, double billing, fabrication of patient reports, and kick backs for referring, are punishable under the Tennessee Medicaid false claim act. Actions pertaining to falsification of records, conspiracy, avoidance of obligations, deliberate ignorance, and involvement in false claims with a intention to get monetary benefit also come under the legal purview of the act.

            Any one, a whistleblower or a resident of the state with evidence to suggest fraud, can file a complaint with the authorities or file litigation with the aid and advice of a Tennessee false claims lawyer. However, a lawsuit claiming false claim in Tennessee must be initiated within three years of its discovery, subject to a 10-year statute of limitations.

            For false claims free case evaluation and consultation with an expert Tennessee false claims attorney, please contact us or call on 1-800-632-1404.

            Contact a Tennessee False Claims Act Attorney

            We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

            CALL 1-800-632-1404

            or fill out this form below for a free initial consultation.

              Your Name (required)

              Your Email (required)

              Your Phone Number (required)

              Case Details

              captcha

              Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

              Posted on

              Tennessee False Claim Lawsuit: Dermatologist, Insurance Company Accused of Fraud

              False-Claims-Act-Attorneys

              FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

              Two separate Tennessee false claim lawsuits filed last month have accused a Memphis dermatologist, health insurance firm CIGNA, and medical billing major Zotec of defrauding Medicare funds. The Tennessee Medicaid False Claims Act of 1993 provides incentives and procedures for qui tam plaintiffs and whistleblowers to expose individuals and organizations embezzling healthcare funds and recovering the tax payers’ money misappropriated.

              Dr. George Woodbury, a Memphis dermatologist running Rheumatology & Dermatology Associates, has been accused of presenting fake bills showing higher amounts between January 2008 and December 2011. The doctor “presented a large volume of claims to Medicare for adjacent tissue transfers or grafts that were either not supported by documentation or medically unnecessary,” according to the TN false claim attorney representing the qui tam plaintiff

              Woodbury also submitted forged false for carrying out “other medical procedures” and even sought reimbursement for “unnecessary office visits.” The false claim lawsuit, which seeks recovery, penalties, and damages, has now been joined by the US attorney office.

              The second whistleblower claim targets medical billing major Zotec Partners and CIGNA, a well-known name in health insurance sector. Filed in Davidson County Circuit Court by a former business intelligence analyst at the insurance company, the Tennessee false claim lawsuit alleges “manipulative process by CIGNA that has resulted in artificially increase in the risk for members and inflated premium prices.” The firm increased “premiums through incentives, strategic claims acceptance and by leveraging weaknesses in the ICD-9 coding system” and passed “expensive procedures onto the consumer,” insists the TN whistleblower lawyer hired by the plaintiff.

              Zotec Partners is accused of supporting CIGNA in submitting upcoded bills. The whistleblower had worked at the billing company prior to joining the insurance giant.

              “Together, CIGNA’s and Zotec Partners’ unscrupulous methods have made disputing medical bills enormously complex and convoluted with the intent of placing an undue burden on CIGNA members, resulting in tremendous unfair damages,” the TN false claim lawsuit maintains.

              Tennessee False Claim Lawsuit: Explaining the Basics

              • Who Can File

               

              The state false claim act enables any Tennessee resident with adequate evidence and information about defrauding of taxpayers’ money to file false claim lawsuit. Even outsiders working in a state can become whistleblowers and benefit and protection under the state law. However, such litigations must be brought within three year of its discovery.

              • The Coverage

               

              The state False Claim Act covers all types of practices that result in misappropriation of public money or losses to federal, state, or local governments occurred in Tennessee. In 1993, a separate false claim law related to healthcare fund misappropriation was enacted to curb the increasing number of Medicare fraud.

              • How To File

               

              Filing a whistleblower lawsuit involves complex legal process and it is advisable to consult a TN false claim attorney. He will evaluate the claim and prepare a credible presentation based on your information. It is filed “under seal” at the court or with the offices or regulators empowered to investigate such cases. The state agencies may interview the whistleblower to ascertain his credibility and your lawyer is help to prepare for this. Based on the findings, the state may or may not join the prosecution initiated by you. However, plaintiffs can be party to such litigations and fight it without state assistance.

