News & Cases

The Securities and Exchange Commission’s (SEC) record-breaking enforcement numbers reported for fiscal year 2016 highlight the importance of securities fraud whistleblowers in combatting misconduct and illegal activity.

The agency played hardball against securities fraud this year, implementing innovative data and analytics techniques to detect suspicious activity and investigate investment advisors, accountants, companies and their C-Suite leaders.

Whistleblowers across the globe aided in uncovering misconduct and contributed heavily to the overall success of the SEC’s fight against fraud....

The government has joined a False Claims Act lawsuit against Energy & Process Corporation (E&P), which was filed by whistleblower Deborah Cook. According to the qui tam (False Claims Act whistleblower) lawsuit, E&P supplied defective reinforcement bar (rebar) for the construction of a nuclear processing facility in the Department of Energy’s Savannah River site in South Carolina.

Georgia-based E&P received millions of dollars from the federal government to perform critical safety work on rebar that was used to build the Savannah River Site facility, also known as the MOX Facility, which was designed to process nuclear waste. As the lawsuit states, because of the hazardous nature of the radioactive material, the facility was “required to be built to withstand earthquakes.”...

In October 2015, whistleblower James Thomas Webb received a $3,115,000 cash award after filing a False Claims Act (FCA) lawsuit alleging Boeing Company submitted false claims for labor charges on C-17 maintenance contracts. Boeing paid a total of $18,115,000 to settle the allegations.

Mr. Webb is not the only Boeing employee who has brought a whistleblower lawsuit against the world’s largest commercial jetliner and military aircraft producer. The Project on Government Oversight’s Federal Contractor Misconduct Database reports 66 instances of misconduct since 1995. Boeing has racked up over $1,456,789,469 in penalties in that time. For decades, Boeing has continued to violate U.S. rules and regulations, wasting taxpayer dollars and putting our nation’s citizens and armed forces at risk....

A whistleblower lawsuit has accused the Visiting Nurse Service of New York (VNSNY) of defrauding Medicaid and Medicare and receiving millions of dollars for care ordered by doctors, which the patients never received. According to the allegations, VNSNY systematically billed for the full number of nursing and rehabilitation visits ordered by doctors, but patients received only a fraction of them.

The lawsuit was initiated by whistleblower Edward Lacey, VNSNY's former VP of Operations Improvement and Integration, who had been with the organization for 16 years. Investigations into fraudulent conduct are, however, nothing new for the healthcare provider Visiting Nurse Service of New York. In 2014, VNSNY paid the government $35 million to settle a lawsuit alleging that it had enrolled over 1,700 ineligible individuals into Medicaid plans.

Under the False Claims Act, whistleblowers such as Edward Lacey who have information about fraud against the government can file a lawsuit on the government's behalf and are entitled to a portion of any received damages and civil penalties. Whistleblower rewards range from 15 to 30% of the total recovery....

Sylvia Daniel, a former health information coder at Vibra Hospital of Southeastern Michigan, will receive a whistleblower award of at least $4 million after filing a qui tam lawsuit alleging the hospital billed Medicare for medically unnecessary services, the Department of Justice announced Wednesday. Vibra Healthcare LLC, a Mechanicsburg, Pennsylvania-based national hospital chain, has agreed to pay $32.7 million plus interest to resolve claims its facilities violated the False Claims Act.

“Medicare beneficiaries are entitled to receive care that is determined by their clinical needs and not the financial interests of healthcare providers,” said Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department’s Civil Division, commenting on the settlement of Sylvia Daniel’s whistleblower lawsuit against Vibra Healthcare.

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

The United States filed a False Claims Act lawsuit against Brentwood, Tennessee-based Vanguard Healthcare LLC., alleging the company submitted false claims to Medicare and TennCare, provided either non-existent or “grossly substandard” care for elderly patients in six of its Tennessee nursing homes, and forged signatures on required nursing facility Pre-Admission forms, the Department of Justice announced today.

Nursing Home Residents Suffer Non-Existent, Substandard Care

According to the False Claims Act lawsuit, between January 2010 and December 2015, six Vanguard Healthcare nursing homes exhibited ongoing staffing and medical supply shortages, failed to practice standard infection control procedures, failed to deliver prescribed medications, failed to follow physicians’ orders in caring for wounds, failed to practice proper pain management, gave “unnecessary and excessive” psychotropic medications to residents and used unnecessary physical restraints....

Louisville-based post-acute care provider, Kindred Health Care, Inc., has paid the largest penalty ever imposed by the Office of the Inspector General (OIG) for failing to comply with a corporate integrity agreement (CIA). The record penalty amounted to over $3 million, the Department of Health and Human Services’ (HHS) Inspector General Daniel R. Levinson announced today.

OIG Imposes CIA In Exchange for Exclusion from Medicare Program

Kindred Health Care provides hospice services for Medicare patients with life expectancies of six months or less. Patients receiving hospice care agree to cease curative care and only receive palliative care to lessen their symptoms....

You don't have to be a U.S. citizen to get a whistleblower award. The U.S. Securities and Exchange Commission (SEC) has paid an Australian and former BHP Billiton employee a $3.75 million whistleblower award for reporting the company’s violations of the Foreign Corrupt Practices Act at the Beijing Olympics, the Sydney Morning Herald announced Monday.

First Time SEC Pays Whistleblower Award to Australian Employee

The BHP Billiton case marks the first time the SEC has paid a whistleblower award to an employee of an Australian company. Under the Sarbanes-Oxley Act, the SEC offers whistleblowers cash awards for tips leading to successful government recovery. The Australian government does not offer whistleblower rewards or protections to its citizens, and the case is causing regions of Australia to evaluate the possibility of implementing its own whistleblower laws....