Bracker & Marcus LLC would like to congratulate their friend and colleague Benjamin Cheesbro, who yesterday was sworn in as federal magistrate judge for the United States District Court for the Southern District of Georgia, Brunswick Division. Congratulations, Ben, and best of luck in Brunswick! We look forward to being in Judge Cheesbro's courtroom in the near future!
Let's celebrate this holiday dedicated to the American workers. Their contributions to the strength, prosperity, and well-being of our country are invaluable. We are honored to represent these workers every day. We hope you all relax, enjoy, and celebrate today!
The United States Department of Justice and U.S. Attorney for the Eastern District of Michigan has announced a settlement with William Beaumont Hospital of $84.5 million to resolve a False Claims Act lawsuit brought by our client, David Felten, M.D., Ph.D.
Surely one of the most prestigious whistleblowers in FCA history, Dr. Felten was recently listed among the “Thirty Most Influential Neuroscientists Alive Today.” Among many other honors, Dr. Felten is the lead author for Netter's Atlas of Neuroscience, and recipient of a MacArthur Genius Grant and two 10-year research MERIT Awards from two different National Institutes of Health. He is widely credited with creating the field of psychoneuroimmunology.
Bracker & Marcus LLC and Caplan Cobb LLP are proud to represent Dr. Felten and congratulate him, the federal government (in particular AUSAs Peter Caplan, Leslie Wizner, and Carolyn Bell-Harbin, lead investigator Jonathan Sonbay, and DOJ attorney Laurie Oberembt), and the state of Michigan for this outstanding result. In addition to the qui tam settlement, our firms continue to litigate a False Claims Act retaliation claim on his behalf. The case is captioned United States ex rel. Felten v. William Beaumont Hospitals, 2:10-cv-13440 (E.D. Mich.).
For more information on the case and settlement, please see our press release.
National Whistleblower Appreciation Day is an annual recognition of whistleblowers whose actions have protected the American people from fraud or malfeasance. In 2018, the U.S. Senate unanimously passed a resolution to mark July 30 as the commemorative day led by Chuck Grassley.
Thank you to all of our former, current, and future clients for being so brave and selfless, and for choosing Bracker & Marcus LLC to represent you in your quest for justice! You are the unsung heroes of our nation, and we are honored and privileged to work with you! We will continue to use the False Claims Act, IRS Whistleblower Act, Sarbanes-Oxley Act, and National Defense Authorization Act to protect and fight on behalf of whistleblowers and the American taxpayers.
According to a recent report by HHS-OIG, insurers who manage Medicaid insurance plans are ineffective when it comes to monitoring its managed care plans for Medicaid fraud and reporting that fraud to the state. The OIG's report, Weaknesses Exist in Medicaid Managed Care Organizations’ Efforts To Identify and Address Fraud and Abuse, reveals that one-third of the health plans it examined had referred fewer than 10 cases each of suspected fraud or abuse to state Medicaid officials in 2015. Two of the insurers, which serve mostly low-income families, reported ZERO cases of fraud all year.
Even when insurers terminate doctors from their network due to fraudulent billing (179 such contracts were terminated "for cause" in 2015), they fail to inform the state. Therefore, that doctor is free to continue their fraudulent billing practices through other insurance providers.
Medicaid plans “are required by law to find fraud and abuse and to share information with states,” said Meridith Seife, a deputy regional inspector general in New York and a co-author of the report. “We are concerned anytime we see evidence that managed-care organizations are not doing that in a rigorous way. There’s a lot of taxpayer dollars at stake.”
This report further highlights the necessity of a robust False Claims Act. With so few safeguards in place, particularly with the private insurance companies tasked with managing Medicaid and Medicare Advantage plans, it often takes a whistleblower to uncover and report fraud being perpetrated by health providers.