Articles Posted in Government Contracts Fraud

israel-palacio-463979-copy-300x200While qui tam cases brought under the False Claims Act (FCA) are often related to health care, qui tam cases can be in connection to any type of claim made to the federal government for payment. In addition to the health care industry, defense contractors are another area in which the government is vulnerable to fraudulent schemes. For example, Lockheed Martin Corporation has agreed to settle FCA allegations by paying the federal government $4.4 million. Lockheed is accused of providing defective communications systems to the U.S. Coast Guard.

Defective Equipment for the Military

The defense contractor provided Radio Frequency Distribution System (RFDS) for the Coast Guard’s National Security Cutters. According to the U.S. attorneys, the RFDS failed to be able to conduct simultaneous operations, meaning it could receive and transmit different radio signals at the same time without interference.

When qui tam cases under the False Claims Act (FCA) are first filed, they are to remain under seal for 60 days. During this time, the case is secret. The defendant is not even served yet, so it likely does not know there is a suit filed against it unless there are quiet rumblings or leaks. During this 60-day period, the government is given an opportunity to investigate the allegations and decide whether to join the suit or not. Once the government makes its decision, the case is unsealed. In certain instances, this is when the defendant is served. However, in many cases, the seal is partially lifted and the defendant is served prior to the whistleblower case being made public.

The truth of the matter, though, is that a qui tam case is never under seal for just 60 days. The FCA, the government can ask for extensions of the seal period if they can show it is for good cause. This happens regularly and continuously to the point where many qui tam cases remain confidential for years.

How Long Do Qui Tam Cases Remain Under Seal?

jerry-kiesewetter-210547-copy-300x199The Department of Justice (DOJ) announced on June 7 that the U.S. is intervening in a qui tam suit against Los Angeles and CRA/LA, formerly known as the Community Redevelopment Agency of the City of Los Angeles, regarding allegations that the city and organization falsely certified that they were compliant with federal accessible housing laws to obtain grants from the U.S. Department of Housing and Urban Development (HUD). In short, the U.S. is joining a lawsuit that alleges the city and its agency unlawfully gained and misused federal funds. If the U.S. and whistleblowers are successful, the settlement or judgement could amount to millions of dollars.

An FCA Claim Against L.A.

The qui tam suit was brought under the False Claims Act (FCA) by Mei Ling, a Los Angeles resident who uses a wheelchair, and the Fair Housing Council of San Fernando Valley, (the Council), a local nonprofit. Ling and the Council provided evidence to the court that L.A. and CRA/LA repeatedly lied to HUD about building accessible housing for people with disabilities. Instead, the defendants used federal grants to build housing that violated Section 504 of the Rehabilitation Act and the Fair Housing Act. The whistleblowers also argue that the defendants violated their affirmative duty to provide people with disabilities fair and equal access to public housing.

benjamin-child-90768-300x200Vinod Khurana alleged he should receive part of a $500 million settlement agreement between Science Applications International Corp. (SAIC), New York City, and the Southern District U.S. Attorney’s Office since he was a whistleblower who informed the government of SAIC’s fraudulent billing and record-keeping system. However, the court denied this claim stating that Khurana was not a valid qui tam relator in relation to the settlement. Therefore, he had no right to a portion of the agreement as if it were the government’s alternate remedy.

Khurana’s History with SAIC

Khurana was a software engineer with Spherion, a quality assurance company that was hired to review SAIC’s records and billing on the CityTime system, which was used to track municipal workers’ hours. By working with CityTime, Khurana discovered that SAIC managers had a fraudulent billing and record-keeping system that made them money. He claims his bringing forward information about this fraud between 2004 and 2007 was what led to his dismissal in 2007.

file5601297827370-300x225Each week new qui tam suits, possible under the False Claims Act (FCA) are brought by private individuals against other individuals and businesses on behalf of the federal government. Many of these lawsuits take years to investigate and litigate. Additionally, each week sees some of these cases settled, finalized, or appealed. Here are a few cases that wrapped up this past week:

  • In February, a physician’s practice in Florida agreed to settle a FCA claim based on Medicare fraud for $750,000. The qui tam suit against Dr. Paul B. Tartell was filed by a former patient Theodore Duay. Duay alleged that Tartell would bill Medicare and the Federal Employee Health Benefits Program for procedures that were not medically necessary or not performed at all. Numerous federal agencies were involved in negotiating this settlement, and Duay will receive $135,000 for filing the action.
  • TeamHealth Holdings will pay $60 million plus interest due to allegations its business, IPC Healthcare Inc., committed fraud against Medicare, Medicaid, the Defense Health Agency, and the Federal Employees Health Benefits Program by billing for more expensive medical services than what were actually provided. Dr. Bijan Oughatiyan filed a qui tam action under the FCA alleging the practice of “upcoding.” The federal government investigated and chose to intervene, providing a detailed description of how IPC Healthcare used false codes to receive greater reimbursements. Oughatiyan will receive $11.4 million for his participation.

In_the_crosshairs-300x200This February, a federal district judge from the Southern District of New York, part of the Second Circuit Court of Appeals, determined a whistleblower who voluntarily dismissed his False Claims Act (FCA) case against L-3 Communications EOTech Inc. in 2014 could not share in a settlement later reached between L-3 Communications and the federal government in 2015. While this ruling may not be law across the U.S., it is an important opinion for potential qui tam plaintiffs to consider since other federal judges would likely come to the same conclusions. Ultimately, whistleblowers will need to see the entire case through to benefit from a settlement or judgment in the government’s favor.

