Good News for Medicare Beneficiaries and Taxpayers
July 2016 — DOJ announced a $7.4 million settlement of my client’s intervened case alleging unnecessary cardiac procedures. The settlement allocates an 18% relator share, plus statutory fees, which my client shares with a second to file relator.
FCA Actions are Exempt from Bankruptcy’s Automatic Stay Judge Roy Dalton Jr. found FCA actions are exempt from the Bankruptcy Code’s automatic stay, 11 U.S.C. § 362(a). United States ex rel. Green v. Inst. of Cardiovascular Excellence, PLLC, 2016 U.S. Dist. LEXIS 64647 (M.D. Fla. May 16, 2016).
Work Product Doctrine Protects False Claims Act Disclosure Statement
Judge Julie S. Sneed ruled for my client that his disclosure statement is eligible for protection under the work product doctrine. United States ex rel. Bingham v. Baycare Health Sys., 2016 U.S. Dist. LEXIS 50940, *16 (M.D. Fla. Apr. 15, 2016).
Federal Judge Denies Motion to Dismiss by Dr. Qamar and Inst. of Cardiovascular Excellence (ICE)
Judge Roy Dalton denied defendants’ motion to dismiss. He found plausible allegations of kickbacks and medically unnecessary procedures. In reaching his decision, Judge Dalton relied on allegations and on “statistically-valid random samples.” (M.D. Fla Nov. 5, 2015).
Federal Judge Denies Baycare’s Motion to Dismiss
Judge Steven Merryday denied Baycare Health Systems’ motion to dismiss my client’s case. My client alleged Baycare spent millions of dollars to construct parking garages, and then transferred to referring physicians a near permanent right to use the garages. He estimated that the referring physicians each received a benefit exceeding $10,000 per year. In addition, he alleged that Baycare conveyed rent discounts in the form of valuable tax benefits to referring physicians by claiming that for-profit physicians’ offices were entitled to nonprofit tax exemptions. Baycare argued the allegations were implausible and improperly pled. Judge Merryday disagreed. U.S. ex rel. Bingham v. BayCare Health Sys., 2015 U.S. Dist. LEXIS 107220 (M.D. Fla. Aug. 14, 2015).
Federal Judges Enjoy Life Tenure (Not News for Most of Us)
Defendant Qamar (a cardiologist we allege to have committed unnecessary catheterizations) reminded me to be grateful federal judges are not beholden to politicians. He retained two DC lobbying powerhouses: Greenberg Traurig, and Arnold and Porter, apparently under the impression their political clout will solve his problems.
“One suit in the Qamar case was filed by an unnamed whistleblower.”
— Wall St. Jrnl., Jan 5.
Jan. 2015 — My client and I are grateful to the lawyers at the U.S Attorney’s office and the Department of Justice for their sensitivity and willingness to defer the disclosure of J. Doe’s identity until it is necessary for them to do so.
J. Doe knew his/her identity would eventually be revealed when the United States files its complaint in intervention. However, widespread coverage has not revealed J Doe yet, including Wall Street Journal, New York Times, Central Florida television and print media, and other national publications for healthcare lawyers and executives.
U.S. Intervenes in Case Alleging Unnecessary Cardiovascular Procedures
Dec. 2014 — The United States intervened in my client’s case, United States ex rel John Doe v. Asad Qamar and Institute of Cardiovascular Excellence, MD Fla, 2011. My client alleged unnecessary catheterizations, and other unnecessary procedures.
Necessary catheterizations can save lives. But if you don’t need one, having a wire shoved in and around you risks many harms.
Whistleblowers like my client save taxpayers millions of dollars and in cases like these, whistleblowers can saves lives too. More here: www.justice.gov/opa/pr/government-intervenes-lawsuit-against-florida-cardiologist-alleging-unnecessary-peripheral
U.S. Intervenes in Community Mental Health Center Case
Oct. 2014 — The United States intervened on some individual defendants in my client’s case against a now-defunct CMHC (community mental health center), Biscayne Milieu, and various individuals. The Court unsealed our case in August, but by then there had been plenty of press on the criminal side, reporting arrests, pleas, trials, over 25 convictions, and sentences (including one for 50 years), and the Miami Herald reported new indictments against a doctor and others. Biscayne Milieu Attorney / Professor Joel Hesch, brought me in as local counsel on this.
