https://www.fraudwhistleblowersblog.com/ Member States of the European Union, over the last several years, have passed a series of so-called “Whistleblower Laws.” These laws are being implemented allegedly to bolster anti-corruption efforts throughout Europe. While corruption is no stranger to either side of the Atlantic, the European Union would advance their fraud fighting efforts exponentially by taking a focused look at the highly successful American False Claims Act.
France, Ireland, Italy, Greece, Germany, Netherlands, Sweden, Hungary, Lithuania, Malta, Slovakia, the United Kingdom, as well as others, have passed or amended some type of a putative whistleblower law. Here is the issue. None of these whistleblower statutes, in our opinion, contain the basic tenents of a strong and effective whistleblower program. The development of the whistleblower statutes within the United States of America illustrates the bedrock elements of an effective and successful whistleblower law.
In 1986, the U.S. Congress amended the existing whistleblower statute, the False Claims Act, which was passed during the American Civil War by President Abraham Lincoln. The 1986 Amendments to the False Claims Act included provisions that finally gave the law real fraud combatting teeth. Examining these 1986 Amendments (and even more recent Amendments) illustrates the changes needed in the European Union member States’ whistleblowing statutes. Without such robust amendments the European Union laws will never have a real and palpable impact on fraud, waste and abuse.
The American statute, known as federal False Claims Act, or the Qui Tam Law, has at its heart the following key provisions:
The United States has what is known as a “qui tam”[4] or whistleblower provision.
A whistleblower who comes forward and meets the statutory requirements is authorized by the statute to bring an action on behalf of the government and is entitled to receive a set amount of any settlement or judgment the government receives from the defendant from 15% to 30%. Read More
Marc S. Raspanti and Pamela Coyle Brecht will be speaking at the Compliance and Healthcare Conference in Paris, France on May 16-17, 2019. Mr. Raspanti and Ms. Brecht will be speaking on the topic of Health Care Fraud, Waste and Abuse Enforcement – American Style. The Conference is being held by The Institute of Risk & Compliance. To find more information on this conference, visit here https://www.institutriskcompliance.com/compliance-and-healthcare/. Read More
PITTSBURGH and PHILADELPHIA, PA (May 10, 2019) – Twenty Pietragallo Gordon Alfano Bosick & Raspanti, LLP attorneys were named to the 2019 Pennsylvania Super Lawyers and Rising Stars list, including founding partner William Pietragallo, II. These designations are awarded to lawyers who received the highest point totals in the Pennsylvania Super Lawyers2019 nomination, research, and review process, an honor reserved for only 5% of the Pennsylvania Bar.
In addition to Mr. Pietragallo, the following firm lawyers were acknowledged by the publication as 2019 Pennsylvania Super Lawyers: Gaetan J. Alfano, Joseph J. Bosick, Mark Gordon, P. Brennan Hart, Christopher A. Iacono, James W. Kraus, Michael A. Morse, Francis E. Pipak, Jr., Marc S. Raspanti, Douglas K. Rosenblum, John A. Schwab, Clem C. Trischler, and Paul K. Vey.
The following firm lawyers were recognized by the publication as 2019 Pennsylvania Rising Stars: John R. Brumberg, Joseph L. Gordon, Leslie A. Mariotti, and Douglas E. Roberts. The exclusive Rising Star list is comprised of only 2.5% of Pennsylvania attorneys who are 40 years of age or younger or have been in practice for 10 years or less.
Super Lawyers is a Thomson Reuters rating service of outstanding lawyers from more than 70 practice areas who have attained a high degree of peer recognition and professional achievement. The patented selection process encompasses a nomination, independent research of candidates, and a peer evaluation process. Selections are made on an annual, state-by-state basis. Read More
Members of the Firm were delighted to attend the Pittsburgh Parks Conservancy’s 21st Annual Spring Hat Luncheon on Sautrday May, 4th. The Luncheon raised more than $550,000 to benefit Pittsburgh’s green spaces. This was the first Spring Hat Luncheon in Allegheny Commons Park, Pittsburgh’s oldest park. The Pittsburgh Parks Conversancy, in partnership with the Allegheny Commmons Initiative and the Northside Leadership Conference, oversaw the design and construction of the recently restored Northeast Fountain in that park. The grand reopening of the Fountain was May 2. Read More
Roughly three out of four large U.S. employers utilize exit interviews, which are considered a low-risk, low-cost way to acquire valuable information. However, companies who approach exit interviews with an “auto-pilot” mentality may expose themselves to increased employment liability if they do not think strategically about how and why they conduct such interviews. Conversely, a robust exit interview program may reduce a company’s exposure to certain types of prospective liability, such as whistleblower claims. Likewise, exit interviews can combat against disclosure of a company’s trade secrets. Depending upon a company’s industry, culture and processes, conducting exit interviews may or may not be advisable. This article discusses some considerations to guide that decision-making process.
General Employment Liability Risks
Departing employees can, and do, raise allegations during exit interviews that create increased employment liability exposure. This often happens when a departing employee is interviewed by a human resources representative. Even though HR employees are most likely to conduct an exit interview, they often lack insight into the employee’s history at the company and may not be prepared to meaningfully respond to an allegation that is grounded in the departing employee’s daily experience.