              • State Joining Prosecution

               

              Federal and state governments may or may not be party to the case. This also does not impact the plaintiff’s allegations. He can pursue it with his own TN whistleblower lawyer and recover defrauded money on behalf of the people.

              • Recovery and Damages

               

              A successful Tennessee false claim lawsuit recovers up to three-fold of the money defrauded. According to the 2013 amendments, the court is allowed to impose a hefty penalty on the defendant, who is also required to pay up to $25,000 in fine.

              • Whistleblower Compensation and Security

               

              A Tennessee false claim lawsuit provides for a reward ranging from 15 to 33 percent of the recovered amount for the whistleblower. It remains between 15 and 25 percent when the state joins the prosecution. The compensation goes up to a third of the total amount settled for, if the plaintiff proceeds without state support.

              For false claims free case evaluation, please contact us or call on 1-800-632-1404.

              Contact a Tennessee False Claims Act Attorney

              We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

              CALL 1-800-632-1404

              or fill out this form below for a free initial consultation.

                Your Name (required)

                Your Email (required)

                Your Phone Number (required)

                Case Details

                captcha

                Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

                Posted on

                Tennessee False Claims Lawsuit Settled for $11.3 Million

                False-Claims-Act-Attorneys

                FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

                Medical equipment manufacturer Smith & Nephew has settled a Tennessee False Claims lawsuit filed against it for $11.3 million. As intimated to the Western District Federal Court on September 3, 2014, the settlement involves a whopping $2.3 million share to the Tennessee whistleblower who initiated the lawsuit. The London-based company was accused of breaching the manufacturing and marketing conditions set by the federal Trade Agreements Act.

                The whistleblower lawsuit was filed by Samuel Cox in 2008. Mr Cox, a former IT manager with the medical device maker, alleged that the company sold devices imported from Malaysia to the federal government by “misrepresenting the country of origin.” The Department of Veterans Affairs purchased orthopedic equipment from the manufacturer in 2007 and 2008. According to the Trade Agreements Act, Smith & Nephew is required to provide only items made in the United States or other countries signatory to the trade pact.

                However, the company procured devices from Straits Orthopedics of Malaysia and supplied them to the government, the whistleblower lawsuit asserted. In the absence of any trade pact with that country, Smith & Nephew is debarred from selling Malaysian equipment to the Veterans Affairs department. The company went a step ahead claiming that the supplied devices were US made, claims the TN false claim attorney representing Mr Cox.

                The US government refused to intervene in the false claim lawsuit allowing the plaintiff to proceed on his own. He along with his Tennessee whistleblower lawyer continued the litigation that eventually forced Smith & Nephew to settle it out of court. While the government recovered $6 million following the settlement, the plaintiff received a large share of the total amount paid as his relator’s fee.

                Tennessee False Claim Lawsuit: Must Know Aspects

                • There are separate false claims acts in Tennessee governing whistleblower lawsuits over misappropriation of Medicaid and other funds. The Tennessee Medicaid False Claims Act enacted in 1993 covers all litigations related to the recovery of healthcare funds. All other qui tam claims come under the Tennessee False Claim Act last amended in 1986.
                • “Any deliberate or knowingly false or fraudulent claim, conduct, representation, or practice in order to receive money, property, or service directly or indirectly from the state or any political subdivision” by an individual, business organization, entity, partnership, or trust leads to “liability to be prosecuted” under the law.
                • The federal and state governments are at liberty to join or refuse to be party to a Tennessee false claims lawsuit. However, it is no way impact the progress of the litigation until the qui tam plaintiff is ready to continue.
                • The whistleblower can continue the lawsuit with the help of his Tennessee false claims lawyer and seek the recovery of misappropriated public money.
                • The defendant convicted of false claim is directed to pay money three-time more than the value of the loss caused or defrauded along with punitive fines.
                • A share of the total money recovered is paid to the whistleblower and his attorney. It ranges between 15 and 30 percent. Legal protection is also assured to the whistleblower to safeguard him against “discharge, demotion, suspension, threat, harassment, denial of promotion, or discrimination for disclosing or furthering a false claims action.”
                • TN false claims lawsuits must be initiated within 10-year of the act committed or three-year of its discovery.

