What Are the Best Whistleblower Lawsuits

The term qui tam is an abbreviation for the Latin phrase, "qui tam pro domino rege quam pro se ipso in hac parte sequitur," which means "Who sues on behalf of the King as well as for himself." A qui tam lawsuit is an action where an individual with knowledge of harmful activities can bring forth a lawsuit on behalf of the government. In this type of action, the individual bringing the lawsuit is called a relator. Yet, the plaintiff is the government, not the relator. The government can choose to be part of the qui tam action or leave it to the private relator and their legal team. However, the relator can get financially rewarded if successful. First, let's look at how qui tam actions are protected under the False Claims Act.

The False Claims Act (FCA) came to be in 1863 when Congress became concerned that the Union Army suppliers of goods were defrauding the Army during the Civil War. The FCA stipulates that any person who intentionally submits false claims to the government would be liable for double the government's damages, plus an additional $2000 penalty for each false claim. The FCA has been strengthened several times since its inception. Most notably, in 1986, damages were increased from double to treble, and penalties were increased from $2000 for each abuse to $5000 to $10,000.

Twenty-nine states, including the District of Columbia, have false claim acts with provisions for qui tam actions that enable whistleblowers to initiate lawsuits on behalf of the state government and recover financial awards for their courage. Most state FCAs look very similar to the federal FCA; however, eleven state FCAs only apply to false claims submitted that concern fraud against the state's medical assistance programs. Those states are Colorado, Connecticut, Georgia, Louisiana, Maryland, Michigan, New Hampshire, Oklahoma, Texas, Washington, and Wisconsin.

A successful qui tam action could enable the relator to receive up to 30% of the government's award. It's common for a qui tam action to have more than one relator, and there may be multiple defendants. For example, fraud involving Medicaid and Medicare may involve dozens of states.

The foundation of any qui tam action is that there is proof of fraud or other misconduct covered by the whistleblower reward programs. A whistleblower does not need to be an eyewitness to the alleged fraud or misconduct, but they must have irrefutable evidence it transpired. Suspicion and hunches aren't enough. Having concrete and specific facts will bolster your claim. Typically, you'll need to provide the government with information they are unaware of, so information readily found on the internet or other media won't be sufficient. However, suppose you have information that is strengthened by public knowledge. In that case, you may be able to use this information to demonstrate fraud.

Documentary evidence can be vital. Emails, chats, billing records, voicemails, internal communications, internal studies, and more can go a long way to prove your allegations. Suppose you feel that you may have evidence to expose fraud or corruption. In that case, speaking with a lawyer whose expertise falls under whistleblower claims is crucial. These types of legal actions are far different from what most attorneys are used to handling in civil lawsuits. At Morgan and Morgan, we have experienced qui tam action lawyers who can guide you through the entire complicated and lengthy process.

We know how to present your information to entities in a compelling manner and provide robust assistance to the government while ensuring you get the maximum award possible. We will also make sure you understand and take advantage of the protections guaranteed under the FCA.  

During the 2021 fiscal year, the Justice Department's FCA settlements and judgments exceeded $5.6 billion. The bulk ($5 billion) of these concerns health care industry fraud. Whistleblowers filed 598 qui tam lawsuits in 2021. Here are some 2021 examples to answer, "what are the best whistleblower lawsuits?"

Fighting the opioid epidemic - Thousands of Americans die from opioid overdoses yearly. Parties responsible for triggering and inflaming the epidemic were held accountable. Prescription opioid manufacturer, Indivior, agreed to pay $209.3 million to the federal government to resolve civil allegations that the company engaged in the promotion of their opioid-addiction treatment drug called Suboxone to physicians who were giving out the prescriptions for uses that were not acceptable. The manufacturer further made false and misleading claims about their medication, indicating it was less likely to be misused or abused.

Opioid manufacturer Purdue agreed to a $2.8 billion bankruptcy claim to resolve its civil allegations. The company was accused of providing kickbacks to physicians, specialty pharmacies, and an electronic health records developer to expand the use of its opioid products. Members of the Sackler family who sat on the board and were shareholders in the company paid an additional $225 million in connection to a new marketing program they had approved that increased the marketing of OxyContin to high-volume prescribers, which fanned the flames of the opioid epidemic.

