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 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.