Archive for 2018

Class Members Get Checks in Long Awaited Payday Lending Settlement

Payday lending class action settlement profiled in report on WFLA channel 8 in Tampa. Watch the video to see the story.  James Hoyer Partner Jesse Hoyer is interviewed.

Long-awaited Settlement:

$4.3 million payday lending class action settlement

After a nearly two decade long battle, a $4.3 million class action settlement is returning thousands of dollars to Florida consumers who took out pay day loans in the late 90’s.  More than 3-thousand Floridians are receiving checks in the mail this week to compensate them for exorbitant fees they paid for their loans. National Cash Advance and/or Advance America charged customers interest rates of nearly 400%, which left many trapped in a cycle of debt.

“This is long-awaited and well-deserved compensation for these class members,” said James Hoyer Partner Sean Estes, one of the attorneys representing the class.

Payday lending class member Stephanie Marshall

WFLA channel 8 in Tampa interviewed class member Stephanie Marshall about the settlement. She received a check in the mail for $1521.90 as compensation for $570 in fees she paid for loans she took out 20 years ago to make ends meet.

“I remember it like it was yesterday,” Marshall said.  “Every other Saturday I went from one place to the next, writing a check, paying the fees, rolling it over.”

Marshall says she is grateful to receive the check today, but advised others thinking about taking out payday loans not to do it.

“Don’t do it! I was like a rat chasing my tail.  I had to stop cold turkey to get control back,” she said.

More than 3000 class members receive checks

Payments to consumers range anywhere from a couple hundred dollars to more than $3,000 dollars, and include people in Tampa, Orlando, Miami, Jacksonville, and dozens of other cities in Florida and around the country. The class claims are for violations of the: Florida Lending Practices Act; Florida Consumer Finance Act; Florida Deceptive and Unfair Trade Practices Act; and Civil Remedies for Criminal Practices Act.

James Hoyer Partner Jesse Hoyer interviewed by WFLA

The victory is somewhat bittersweet.  While several thousand class members will receive long awaited and well deserved compensation, more than 100-thousand others who signed a mandatory, arbitration clause with the check cashing companies will not receive restitution, because the clause includes a class action waiver.  It’s important for consumers to understand the dangers of mandatory arbitration, as well as predatory payday loans, which continue in Florida and across the country, under some new restrictions.

“Mandatory arbitration is dangerous for consumers, because it takes away a lot of your rights. ,” said James Hoyer Partner Jesse Hoyer.  “You’ve got to be careful what you’re signing up for. Make sure you read and understand the terms.”

Click here to read the detailed class settlement notice.


$65 Million Prime Healthcare Whistleblower Settlement

Prime Whistleblower

Whistleblower’s Fearless 7-Year Pursuit of Justice:

Los Angeles, CA- August 3, 2018— The 5th largest for-profit hospital system in the country has agreed to pay $65 million to settle civil charges of healthcare fraud against the government. Prime Healthcare has also agreed to abide by a Corporate Integrity Agreement with strict requirements and oversight to ensure it will follow Medicare rules in the future. Prime, headquartered in Ontario, CA, has 45 hospitals in 14 states. It was a long-fought battle against the healthcare giant lasting nearly a decade, but whistleblower Karin Berntsen is grateful to finally see Prime held accountable.  Read More…


Puerto Rico Tackles Medicaid Fraud with the Passing of its own False Claims Act

The Commonwealth of Puerto Rico recently announced the enactment of House Bill 1627, simultaneously enacting a Puerto Rican False Claims Act and authorizing the establishment of a Medicaid Fraud Control Unit. The new law allows whistleblowers to report any fraudulent act against the Puerto Rican government.   Read More…


CFTC Announces First Whistleblower Award to a Foreign Whistleblower


The Commodity Futures Trading Commission (CFTC) recently announced a whistleblower award of more than $70,000 to a foreign whistleblower, a first of its kind award for a foreign individual who significantly contributed to an ongoing CFTC investigation that led the CFTC to a successful settlement. It’s the sixth award to a whistleblower who provided valuable information about violations of the Commodity Exchange Act (CEA). Read More…


CFTC Announces Its Largest Ever Whistleblower Award of Approximately $30 Million

The Commodity Futures Trading Commission (CFTC) announced its largest-ever whistleblower award of approximately $30 million today.  The CFTC wrote that the whistleblower “voluntarily provided key original information that led to a successful enforcement action.”   Read More…


CBS Premieres New Whistleblower Program

New CBS program. Premieres on Friday, July 13th, 8pm.

