Various U.S. governmental agencies encourage reporting Medicare fraud. The Department of Health and Human Services (HHS) Office of the Inspector General maintains a hotline at 1-(800) HHS-TIPS. The HHS and the Department of Justice created a website entitled “Stop Medicare Fraud” (www.stopmedicarefraud.gov). This website also refers to the HHS Office of Inspector General Hotline, and also provides postal addresses and email addresses for reporting.
While well-intentioned, these may be inadequate vehicles for sophisticated insiders to report Medicare fraud and make something happen. The HHS tips hotline and the “Stop Medicare Fraud” website are for the most part directed to Medicare beneficiaries themselves, not insiders with knowledge of complex fraud issues. Moreover, the amount of tips and complaints actually fully and properly investigated is quite low.
Nolan Auerbach provides a complete evaluation/investigation for cases it accepts, and will provide initial feedback to determine whether or not fraud allegations are valid and qualify under the False Claims Act. Not every overpayment situation is necessarily fraud; some conduct resulting in overpayment to the Government is the result of oversight or negligence, or rogue employees. Unlike those situations, Nolan Auerbach is focused on intentional and widespread fraud that permeates the corporate culture.
Should you choose to contact us, or any other law firm, we suggest taking the following steps:
1. Document – Gather all relevant documentation which you are otherwise entitled to receive as part of your job duties. (Do not photocopy, download, or take any documentation to which you are not entitled to view, or is in violation of company policy or procedure);
2. Write a short summary of the fraud. This is important as the facts are fresh in your mind now, as opposed to years from now when you may be called to testify;
3. Make a list of all documents that are not in your possession but that you believe are relevant. Doing so now will be helpful to you to crystallize the facts, whether or not you file a qui tam lawsuit;
4. If your case involves an FDA regulated product, see How to Report FDA Fraud for more information.
Should you provide this information to Nolan Auerbach, we will engage in a thorough and confidential evaluation of the facts. We will follow-up on any relevant leads that you provide, and we will make sure that the law and regulations support a showing of the widespread fraud. We understand that a lot is at stake for you as a whistleblower, especially if you are a current employee.
Kathleen Hawkins, RN MSN, had been employed by Defendant, Catholic Healthcare West (CHW) for approximately 6 years when she decided she had had enough of trying to change the hospital system from within.
CHW, a California not-for-profit corporation that operated hospitals in California, Arizona, and Nevada, was at the time the eighth largest hospital system in the nation and the largest not-for-profit hospital provider in California.
Joe Strom contacted us in 2005. We were very grateful that he did. We immediately formed an all-star legal team and a process to stop a very harmful pharmaceutical marketing strategy. It was this process we set into motion that ultimately returned hundreds of millions of dollars to the U.S. Treasury, and a portion of that, very well-deserved, into Joe’s bank account.
Joe told us a very troubling story about the off-label promotion of a pharmaceutical drug for patients who already suffered from chronic heart failure.
Bruce Moilan was a seasoned hospital systems expert by the time he contacted our Firm. At the time he decided to file his qui tam lawsuit, he was employed by South Texas Health System as a System Director for Materials Management. In this position, he oversaw $24 million in annual purchases of supplies and equipment and helped determine budget, reduction and cost analysis throughout the contract bidding and negotiations process. His job was to insure proper implementation for purchasing, receiving and management of inventory, for McAllen Hospitals, L.P.