In its 2016 Annual Review of Corporate Fraud and Corruption, Financier Worldwide magazine reported that, every year, corporate fraud causes companies to lose about 5% of their annual revenue.1 In dollar terms, this converts to trillions of dollars each year lost through fraud worldwide. As a result of this problem, countries globally are introducing new laws relating to anti-bribery and anti-corruption. Many countries are working cooperatively with other jurisdictions to combat fraud. While the United States has been a leader in this regard, other countries like the UK, Netherlands, Germany, France, Canada and Australia have introduced anti-bribery and anti-corruption compliance regulations and have employed robust enforcement activities.2 Further, the United Nations Convention Against Corruption has placed pressure on member nations to implement and enforce anti-bribery and anti-corruption laws.3
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MINNEAPOLIS – (Dec. 15, 2016) The MiMedx Group (NASDAQ: MDXG) persistently inflated its quarterly revenue figures over several years, using a fraudulent practice known as “channel stuffing” to book sales of products that customers never ordered, according to a whistleblower lawsuit filed by Halunen Law against the company and its CEO today in federal district court in Minneapolis. When two top company salespeople objected to being part of what they perceived to be a scheme to defraud shareholders and the investing public, senior-level executives retaliated with threats, intimidation, and ultimately, termination, according to the lawsuit.
Honesty is the best policy. It’s one of the first lessons we learn, and yet it seems there is an epidemic of selective memory loss among providers who choose to defraud Medicare. Our journey begins in South Carolina where another medical provider is paying out millions in an effort to put the allegations of wrongdoing behind them.
This past summer, the Justice Department announced that Lexington County Health Services District Inc. d/b/a Lexington Medical Center located in West Columbia, South Carolina, had agreed to a $17 Million settlement. (1) The settlement resolved allegations that the Center had maintained improper financial relationships with physicians they employed and submitted fraudulent claims to Medicare. This is extremely troubling considering a large percentage of their income is from Government funded programs.
People who rely on Medicare are among our nation’s most vulnerable citizens, including the elderly, disabled and terminally ill. In many cases, this is truly their only hope for receiving the medical care they so desperately need, but many could not otherwise afford. Subsequently an extensive body of law protects the rights of these recipients and safeguards the tax payer dollars funding these services with severe penalties for those who choose to ignore them.
Hospice and greed. Two words that are diametrically opposed and when combined—toxic.
At its inception, hospice in America was mostly a philanthropic movement led by volunteers and non-profit entities. Today the hospice industry is big business including a large percentage of for-profit providers. According to the Medicare Payment Advisory Commission (MEDPAC) in 2013 Medicare hospice expenditures alone totaled about $15.1 billion for services rendered by over 3,900 providers. (1)
The hospice movement is built on the core belief that patient dignity and respect are fundamental to providing compassionate care to the dying. When the prognosis of a terminal illness carries a life expectancy of 6 months or less it’s devastating. Hospice includes access to essential medical care along with emotional and psychological support which enables individuals and their loved ones to live as fully as possible in the time remaining while striving to come to terms with saying good-bye.
With changing times and expanding needs, the government finds itself increasingly reliant on the private sector to help deliver an array of services. As the private sector’s role has expanded, one thing remains constant: some businesses cheat—they commit fraud against the government. These deceptive practices date back to the Civil War era.
When a person has knowledge of such fraudulent business practices, they can “blow the whistle” through the False Claims Act. The process is complicated and whistleblowers need knowledgeable legal counsel to provide expertise and guidance, when exploring the possibility of becoming a “relator,” the term used for False Claims Act whistleblowers. Under the False Claims Act, if information provided by the relator ends in a government recovery, relators are compensated with a percentage of the total recovery.
Fraud against the government is nothing new. It’s an age-old problem dating back to the Civil War era when contractors supplied the army with broken guns, sand-packed bullets, lame pack mules, cardboard boots and more. President Lincoln asked Congress for a law setting severe financial penalties those who engaged in the practice. Today, the False Claims Act (FCA) —also known as the original Whistleblower Law—is still a viable way to protect the United States government and people who “blow the whistle” on fraudulent activity. Someone claiming fraud, also known as a relator, can sue a company for its illegal action. If the lawsuit is successful, relators receive a percentage of what the Government recovers.
