The Qui Tam Team Blog Join In the Fight Against Fraud

18Jun/100

Whistleblower in a Coal Mine

This post was written by Josh

Remember the story of the miners who died in the West Virginia coal mine before the story was overshadowed by the latest fossil fuel debacle? Well, a whistleblower has filed a federal whistleblower complaint claiming that Massey fired him in retaliation for pointing out safety violations at mines in West Virginia--including the one in which an explosion occurred on April 5th,  killing 29 miners. The whistleblower, Ricky Lee Campbell, is a sort of coal-dusted Cassandra.

Campbell filed a complaint with the Labor Department alleging that he was fired for his role in the federal investigation as well as for safety complaints he made to mine management.  Federal administrative law Judge L. Zane Gill agreed with Campbell, stating that there was "substantial evidence to support a reasonable cause to believe" that Campbell's complaints led to his firing.  The administrative law judge ordered Massey to temporarily reinstate Campbell, and the ball is now in the Labor Department's court to file a complaint seeking permanent reinstatement.

The harsh world of mining seems to lend itself to a wide array of egregious violations. If you're still fired up about mines, here's a shameless plug for the film North Country, which is the semi-fictionalized story of a group of women who had the guts to stand up to a mining corporation and bring a sex discrimination lawsuit despite outrageous threats and harassment. The lawsuit at the center of the film is based on Jenson v. Eveleth Taconite Co. The case was filed in 1988 on behalf of Lois Jensen and other female workers at EVTAC mine in Eveleth, Minnesota. Jensen began working at the mine in 1975 and endured outrageous sexual harassment. She quit working at the mine in 1992, and was diagnosed with post-traumatic stress disorder shortly thereafter. It wasn't until 1998, when another trial was set to begin following years of protracted litigation, that the company settled with 15 female plaintiffs for $3.5 million.

Both the Massey mine situation as well as the Eveleth sexual harassment suit illustrate that even in harsh, remote environments such as mines, concerned individuals can make a difference by letting their voices be heard. No matter how far underground you may be, there is always a path to the courtroom.

This article is brought to you by the QTT, the epicenter for whistleblowers and people interested in the False Claims Act, Qui Tam Provisions, and Medicare and Medicaid fraud. To discuss a potential case, please call Eric Young at 1 (800) 590-4116.

14Jun/100

Why is the IRS Sitting on its Hands?

This post was written by Josh

It has been more than three years since UBS whistleblower extraordinaire  Bradley Birkenfeld approached the DOJ, IRS, and SEC with information about potential tax evasion by U.S. clients facilitated by UBS AG. Since then, the IRS appears to have been sitting on its haunches and not making the most effective use of the information Birkenfeld provided. Whistleblower booster Senator Chuck Grassley (R-Iowa) has contacted the IRS, demanding an accounting of what, exactly, the agency has done with the seemingly incredible gift Birkenfeld gave it. Keep in mind that the only reward Birkenfeld has received so far for coming forward is jail time.

The main reason for Senator Grassley's concerns is that the Swiss Parliament this week rejected a deal made with the U.S. last August to hand over banking information on more than 4,000 wealthy American UBS clients suspected of tax evasion. In his letter to the IRS, Senator Grassley argues that the agency should not be sitting around waiting for treaties to be ratified. The agency has the information in its hands now, and Senator Grassley is concerned that it is wasting time while the Swiss government unravels its agreements with the DOJ. (Banking secrecy has until recently been ironclad in Switzerland, so the parliament may be rattling its legislative sabers a bit in an effort to shore up the nation's reputation).

If the entire Swiss parliament does not approve the deal with DOJ by June 18th, things could get really ugly for UBS. DOJ could revive a lawsuit to turn over 52,00 names (way, way beyond the 4,450 stipulated in the original agreement). If UBS failed to turn over the 52,000 names, it could end up facing fines amounting to millions of dollars per day of refusal. Furthermore, if UBS fails to turn over any of these names, it could face indictment.

Either way, the skies look rather stormy for UBS right now. This still doesn't explain why the IRS is not taking advantage of the leads Birkenfeld provided.  Perhaps Senator Grassley's letter will be enough to get a few accountants' motors running!

This article is brought to you by the QTT, the epicenter for whistleblowers and people interested in the False Claims Act, Qui Tam Provisions, and Medicare and Medicaid fraud. To discuss a potential case, please call Eric Young at 1 (800) 590-4116.

10Jun/100

A New Flavor: Ambulance Fraud

This post was written by Josh

There is fraud at all stages of the health care delivery process, and as a settlement in a district court case in the Eastern District of New York emphasizes, even ambulance companies are trying to get a bigger piece of that Federal pie, courtesy of you the taxpayer.

The case is

United States ex rel. Kaplan v. Metropolitan Ambulance & First-Aid Corp. et al., Civil Action No. 00-3010 (E.D.N.Y.).

According to allegations in a qui tam suit by the former CFO of one of the companies, Metropolitan Ambulance & First Aid Corp. (now known as SEZ Metro Corp.), Metro North Ambulance Corp. (now known as SEZ North Corp.) and Big Apple Ambulance Service Inc. (formerly known as United Ambulance), and the president of the companies, Steve Zakheim, used falsified records to appeal a Medicare refund demand. The situation is a bit convoluted, but what the companies were doing essentially consisted of the old health-care fraud standby: taking patients on unnecessary and expensive ambulance trips, and billing Medicare for the services. The government determined that these trips were in fact unnecessary and demanded a refund of the tens of millions of (tax payer) dollars that had been paid out. As is customary, an extensive appeals process was available.

However, Zakheim and his ambulance armada apparently didn't have the required proof to back-up their case on appeal, so they allegedly doubled their fun/fraud by submitting hundreds of forged letters verifying that the ambulance trips were medically necessary! The ROI was not so good here: Zakheim and the companies must pay $2.5 million in settlement money, not to mention the millions of dollars to be refunded. Vigilant whistleblower Larry Kaplan will pocket $618,450.

One has to ask: was it really worth it to engage in the fraud in the first place? This is yet another case in which the business logic behind some of the decisions seems to have been seriously lacking. The next time you see an ambulance speeding along (possibly with a bunch of cash flying out the windows) keep in mind that it might be following the  road to fraud!

This article is brought to you by the QTT, the epicenter for whistleblowers and people interested in the False Claims Act, Qui Tam Provisions, and Medicare and Medicaid fraud. To discuss a potential case, please call Eric Young at 1 (800) 590-4116.