Medicare Part C fraud - In this program, healthcare providers and plans are paid based on various risk factors that impact the provider's expenditures. The department found wrongdoers manipulating the risk adjustment system through the submission of unsupported diagnosis codes to make patients appear more ill than they actually were. Sutter Health paid a $90 million settlement to resolve allegations it submitted false diagnosis codes to inflate its payments. Kaiser Foundation Health Plan paid $6.3 million for its similar fraudulent activities.

Unlawful kickbacks - In the healthcare industry, kickbacks threaten to subvert medical decision-making and increase costs for us all. Arriva, a mail-order diabetic testing supply company, paid $160 million for kickbacks to Medicare beneficiaries by providing free medical devices and not making reasonable efforts to collect copayments for testing supplies.

Daniel McCollum paid $140 million for paying unlawful kickbacks to providers in an effort to get them to use his urine drug tests over competitors. Athenahealth Inc, an electronic health records vendor, paid $18.25 million for its practice of inviting potential clients to all expenses paid sporting, recreational, and entertainment events. Taro, Sandoz, and Apotex paid over $400 million for paying and receiving compensation as part of a drug price-fixing conspiracy.

Unnecessary medical services - Medical providers and health care programs were under scrutiny for providing unnecessary medical services and services not rendered as billed in 2021. SavaSeniorCare LLC paid $11.2 million for aggressively targeting businesses to use rehabilitation therapy services for their Medicare patients that were unneeded, unwarranted, and administered by unskilled staff.

Alere paid $48.75 million for billing for and causing others to bill Medicare for defective rapid point-of-care devices used by Medicare beneficiaries. Patients used the devices to monitor blood coagulation when using anticoagulant drugs. Apria Healthcare LLC agreed to pay $40.5 million for the submission of false claims for the rental of expensive non-invasive ventilators to Medicare beneficiaries who did not use or need to use the devices.

St. Jude Medical Inc. paid out $27 million for allegations that it knowingly sold faulty implantable heart devices and did not disclose serious health risks in connection with premature battery depletion in the devices. Regency, Inc. agreed to pay up to $20.3 million to settle claims that it falsified documents to bill federal healthcare programs for medically unnecessary equipment.

Procurement fraud - Committing fraud related to the government purchase of goods and services is a top priority of the Justice Department. Navistar Defense LLC paid $50 million for allegations that it defrauded the U.S. Marine Corps, causing it to enter into an agreement for a suspension system component for armored vehicles at inflated prices. Insitu Inc. paid $25 million for knowingly submitting false cost and pricing data for contracts with the U.S. Special Operations Command and the Department of the Navy to supply and run Unmanned Aerial Vehicles.

In other cases, the department went after government contractors that failed to comply with contract requirements. For example, United Airlines paid $32.1 million for failure in its contract with the U.S. Postal Service to deliver international mail on behalf of the government. Cognosante LLC paid $18.9 million for using unskilled labor and overcharging the government. AAR Airlift paid $11 million for its failure to maintain nine helicopters and for erroneously certifying the helicopters were fully mission capable.

Kickbacks on government contracts were also under scrutiny. Level 3 Communications LLC paid $12.7 million for taking kickbacks from two subcontractors for more favorable treatment on government contracts. Schneider Electric Buildings Americas Inc. paid over $9 million after allegations that a senior project manager solicited kickbacks from subcontractors and defrauded the government for design costs.

Covid-related fraud - The misuse of pandemic relief funds has drawn the critical eye of the Justice Department. Improper payments and misuse of Paycheck Protection Program (PPP) funds included businesses that fraudulently claimed they had not received a PPP loan. Dr. Walia falsely certified on behalf of his practice that the medical practice had not received a previous loan. He had to repay the loan and paid $70,000 under the FCA.

Sextant Marine Consulting LLC, a duct cleaning company, paid $30,000 for a second improperly obtained PPP loan. Finally, Seth A. Bernstein, a jet charter company owner, paid $287,055 for using PPP funds for personal expenses unrelated to his business.

When looking for a list of the best whistleblower lawsuits, it's important to remember the success of a whistleblower lawsuit may come down to your legal representation and the evidence you have. You can remain anonymous while the investigation is underway, and the FCA protects you from retaliatory actions after the investigation and legal proceedings are complete. Whistleblower cases are extraordinarily complex and can be drawn out.

You may need to gather more evidence for which we can provide guidance on how to procure. Exposing corruption takes courage, and you should be rewarded for your efforts. Morgan and Morgan qui tam lawyers will help you every step of the way in your pursuit of justice. Contact us today for a free and confidential case evaluation.