Posts Tagged ‘whistleblowers’

James Hoyer Partner Leads Panel Discussion at TAF Conference

(L to R) Elaine Stromgren, Susan Gouinlock, Sean Keefe, Kristen Folding

James Hoyer partner Elaine Stromgren had the honor of leading a panel on statistical sampling at this year’s annual Taxpayers Against Fraud conference in Washington D.C.  Statistical sampling can be an essential tool in False Claims Act cases, especially when the fraud is too widespread to prove each false claim on an individual basis.

Elaine was able to successfully use statistical sampling to aid in settling the recent Prime Healthcare case for $65 million. She proposed the topic for this year’s conference and worked to assemble stellar panel members to share their expertise.

The distinguished panelists included attorney Susan Gouinlock, co-counsel in the Prime Healthcare Case, Assistant U.S. Attorney Sean Keefe (former James Hoyer partner), and statistics expert Kristen Folding of Amenity Consulting.

The panel discussed important aspects of statistical sampling to help relators’ counsel understand the basic concepts involved in developing an effective and reliable statistical sampling plan. They also tackled tough issues like aggressive challenges by defendants who have attacked sampling as a method to prove liability.  Attendees learned ways to overcome legal challenges to sampling and extrapolation.

As always, this panel and others at this year’s TAF conference provided a wonderful forum to share ideas and help fellow attorneys in our efforts to represent whistleblowers and fight fraud against the government.


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.


Whistleblower in IU Health Case Speaks at Annual TAF Conference

Dr. Judy Robinson speaks on TAF whistleblower panel

Dr. Judy Robinson, James Hoyer client and whistleblower in the $18 million IU Health/HealthNet case, spoke on the whistleblower panel at the annual Taxpayers Against Fraud Conference in Washington D.C. on November 3rd.  Dr. Robinson gave a powerful presentation talking about the important and sometimes difficult road whistleblowers face in order to do the right thing.

Dr. Robinson with James Hoyer Investigator & Communications Director Angie Moreschi

Dr. Robinson with James Hoyer Investigator & Communications Director Angie Moreschi

Dr. Robinson is a prominent Indianapolis Ob/Gyn and former employee of both IU Health and HealthNet, a Federally Qualified Health Center (FQHC) which primarily provides services to low income populations. She came forward as a whistleblower to expose what she believed was substandard care being provided to pregnant women and babies on Medicaid.  Her case was featured prominently in both local and national media, drawing attention to the need to protect those women and babies.  The Indiana Trial Lawyers Association will name her Consumer Advocate of the Year at their annual luncheon on November 7th.

Dr. Robinson’s qui tam suit alleged that IU Health and HealthNet violated Indiana Medicaid rules to save money by using CNMs, instead of doctors, to care for medically high-risk pregnant women.  She documented three instances of babies suffering permanent neurological damage and 17 “near misses” in just six months, as a result of care to high risk patients by CNMs. When her efforts to change the system fell on deaf ears, Dr. Robinson was ostracized and ultimately fired.  She then learned that billing for CNM care of high risk patients violates Indiana Medicaid rules and felt compelled to bring her information forward to the government.

TAF Chairman Neil Getnick, Dr. Robinson, and fellow whistleblowers Eben Steele & Don Galmines

TAF Chairman Neil Getnick, Dr. Robinson, and fellow whistleblowers Eben Steele & Don Galmines

Dr. Robinson, along with her attorneys from the James Hoyer Firm, ultimately secured an $18 million settlement from two of Indiana’s largest healthcare providers to resolve illegal kickback claims and and an additional $1.4 million for false billing claims.  In addition, HealthNet agreed to a Corporate Integrity Agreement with the federal government related to the kickback allegations, which required the clinic to restructure and maintain complete independence from IU Health.  In a written agreement, HealthNet also agreed to follow the rules and change its practice of having CNMs care for high risk pregnant women.  IU Health must submit to regular monitoring.


New Study Proclaims the Value of Whistleblowers

Whistleblowers are getting a pat on the back from a new study by a University of Iowa assistant professor of accounting.  The research by Jaron Wilde shows that these insiders, often former or current employees of a target company, have an impact in getting the companies to change their bad behavior.

New York Times reporter Gretchen Morgenson recently wrote about the study and interviewed Wilde. Here is an excerpt of her article:

For those who doubt that whistle-blowers are a force for good in corporate America — and yes, such skeptics exist — a new study out of the University of Iowa could not be more important. It demonstrates for the first time that financial shenanigans at companies decrease markedly in the years after truth tellers come forward with information about wrongdoing inside their operations.

Federal and state whistle-blower programs that award bounties to individuals providing tips about corporate fraud have grown in recent years. They are increasingly seen as a way to help understaffed regulators enhance their oversight of sprawling and complex corporations.

But the costs to whistle-blowers are high; they often face retaliation from their employers and are unable to find work because they are blackballed in their industry. These very real perils underscore the significance of the new research by Jaron H. Wilde, an assistant professor of accounting at the University of Iowa’s Tippie College of Business; he found a sharp and lasting drop in financial wrongdoing at companies that were subject to whistle-blower investigations.

The incidence of such tips appears to be rocketing. The whistle-blower program at the Securities and Exchange Commission, for example, heard from 4,218 tipsters in fiscal 2016, up 40 percent from the number who came forward in 2012.

Click here to read the rest of Morgenson’s article in the New York Times.


Better Year for IRS Whistleblowers in 2015

IRS Whistleblower Claims

IRS Whistleblower ClaimsThe IRS Whistleblower Program’s annual report to Congress for FY 2015 shows the IRS paid more than $103 million to whistleblowers in FY 2015. That is a big increase, nearly doubling the amount in awards granted in FY 2014, which was $52 million.

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