Halunen Law attorneys have brought FCA cases on behalf of relators across the county. In this video, Halunen Law Founder and Managing Partner Clayton Halunen discusses the law in more detail. If you’re aware of fraudulent activity against the government, the team at Halunen Law is there to help.
Video link: reellawyers.com
Forged Under Civil War Fire, The False Claims Act Continues To Serve As Basis For Private Citizens To Blow The Whistle On Would-Be Fraudsters Of The Government Trust
Under a little-known law, private citizens with knowledge of fraud against the government can bring a lawsuit against the offending organization. Called the False Claims Act, the law—often called the original Whistleblower Law — originated in the Civil War era, when rampant fraud against the U.S. government threatened the very existence of the country.
Sickened by the spectacle of contractors supplying the army with broken guns and sand-packed bullets, lame pack mules and cardboard boots, President Lincoln pressed Congress for a law setting severe financial penalties for fraud against the government. The law also included a provision to empower private citizens to sue fraud perpetrators on behalf of the government. Known by its Latin name as “qui tam,” this provision allows the courts to award whistleblowers, called “relators” under this law, a share of the monies recovered by the government in fraud cases. In Lincoln’s time, the law brought corrupt defense contractors to heel. Today it serves to protect taxpayers against fraud from contractors in any number of industries. Equally important, the law protects individuals, like the Civil War soldiers fighting with inferior equipment, who suffered injury as a result of the fraud. Many states, including Minnesota, have adopted whistleblower laws to protect against fraud against state agencies.
The diagnosis: Cancer. Few words have the power to alter one’s life as dramatically as those six letters linked with the phrase – “test results.” The Journey begins. The two critical elements for any cancer patient are affordable care and a physician that, above else, you can trust with your life. There is an ethical expectation that providers will live up to their oath to make the patient’s need their top priority, abstain from medical malfeasance and recognize and be mindful of the impact their patients’ care can have on the stability of their families and finances.(1)
Tuesday, March 8, 2016, a press release by the Department of Justice (2) announced a $37-million-dollar settlement with 21st Century Oncology Inc., the nation’s largest physician led integrated cancer care provider, and its wholly owned subsidiary South Florida Radiation Oncology LLC. The False Claims Act lawsuit included allegations that they defrauded Medicare and other federal health care programs including TRICARE, the Department of Defense military health program supporting our uniformed services.
The Star Tribune published an article today about how a mental health agency, Complementary Support Services, that was supposed to provide quality services to a vulnerable population, instead is reported to have engaged in rampant fraud that “bilked the state’s Medicaid program of millions of dollars and provided inadequate supervision of unlicensed practitioners.” That private agency is now the subject of a federal and state False Claims Act qui tam lawsuit that resulted from a report to the government by a former employee.
The False Claims Act is designed to encourage citizens to challenge conduct that cheats private agency clients and wrongfully takes taxpayers money to do so. It also provides whistleblower protection to employees who are treated badly or fired because they challenge, report or refuse to engage in illegal conduct. The goal of the law is to stop fraud in its tracks by encouraging oversight by employees, recipients of services and the public.
Today, July 30th, is National Whistleblower Appreciation Day. Halunen Law applauds the men and women who have the courage to blow the whistle when they become aware of illegal conduct by their employers. Managing Partner Clayton Halunen observed, “We have had the honor of representing many whistleblowers, and what is so impressive is their sense of integrity and their determination to do the right thing even in the face of personal risks. Their commitment brings to mind the words of Martin Luther King: ‘Our lives begin to end the day we become silent about things that matter.’ We are grateful for whistleblowers who do not become silent about things that matter and pledge to use our resources to protect and support whistleblowers in whatever way we can.”
Halunen attorneys represent whistleblowers across the country. Their fierce advocacy has resulted in hundreds of millions of dollars recovered on behalf of their clients and the government.
Phone: (312) 222-0660
Fax: (612) 605-4099
Phone: (602) 535-2203
Fax: (612) 605-4099