The courageous stories of whistleblowers are about to get some national recognition. CBS is launching a new true-crime series that takes a look at the contributions of whistleblowers in helping to stop fraud against the government. The name of the program is Whistleblower.

CBS says Whistleblower takes a thrilling look into the real-life David vs. Goliath stories of heroic people who put everything on the line in order to expose illegal and often dangerous wrongdoing when major corporations rip off U.S. taxpayers. Hosted by attorney Alex Ferrer, a former judge and police officer, each hour introduces cases in which ordinary people step up to do the extraordinary by risking their careers, their families and even their lives to ensure others are not harmed or killed by unchecked, unethical corporate greed.

The premiere episode will feature cases concerning a pediatric dental chain and a pharmaceutical giant.  It debuts Friday, July 13th at 8 PM on CBS.


Department of Justice Settles Two Large Lawsuits Alleging Healthcare Fraud

DOJ Whistleblower Attorneys

The Department of Justice recently settled two cases involving alleged violations of the False Claims Act by healthcare providers.

The Department of Justice issued a press release on June 25th stating that Caris Healthcare, L.P. and its wholly-owned subsidiary, Caris Healthcare, LLC, a for-profit hospice chain that operates in Tennessee, Virginia, and South Carolina, have agreed to resolve allegations that they violated the False Claims Act by knowingly submitting false claims, and knowingly retaining overpayments, for the care of patients who were ineligible for the Medicare hospice benefit because they were not terminally ill.

The Justice Department also announced on June 20th that Healogics Inc., a Jacksonville-based company that manages hundreds of hospital-based wound care centers across the country, agreed to settle allegations that it violated the False Claims Act by knowingly causing wound care centers to bill Medicare for medically unnecessary and unreasonable hyperbaric oxygen (“HBO”) therapy.

Caris Settlement

The settlement resolves allegations brought in a lawsuit by Barbara Hinkle, a registered nurse who formerly worked for Caris Healthcare, under the qui tam, or “whistleblower,” provisions of the False Claims Act, which permit private individuals to sue on behalf of the government for false claims and to share in any recovery.  The Act also allows the government to intervene and take over the action, as it did in this case.  The whistleblower’s share in the recovery will be $1.4 million.

The government’s complaint in intervention against Caris alleged that, in an effort to meet the aggressive admissions and census targets set by the company, Caris admitted patients whose medical records did not support a terminal prognosis.

The government’s complaint further alleged that when Caris was alerted to the ineligibility of these patients—via internal audits, concerns raised by its Chief Medical Officer, and recommendations of its nurse employees who actually examined the patients—Caris not only continued to submit hospice claims to Medicare for the patients, but also took no meaningful action to determine whether it had previously received improper payments for these and other patients that should have been returned to Medicare.

Healogics, Inc. Settlement

The allegations resolved by this settlement arose from a lawsuit filed by James Wilcox, a former Director for Research and Quality for Medical Affairs at Healogics, and a separate lawsuit filed by Dr. Benjamin Van Raalte, Dr. Michael Cascio, and John Murtaugh, two doctors and a former program director whom worked at Healogics-affiliated wound care centers.

Remarks from Relator Michael Cascio highlight the serious but rewarding nature of being a qui tam whistleblower, stating that:

I am happy with the result and glad to put this behind me. I feel vindicated because it’s a very lonely feeling to stand up for what you know is right and have almost everyone turn their backs and ignore you.