Meridian Pays $5.12 Million in Whistleblower’s Kickback Lawsuit
Sept 2014 — Meridian Surgical Partners settleed a lawsuit claiming that it paid kickbacks to doctors. Thomas Reed Simmons, a manager at Treasure Coast Surgery Center, Stuart, Florida, one of Meridian’s subsidiaries, claimed that Treasure Coast paid kickbacks for Medicare and Medicaid referrals—a violation of federal law. The federal Anti-Kickback law prohibits payments to doctors for patient referrals. This law is often enforced through the federal False Claims Act, which permits courageous whistleblowers like Mr. Simmons to sue on behalf of the United States. This law lets ordinary people make companies repay fraudulently claimed money back to the government.
Whistleblowers can also get an award for bringing claims—from 15% to 30% of what the government recovers in a victory or settlement. “The False Claims Act rewards regular people who help fight waste, fraud, and abuse of their tax dollars,” said Jonathan Kroner, Mr. Simmons’ Miami lawyer. “Every year, the Federal government rewards whistleblowers who help the government recover billions in wrongfully-paid funds. It takes a lot of courage to come forward and fight your own employer, like Mr. Simmons did.”
Mr. Kroner helped Mr. Simmons bring the suit in May 2011, while he was still an employee at Meridian. They filed suit in Nashville with Michael Hamilton of the Provost Umphrey Law Firm. Later they brought in Sanford Heisler, LLC. The case had been set for trial on September 23.
Judge Denies Motion to Exclude Expert Witness in case alleging unlawful kickbacks paid by ambulatory surgical center owners to physicians to induce patient referrals. United States ex rel. Simmons v. Meridian Surgical Partners, LLC, 2014 U.S. Dist. LEXIS 71918 (M.D. Tenn. May 27, 2014). About a year ago Judge Campbell also denied defendants’ motion to dismiss. 2013 U.S. Dist. LEXIS 62729, 2013 WL 4098663 (M.D. Tenn. May 2, 2013). Co-counseling here with Ross Brooks and Michael Palmer at Sanford Heisler, LLP, New York, and Michael Hamilton, Provost, Umphrey Law Firm, LLP, Nashville.
Tenet’s Motion to Dismiss Denied. March 2013. Tenet Healthcare Can’t Dodge For lawyers: Memo in Opposition to Motion to Dismiss, 9/21/12, successfully arguing sufficiency of allegations and plausibility for AKS and Stark, “certification”, and Stark “financial arrangement;” Order at United States ex rel. Osheroff v. Tenet HealthCare Corp., 2013 U.S. Dist. LEXIS 44235, 4, 2013 WL 1289260 (S.D. Fla. 2013); and Memo in Opposition to MTD 4/23/12, successful issues include Rule 9(b) and public disclosure, 31 U.S.C. § 3730(e)(4), United States ex rel. Osheroff v. Tenet Healthcare Corp., 2012 U.S. Dist. LEXIS 96434, 27, 2012 WL 2871264 (S.D. Fla., 2012).
Published Article: The False Claims Act: Protecting Your Client When Amending a Sealed Complaint, American Bar Association, Litigation Section – Business Torts. Issues to consider when amending a sealed complaint. Written with Erin Campbell, Cincinnati; Jennifer McIntosh, San Francisco; and Shankar Ramamurthy, Chicago. Original here.
Judge enforces client’s $1.6 million settlement. August, 2013. Secured Federal Court Order enforcing $1.6M settlement in favor of my client, overturning Magistrate Judge’s recommendation, and notwithstanding DOJ and US Atty’s Office opposition, and defendant’s attempt to renege. United States ex rel. Osheroff v. MCCI Group Holdings, LLC, 2013 U.S. Dist. LEXIS 108741, 2013 WL 3991964 (S.D. Fla. 2013).
Judge grant’s $16 million default judgment and 27.5% Relator share. January, 2013. Judgment for $16 million. * Please know that my client has expressly consented to my disclosure of information that is otherwise publicly available.