The Qui Tam Team Blog Join In the Fight Against Fraud

30Jun/100

Crankin’up the HEAT

HEAT is the rather odd acronym for the Health Care Fraud Prevention and Enforcement Action Team. It is the brainchild of Attorney General Holder and Health and Human Services Secretary Sebelius, and despite the great stretches of the imagination it takes to make it work as an acronym (HCFPEAT doesn't exactly roll off the tongue), it seems to be taking a bite out of health care fraud.

HEAT is a coordinated effort between DOJ and HHS, and it has a Medicare Fraud Strike Force that has been going around various cities busting health care fraud perps. It's operating in various locations, including South Florida, but no, you are not likely to see Attorney General Holder wearing a Miami Vice suit and driving a go-fast boat into a medical center.

In recent testimony given before the House Ways and Means Subcommittee on Health and Oversight, Edward Siskel, the Associate Deputy Attorney General, stated that since May 2009, the Strike Force has been putting fear in the hearts of health care fraudsters. Strike Force prosecutors have filed over 120 cases charging more than 290 defendants and have obtained 16 convictions. The Strike Force also appears to have had a deterrent effect. In the twelve months since the Strike Force was announced, the Miami area has seen an almost $2 billion reduction in durable medical equipment submissions compared to the preceding 12 month period.

Deputy AG Siskel also notes in his testimony statistics all too familiar to qui tamers: the bulk of the DOJ's civil case load comprises suits against drug and medical device makers. Qui tam suits have proved to be an important weapon in the DOJ's fraud-fighting arsenal, and have helped the government to recover $24 billion since 1986. This goes to show that the civil justice system is just as important as the swaggering Task Force in the fight against health care 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.

23Jun/100

Foot Dragging on the Gulf Spill

It remains to be seen whether the Gulf oil spill will become Obama's Katrina. A recent New York Times/CBS News poll indicates that at the very least, some people believe that Obama is not doing enough to fix things in the Gulf. The poll found that 59% of respondents do not believe that the President has a clear plan for cleaning up the spill. In addition, the majority of respondents believe that more regulation of offshore drilling is needed. Interestingly, at the same time, the majority of those polled also indicated that they believed that the  accident was a result of a failure on the part of the federal government to enforce regulations rather than inadequate regulation.

Criticism continues to be heaped on the federal agency responsible for ''regulating'' off-shore drilling, the Minerals Management Service (MMS), and rightly so. A new report, also in the New York Times, finds yet another maddening instance of MMS' appalling failure to fulfill its mandate. A device known as a blind shear ram was in place at the Deepwater Horizon well, and was supposed to be the last line of defense in preventing a blow-out. Of course, it failed. What is particularly infuriating is that MMS ignored its own experts as to how the risk of blind shear ram failure could be minimized.

There have been some major changes at MMS, so hopefully it won't be business as usual once the country forgets about off-shore drilling again. The new director of MMS is Michael R. Bromwich, who used to be an inspector general over at DOJ (the same guys will intervene in your qui tam case, if you're lucky!). The new agency will have a quick-response, SWAT team-like unit that will supposedly be able to respond with alacrity to allegations of crooked officials or misbehaving companies. The new investigative unit will have its work cut out for it. The old MMS could not be described by any stretch of the imagination as ''ethical.'' Doing crystal meth and then going out to do inspections? Why not? Going huntin' and fishin with on the oil company's dime? Yup. Inspecting drilling platforms of the oil company with which you're simultaneously negotiating for a job? Why the heck not? (Don't forget the crystal meth!).

This is all to say that the level of corruption in this agency is absurdly hilarious, and it will likely be very difficult both to root it out and prevent it from re-occurring, fungus-like, in the future.

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?

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.