The settlement covered conduct from 2010 through 2015, when Healogics allegedly submitted or caused the submission of false claims to Medicare for medically unnecessary or unreasonable HBO therapy.

Hyperbaric oxygen treatments are generally utilized for decompression sickness but can also be useful in treating traumatic wounds and various skin ulcers.  Physicians of hospitals contracting with Healogics were reportedly doubling the amount of necessary hyperbaric oxygen treatments performed on Medicare patients as a result of the alleged up-coding scheme.

Acting Assistant Attorney General Chad A. Readler for the Justice Department’s Civil Division also commented on the settlement, stating that:

All providers of taxpayer-funded federal healthcare services, whether contractors or direct billers, will be held accountable when their actions knowingly cause false claims for medically unnecessary services to be submitted.

Under the settlement, Healogics agreed to pay $17.5 million, plus an additional $5.01 million if certain financial contingencies occur within the next five years, for a total potential payment of up to $22.51 million. Like the Caris lawsuit, these whistleblower lawsuits were filed under the qui tam provisions of the False Claims Act. The settlement could provide for a whistleblower share of up to $4.2 million.

If you have observed similar conduct in the hospice or wound care center industries, please contact us for a confidential case evaluation.


James Hoyer Investigator Speaks at Investigative Reporters & Editors Conference

Angie Moreschi (left) speaking on IRE 2018 panel with David Cay Johnston (center) and Roddy Boyd (right).

James Hoyer law firm Investigator and Communications Director Angie Moreschi spoke at the 2018 Investigative Reporters and Editors’ Conference held in Orlando this June.  The annual event is attended by many of the best investigative reporters in the U.S. and abroad. Angie shared her expertise on how whistleblowers can help reporters find fraud.

Joining Angie on the panel about Finding Fraud were best selling author and Pulitzer Prize winning investigative reporter David Cay Johnston and Founder of the Southern Investigative Reporting Foundation Roddy Boyd.

How Whistleblowers Help to Fight Fraud

Angie speaking about how whistleblowers help to fight fraud.

Angie shared important information about how whistleblowers help to expose fraud against the government and recover money for taxpayers.

The False Claims Act is the law that makes it possible for private citizens to file suit on behalf of the government when they become aware of fraud ripping off government agencies or programs.  Through these whistleblower suits, the Department of Justice recovered $3.7 billion, last year alone.

Angie explained that healthcare fraud is far and away the number one type of fraud against the government.  These cases include improper patient admissions, over-billing, and up-coding at hospitals;  kickbacks for referrals; selling unnecessary medical equipment; and pharmaceutical companies pushing the sale of drugs off-label.

(L to R) Angie Moreschi, David Cay Johnston, Roddy Boyd

Other top areas of fraud include for-profit colleges improperly seeking Title IV federal financial aid dollars, military contractors seeking Department of Defense money, and housing and mortgage scams targeting the Department of Housing and Urban Development and the Veterans Administration.

Angie also discussed how whistleblower lawsuits work and the history of the False Claims Act.

IRE is a grassroots, non-profit organization dedicated to improving the quality of investigative reporting.  Angie was an investigative reporter and IRE Medal award winner prior to joining the James Hoyer Law Firm.


Attorney General Sessions Delivers Remarks Announcing National Health Care Fraud and Opioid Takedown

Yesterday Attorney General Jeff Sessions delivered remarks on the Department of Justice’s nationwide effort to charge more than 600 individuals with health care fraud related to the opioid crisis.  This is the most significant effort yet in the administration’s quest to stem the opioid epidemic.  Read More…


SEC Proposes Whistleblower Rule Amendments

SEC Whistleblower Award

SEC Whistleblower AwardThe SEC voted today to propose amendments to its SEC Whistleblower Program rules.  The SEC Whistleblower Program was established in 2010 and provides that if an individual presents the SEC with original information concerning a violation of federal securities laws leading to an enforcement action that results in over $1 million in monetary sanctions, that individual is eligible to receive an award of 10% to 30% of the amount collected. Read More…