                For false claims free case evaluation, please contact us or call on 1-800-632-1404.

                Contact a Tennessee False Claims Act Attorney

                We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

                CALL 1-800-632-1404

                or fill out this form below for a free initial consultation.

                  Your Name (required)

                  Your Email (required)

                  Your Phone Number (required)

                  Case Details

                  captcha

                  Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

                  Posted on

                  Tennessee False Claims: Hospital Pays $5 Million To Settle Kickback Lawsuit

                  False-Claims-Act-Attorneys

                  FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

                  A Tennessee false claims lawsuit filed against the Meridian Surgical Partners alleging kickbacks has been settled for $5 million, including $1.8 million as reward for whistleblower and his attorney. The qui tam suit was brought in 2011 after a former business manager turned whistleblower and claimed violation of the Tennessee False Claims Act by the surgical chain operator for commercial gains. Two months prior to the Medicare fraud settlement, another whistleblower lawyer representing a Chattanooga businessman sought recovery of $10 million allegedly siphoned through inflated billing.

                  Tennessee False Claims Act Violation by Meridian Surgical

                  Thomas Reed Simmons filed a Tennessee false claims lawsuit against his former employer Meridian Surgical Partners, alleging breach of the federal Anti-Kickback Statute. The hospital chain “purchased a majority of shares of Stuart, Florida-based Treasure Coast Surgery Center and paid higher annual distributions and even stakes in the hospital doctors referring patients to it,” claimed the whistleblower lawyer representing Simmons at a Tennessee federal court.

                  In September 2014, just weeks before trial, Meridian agreed to pay $3.32 million in restitution for Medicare fraud and $1.8 million to the whistleblower, admitting violation of the Tennessee false claims act. The original claim involved accusation of Medicare misappropriation to the tune of $100 million through false billing for referral patients. Simmons and his Tennessee false claims attorney went on their own after the U.S. Department of Justice refused to be party to the prosecution.

                  Tennessee False Claims Lawsuit Seeks Recovery of $10 Million

                  Another Tennessee false claims lawsuit filed in July 2014 has sought recovery of $10 million from the Electric Power Board of Chattanooga. The plaintiff, a former contractor, alleges that the company inflated prices of electricity bulbs supplied to Chattanooga City that caused loss of taxpayers’ money. The whistleblower lawsuit traces its cause to dispute over EPB’s acknowledgement of potential false billing and erratic record keeping.

                  EPB supplied 46,000 bulbs to be used in streetlights at an inflate price billed 27 percent more on an average, the false claim attorney representing plaintiff Don Lepard argues. The supplier justified its action, asserting that it charged the city less and even made replacements at many places without any extra cost.

                  Lepard’s Global Green Lighting provided superior LED replacements for a third of EPB bulbs. According to the plaintiff’s whistleblower lawyer, EPB changed its books following complaints made by his client but did not reimburse the city for inflated prices. Even the city mayor asked the electricity distribution and supply utility to streamline its bookkeeping after it admitted to have overbilled taxpayers. The company’s claim of offsetting the higher prices is disputed by the plaintiff and the city auditor.

                  Tennessee False Claims Lawsuit: Whistleblower Protection

                  Whistleblowers filing false claim lawsuits in Tennessee highlighting defrauding of Medicare or taxpayers’ money are rewarded and protected under the state law. While 15 to 30 percent of the total amount recovered or settled for is awarded to the qui tam plaintiff for his role in ensuring retrieval of public money, the Tennessee False Claim Act provides comprehensive measures to protect him from retaliations of any kind. It offers encouragement to whistleblowers to disclose corrupt practices and empower the state to act against the guilty

                  The state is also at liberty to join a Tennessee false claim lawsuit based on its merit. If it denies participating in the case, the plaintiff still has the option to proceed with the help of his qui tam lawyer. For false claims free case evaluation, please contact us or call on 1-800-632-1404.

                  Contact a Tennessee False Claims Act Attorney

                  We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

                  CALL 1-800-632-1404

                  or fill out this form below for a free initial consultation.

                    Your Name (required)

                    Your Email (required)

                    Your Phone Number (required)

                    Case Details

                    captcha

                    Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.