What Are Some Recent Examples Of Successful Qui Tam Lawsuits?

According to The U.S. Department of Justice, successful Qui Tam lawsuits under The False Claims Act exceeded $2 billion in 2022. There were a series of successful qui tam lawsuits across various sectors, including health care, military services, and COVID-related fraud.

Qui tam actions, enacted under the False Claims Act (FCA), enable private individuals to sue on behalf of the government when they witness fraudulent activities against the government. With these lawsuits, millions of dollars were recovered for the federal treasury, thereby restoring funds to crucial programs. These legal actions also helped ensure accountability and promoted the deterrence of future fraud.

Healthcare Fraud

Healthcare fraud remained a significant focus in 2022, with the FCA playing a crucial role in the settlements and judgments. One prominent case involved Gold Coast Health Plan, a Californian county-organized health system, along with three of its providers – Ventura County, Dignity Health, and Clinicas Del Camino Real, Inc.

They collectively paid $70.7 million to settle allegations that they knowingly submitted or caused the submission of false claims to California’s Medicaid program related to the “Adult Expansion” population. This settlement helped restore funds to critical healthcare programs and, equally important, sent a strong message to potential fraudsters about the consequences of fraudulent actions.

Protecting Servicemembers

In 2022, the government continued its pursuit of fraud matters associated with military and similar programs. Balfour Beatty Communities (BBC), which operates dozens of privatized military housing communities across the country, entered into a $35.2 million civil settlement.

BBC allegedly manipulated data, destroyed or falsified resident comment cards, and induced each service branch to pay for unearned performance incentive fees. Such fraudulent actions not only squander government funds, but can also put servicemembers and first responders at risk.

COVID-Related Fraud

2022 also saw a rise in COVID-related fraud following Congress authorizing historic levels of emergency funding for federal agencies during the pandemic. Among these, the Paycheck Protection Program (PPP) was targeted for improper payments. The Department of Justice pursued borrowers who received inflated or duplicate PPP loans or were otherwise not eligible for any PPP loan. Over the year, the Department resolved 35 False Claims Act matters, recovering over $6.8 million and avoiding more than $1.5 million in losses for the Small Business Administration tied to federal guarantees on improper loans.

In a significant case related to COVID-19 fraud, the Department of Justice targeted organizations misusing pandemic-related resources. MorseLife Health System Inc., a Florida-based entity overseeing a nursing home and an assisted living facility, settled with the United States by paying $1.75 million. The settlement resolved allegations that MorseLife arranged COVID-19 vaccinations for hundreds of individuals that were ineligible for the Centers for Disease Control and Prevention’s Pharmacy Partnership for Long-Term Care Program (LTC PPP).

This program was specifically intended to prioritize vaccinations for long-term care residents when vaccine doses were in limited supply. However, MorseLife was alleged to have facilitated vaccinations for members of its Board of Directors and individuals it targeted for donations to its private foundation, thus misusing the program for personal gain. This case illustrates the government’s commitment to ensuring the ethical and fair distribution of crucial COVID-19 resources during the global health crisis.

Holding Individuals Accountable

The False Claims Act was used to deter and redress fraud by corporations and individuals. A case of individual accountability involved Dr. Minas Kochumian from Los Angeles, California. Dr. Kochumian paid $9.5 million to resolve the allegations he submitted false claims to both Medicare and Medi-Cal.

These included injections of medication intended to treat osteoarthritis and osteoporosis, drainage of cysts, and removal and destruction of various growths. This case reaffirms the vital role of the False Claims Act in holding individuals accountable for fraudulent actions that undermine the integrity of federal healthcare programs.

Qui Tam Solutions at Berg & Androphy

These cases underscore the significance of qui tam lawsuits and their role in combating fraud. The successful resolutions of these lawsuits in 2022 have helped restore funds to federal programs, protect service members, first responders, and public health, and ensure that emergency funds for a global crisis are appropriately distributed.

The attorneys at Berg & Androphy are highly experienced in prosecuting qui tam litigation cases and handling international corruption cases. We proudly represent whistleblowers nationwide in numerous large-scale Medicaid/Medicare health care fraud cases, defense contractor cases, and other instances involving fraud against the government. Upholding these standards to maintain the integrity of our systems is paramount as we move forward.

If you have witnessed fraudulent activities and are considering a qui tam lawsuit, contact our expert team at Berg & Androphy today – let us help you in the fight for justice.