What We Do

We prosecute Healthcare Fraud (including Pharmaceutical Fraud and Medicare fraud) lawsuits for whistleblowers (“Relators”) under the qui tam provisions of the federal and state False Claims Acts. For approximately two decades, our law firm practice has been strictly limited to prosecuting healthcare fraud qui tam cases. We have full familiarity and experience with the statutes, regulations, and agency (FDA, CMS and OIG) views on the various areas of healthcare fraud.

Upon contacting us, if the information that you provide us fits our case requirements, we will immediately conduct a preliminary investigation. This includes verifying the information that you furnish to us, as well as obtaining more information. If we believe that there may be a substantial, provable case, we will investigate further utilizing all of the tools and resources that we have garnered over the years while exclusively prosecuting healthcare fraud for our whistleblower clients.

Once our investigation is complete, and we are retained by you, we will begin drafting the documents necessary to file the qui tam. This will include further fact gathering, legal analysis, and application of the law to the facts. The point is to make the case as complete and clear as we possibly can. Within this process, we draft the Complaint and what is called a Disclosure Memorandum. Upon further confirmation of the viability of the case, and after approval by our client(s) of the specific Complaint allegations, we will file the Complaint with the Court and serve it on the government attorneys. (A week or so before completing this process, we typically communicate with the Department of Justice and/or the U.S. Attorney’s Office).[SR1] 

The case is filed “under seal” in federal court. This means that neither the company the case is being filed against, nor anyone else other than the government, is informed. Similarly, our clients cannot disclose its existence directly or indirectly to anyone. Failure to keep the seal will result in Court sanctions and could lead to dismissal of the underlying qui tam case.

Because qui tam cases based on the same or similar allegations to an earlier case are subject to dismissal, it is critical to file the case first. The Relator (with sufficient information and details) that is first to file the case will be the only Relator who can pursue the case on the same allegations.

After a copy of the Complaint (and other material and information) is provided to the Department of Justice and the local United States Attorney’s Office, they then have a period of time (the “seal period”) in which they, and other agencies such as the Inspector General of the Department of Health and Human Services, the FDA, the FBI, and/or others can investigate the false claims. As part of the investigation, the government typically chooses to discuss the circumstances with our client(s). The meeting typically lasts no longer than one day.

The entire seal period typically lasts two to four years, but sometimes many more. During this period, in most cases, our clients take an active role in helping us contribute to the government investigation. This includes drafting document requests, providing inside information and strategy, reviewing and analyzing documents, and more. In rare cases, our client(s) may be asked to wear a wire or tape record telephone conversations (if they still work for the company). Wearing a wire or tape recording conversations is entirely voluntary.

If there will be a criminal investigation, we will receive few details on the who, what, when, where, and why of anything that the government has found. Because it is a criminal investigation, our clients are not entitled to such information. No Relator is. Even the civil side of the U.S. Attorney’s Office is not entitled to Grand Jury information, except upon successful application to the Court. Other than one’s own frustrations and emotions at not being able to find out what is going on in the criminal investigation, there is no adverse effect whatsoever to the qui tam lawsuit. This is one of the trade-offs in what we believe to be a tremendous process (qui tam) that has the potential to vindicate whistleblowers and pay them well for doing the right thing.

Next, whether the government decides to intervene or not, the seal is lifted, the company is informed of the allegations against it, and the lawsuit proceeds. The distinction in qui tam lawsuits, is that both the United States and our clients are co-plaintiffs. Your main responsibility at that point would be to appear for a deposition, assist us concerning any further information or analysis needed, and of course, if there is a trial, to attend and testify at trial.

These cases take years. There is no instant fix to the fraud, or a quick resolution to the qui tam lawsuit. We ask our clients after their cases are a couple of years old – to please have patience. It is difficult, but in our opinion, it is better for them to go on with their lives, keeping busy with jobs, family, outside interests, and so on. For more information, please see:

  • Whistleblower HIPAA Concerns – explains the provision of the Health Insurance Portability and Accountability Act which authorizes whistleblowers to divulge certain confidential information when exposing fraud.
  • Whistleblower Protection – gives an overview of how whistleblowers are protected if their employers retaliate against them.
  • Whistleblower Rewards – gives an overview of how rewards are calculated under the False Claims Act.

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