The L-3 Communications Case

The whistleblower against L-3 Communications was a quality control engineer for the company from May to June 2013. In August 2013, he stated that the company sold defective holographic firearm sights to the American military and law enforcement agencies. The sights were supposed to work in temperatures from negative 40 degrees to 140 degrees Fahrenheit and with humidity. However, they were allegedly defective because they were inaccurate in extreme hot and cold temperatures and humid conditions.

hduan6byeze-chris-lawton-300x200The False Claims Act is a crucial tool for the government to be able to recover fraudulently obtained or retained funds. Under the FCA, the federal government, or private citizens on its behalf, can bring lawsuits against individuals or certain entities that have made a false or fraudulent claim, resulting in that individual or entity wrongfully obtaining or keeping money from the government. Fraudulent claims are often made in relation to health care programs like Medicare and Medicaid so that individuals or entities receive greater disbursements than they deserve. Under the FCA, the individuals who can be held liable for false claims are “any person.” However, the federal courts have been left to define who counts as a person and who does not.

U.S. ex rel. Brinkley v. University of Louisville

In January, the U.S. District Court of the Western District of Kentucky in the case U.S. ex rel. Brinkley v. University of Louisville had to answer the question of whether a party accused of making a false claim was a person. This federal court is neither the first to do so, nor will it be the last. The plaintiffs in this case filed a qui tam action as private citizens on behalf of the federal government against the University of Louisville, two of the university’s foundations, and eight university researchers. The court found based on previous federal decisions that a state university cannot be held liable under the FCA because it is not a person. No state agencies or entities that can be considered arms of the state are people under the FCA.

upmisxb0wd0-srikanta-h-uBetween Oct. 2015 and Sept. 2016, the Department of Justice (DOJ) won more than $4.7 billion in judgements and settlements from civil fraud and false claims against the government, a DOJ press release stated. This recovery is from cases brought under the False Claims Act (FCA), including qui tam claims in which a whistleblower brings to light a fraud being perpetrated against the government. The amount is particularly important to note since it is the third highest recovery for a fiscal year since the FCA was enacted. It is also crucial in the sense that it confirms the effectiveness of qui tam cases and other claims brought under the FCA. The legal protections and incentives for whistleblowers to come forward enables the government to stop fraudulent schemes and return funds back to programs that support low-income families, veterans, and the elderly.

Fraud is Common within the Health Care Industry

Fraudulent claims within the health care industry cost the government billions of dollars. The DOJ reported $2.5 billion was recovered for the federal government in relation to this sector from hospitals, physicians, nursing homes, labs, medical device companies, and drug companies during the 2016 fiscal year. Additionally, a total of $19.3 billion has been won in health care fraud claims since January 2009. The recovered funds go back to federally funded medical programs such as Medicare, Medicaid, and TRICARE.  

It is no secret that, as a whistleblower’s law firm, we are big fans of the False Claims Act (“FCA” or “the Act”).  The Act holds liable any person/entity that presents a false or fraudulent claim for payment to the federal government (or an agency thereof) and/or create false records to that end.  In essence, it forbids overcharging the government for goods or services or charging for goods/services that are never delivered.  The Act’s qui tam provision is particularly powerful since it enables private individuals to bring suits on the government’s behalf.  This is key because it is often private parties, rather than the government itself, who are aware of these fraudulent schemes.  Recent trends show that the legislature and the courts are committed to working with whistleblowers and, more generally, to using the False Claims Act as a powerful tool to battle health care fraud and other forms of fraud on the U.S. government.

DOJ Nearly Doubles Per Claim False Claims Act Penalties

As Becker’s Hospital Review, a healthcare industry journal, reported last month, the Department of Justice (“DOJ”) recently published an interim final rule substantially increasing the monetary penalty for violations of the FCA.  Previously, penalties ranged from $5,500 to $11,000 per claim.  The new penalties neacash2rly double the old ones and range from $10,781 to $21,563.  These increased penalties took effect on August 1 and only apply to violations occurring after November 2, 2015.  The increase was made pursuant to the Bipartisan Budget Act of 2015 which required agencies to increase FCA penalties and authorized rulemaking to implement a “catch up adjustment” to account for inflation.  The DOJ is just one of the agencies updating penalties (the Railroad Retirement Board was the first), but it is certainly among the most impactful.

Last week, we flag2wrote about the importance of the False Claims Act as a tool for fighting defense contract fraud.  This week, we continue that discussion by focusing on a case that we touched upon in last week’s post.  This case stands out as particularly egregious of allegations that, if true, could have cost countless military members their lives.  It is an important example of the type of military contract fraud that honest whistleblowers can help bring to an end when they partner with the team at our government contract fraud law firm.

Defense Contractor to Pay $3 Million to Settle Allegations Regarding Ballistic Helmets that Failed Safety Tests

Earlier this year, the Department of Justice (“DOJ”) issued a press release announcing that ArmorSource, LLC would pay $3 million to settle a lawsuit filed pursuant to the False Claims Act.  As the DOJ explains, the U.S. Army entered into a contract with ArmorSource in 2006 pursuant to which the company was to manufacture Advanced Combat Helmets (“ACHs”).  ACHs are used by soldiers in combat and made out of Kevlar to help provide ballistic protection for the wearer.  According to the government, from 2006 to 2009, ArmorSource provided the Army with ACHs that did not conform to the requirementsoldierss in the government contract and did not meet contract performance standards.  The Army began recalling the ArmorSource helmets in May 2010 after several lots failed ballistic safety tests.

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