General Information

Look Out for Fraud During Hurricane Season

As the 2019 hurricane season begins, the Department of Justice and Bracker & Marcus LLC remind the public to be on the lookout for fraud against the Government.

The Department of Justice established the National Center for Disaster Fraud (NCDF) in the wake of Hurricane Katrina, when billions of dollars in federal disaster relief poured into the Gulf Coast region, which opened opportunities for criminals to exploit people and Government assistance during vulnerable times.

While compassion is generally shown in the aftermath of natural disasters, there are some individuals and organizations who use these tragic events to take advantage of those in need. Among others, examples of illegal activity being reported to the NCDF and law enforcement include:

  • Fraudulent submission of claims to insurance companies and the federal government;

  • Price gouging; and

  • Contractor fraud

One example is a False Claims Act verdict that went all the way to the Supreme Court. In U.S. ex rel. Rigsby v. State Farm Fire & Casualty Co., the “good neighbor” insurance company was found to have misclassified wind damage to a home—which State Farm would have had to pay for under the owner’s insurance policy—as flood-related damage, which would have been paid by the federal government’s flood insurance program.

If you suspect fraudulent activities, please contact us for a free consultation.

To Tape, or Not To Tape Debate Happening in Georgia

Recent Georgia gubernatorial candidate Casey Cagle’s career was halted due to a secret recording produced by failed candidate Clay Tippins. At the time, the recording was legal because in Georgia only one person in a conversation has to agree to be recorded.

Now Senate Rules Chairman, Jeff Mullis, wants the law changed to make such tapings illegal. Mullis’s bill would require all parties to give “prior consent” to being recorded.

It’s something that Georgia First Amendment Foundation President Richard T. Griffiths said would be “very bad for the public.” Not only would it have an impact on investigative journalism, it would keep people from being able to pursue legal action against people trying to commit fraud over the phone, Griffiths said.

Of course, there are pros and there are cons to recording conversations. Whistleblowers frequently come to us with recordings of conversations with managers and co-workers. Often, particularly when they sense they are about to be retaliated against, they turn on their phone recorders during important meetings or when called in to talk with HR. This can result in strong evidence of retaliation, but also of fraud, and can be vital evidence in a False Claims Act case. Or, if the employer feigns ignorance of the fraud and claims to be firing you for non-retaliatory reasons, it can be devastating to your case.

If you want to know our opinion on recordings, check out this previous blog post.

$50 Billion in Medicare Waste? That's an Understatement.

There is $50 billion a year wasted in the Medicare program. That’s a billion dollars a week.

At an April 11 town hall, presidential candidate Tim Ryan of Ohio made the above statement in response to a question about how he would stop the federal government from wasting taxpayer money. Politifact investigated his statement and found it to be “mostly true.”

Specifically, Politifact reviewed testimony from a GAO director of audit services, who noted $48.5 billion in improper payments by Medicare for fiscal year 2018. Politifact determined that Ryan’s statement was mostly true because approximately $7 billion of that amount consisted of underpayments, and so that money was hardly “wasted” - rather only $45 billion of overpayments were made in that year.

Still, this amount is far from accurate. First, Politifact correctly noted that this amount is only what was caught. As one expert stated, “the audit protocols that Health and Human Services uses to produce the estimates are weak, ‘so the actual levels of overall waste, or overpayments, are undoubtedly much higher than these government estimates.’” False Claims Act whistleblowers report fraudulent schemes in the hundreds of millions of dollars that slip by CMS auditors.

Second, the amounts likely do not include fraud resulting from violations of the Stark Law or Anti-Kickback Statute, which can result in overprescribing of drugs and services in exchange for kickbacks, or for providing services that are not medically necessary or reasonable. For example, Bracker & Marcus LLC recently settled an $84.5 million kickback scheme with a hospital group. Third, this statement does not include fraud on other government healthcare programs such as Medicaid, Tricare, or the VA.

If anything, Ryan understates the amount of fraud, waste, and abuse committed against Medicare, which is shocking when he is already talking about a fifty billion dollar annual problem.

Bracker & Marcus LLC is part of the solution. We represent whistleblowers in healthcare fraud cases and have helped to recover tens of millions of dollars for the Medicare program. If you are aware of Medicare fraud, please contact us today.

Whistleblowers are Vital to National Security, Now More than Ever.

Note: This was scheduled to post on Wednesday, it didn’t due to technical difficulties, and now the shutdown is over! But with yet another potential shutdown on the horizon, I’m posting this anyway. Enjoy!

“One overriding fact is clear when you listen to FBI Agents: Financial security is national security.”

Earlier this month, the FBI Agents Association released a presentation called Voices From the Field: FBI Agent Accounts of the Real Consequences of the Government Shutdown, giving firsthand accounts of the affects the shutdown is having not only on the individual agents, but also on ongoing federal investigations.

“The shutdown has eliminated any ability to operate.… It’s bad enough to work without pay, but we can only conduct administrative functions while doing it. The fear is our enemies know they can run freely.”

Over the last two years, media reports about the FBI have been so targeted towards their investigations into political activities, it is easy to forget that this is just small part of what the FBI addresses. Regardless of your political views, the FBI performs essential roles that we can all agree are necessary to maintain a safe and secure country, including:

  • Crimes Against Children and Sex Trafficking

  • Drug and Gang Crime

  • Counter-Terrorism

  • Cybersecurity

  • Healthcare and Securities Fraud

“Operationally, I requested a subpoena from the U.S. Attorney's Office yesterday and was told it may take a while because their legal assistants are furloughed. Depending on how long the shutdown lasts, it could be several weeks before my subpoena is issued.”

As long as the partial shutdown is ongoing, the FBI (like the U.S. Attorneys and Department of Justice) are limited in their ability to investigate both the criminal and civil frauds being perpetrated throughout the country. Bad guys are running rampant, knowing that they aren’t being watched as closely. The Government lacks the resources to monitor fraudulent activity, and so during this time, more than ever, private citizens, aka whistleblowers, are vital to maintaining national security. It is up to you, and to us as your qui tam counsel, to keep an eye on the bad guys and to bring False Claims Act cases to put a stop to fraud.