For example, a departing employee may reveal that they had to pursue another job with better telework arrangements because their boss would not let them work from home, despite a medical condition that made teleworking desirable. Could that employee have a constructive discharge claim under the Americans with Disabilities Act due to a failure to accommodate? Perhaps. Will an HR representative be prepared to answer questions from the departing employee about why another employee in the same department was permitted to periodically work from home? Probably not. Given these potential risks, companies should assess whether their HR representatives have the time to investigate such issues (and whether they are actually likely to do so once an employee has left) before automatically embarking on an exit interview program. Read More
Charlotte, N.C. (April 24, 2019) – Mid-Atlantic Emergency Medical Associates (MEMA), an emergency medicine physician practice based in Charlotte, N.C., along with individual physicians Thomas L. Mason, M.D., and Steven G. Folstad, M.D., have filed an Amended Complaint in the U.S. District Court for the Western District of North Carolina alleging Health Management Associates, LLC (HMA) and its affiliates, now owned by Community Health Systems, Inc. (“CHS”), acted in concert with a national emergency physician staffing company, EmCare, Inc., and its affiliated entities, to defraud Medicare, Medicaid, other federally-funded healthcare programs, private healthcare insurers, and self-paying emergency room patients through medically unnecessary diagnostic tests and hospital admissions for the sole purpose of increasing HMA’s revenues.
When Dr. Mason, Dr. Folstad, and other MEMA physicians complained about and pushed back against these schemes, and took steps to stop HMA’s fraud, HMA retaliated by harassing and threatening MEMA and its emergency room physicians, ultimately terminating their contracts to staff the emergency rooms at CHS’ Lake Norman Regional Medical Center and Davis Regional Medical Center. EmCare, in order to benefit from a national preferred provider agreement with HMA, interfered with MEMA’s contracts – and was ultimately awarded an emergency room and hospitalist contract at Lake Norman Regional.
On September 23, 2010, Drs. Folstad and Mason first filed a sealed qui tam complaint in federal court in Charlotte, North Carolina alleging HMA and EmCare submitted or caused the submission of false claims to federal and state healthcare programs, in violation of the federal False Claims Act and analogous state false claims acts. Their case was later transferred to Washington, D.C., where a number of other cases against HMA and its affiliates were consolidated for investigation and resolution.
In December 2017, EmCare paid $33 million to the United States and named states to resolve the Government’s federal and state False Claim Act claims raised by the physicians’ allegations. Read More
The Government Enforcement, Compliance, and White Collar Criminal Defense Group, with the Allegheny County Bar Association, will host an important seminar for many executives – A Corruption Overview: It’s Not Always Cash in a Bag. For more information about this event, please be sure to check out our EVENTS section. Read More
Articles in This Issue:
The Current Landscape of Personal Jurisdiction in Pennsylvania
Risk Management Solutions for Construction Project Owners & Developers, Part 1
NLRB Issues Employer-Friendly Decisions Limiting Protections for Employee Complaints and Broadening the Definition of an Independent Contractor
The Road to the Future
Superior Court Holds Notice of Mechanics’ Lien may be Served by Fedex in Philadelphia County
Related Information:
Spring 2019 Edition Read More
Pietragallo Gordon Alfonso Bosick & Raspanti LLP is excited to announce Michael Morse will be participating in a panel discussion at the Health Care Compliance Association’s 23rd Annual Compliance Institute in Boston on April 7.
Mr. Morse will be discussing False Claims Act fundamentals and the panel will review recent court interpretations since the Supreme Court’s Escobar decision. The panel will also discuss recent decisions on determining “falsity” in medical necessity cases. For healthcare professionals with an eye on compliance, this is an event that should not be missed.
For more information on False Claims Act, please click here.
To attend the HCCA Compliance Institute and listen to the panel, please click here.
For more information about Mr. Michael Morse, please click here. Read More
An attorney is outside counsel to a midsized, closely held corporation. The attorney reports to a group of officers and directors. The client was just served at corporate headquarters with a grand jury subpoena in connection with a yet unknown fraud investigation. Although the client has been reliable and solvent for many years, the president of the company confides in counsel that the company is currently experiencing cash flow issues and cannot afford representation by counsel’s firm in this serious matter. Appropriately concerned that a new, less experienced attorney might not sufficiently protect the company’s interests, the president looks to outside counsel for a solution. Cutting counsel’s billable rate is not a viable option. Counsel thinks there might be another path: previously purchased and fully funded insurance policies.
Insurance proceeds allow many companies and executives to retain highly qualified counsel when they otherwise would not be in a financial position to do so. When a client calls a defense attorney upon receiving that subpoena and says he is afraid he can-not afford the attorney’s services, the attorney’s reaction need not be a rush to a list of contacts to refer the case to a colleague. Instead, hopefully, counsel will be able to explore insurance coverage with the client and obtain funding for the client’s defense.
An insurance policy’s main purpose is to indemnify an organization against certain enumerated liabilities. Insurers provide coverage through various types of liability policies, and companies are buying the coverage and faithfully paying these premiums. But are companies using the coverage they purchased?
Companies that own liability policies may not realize that they can look to that source for coverage of defense costs, expert fees, and other related litigation costs. Given that investigations and enforcement proceedings for white collar cases continue to be pervasive, defense counsel need to be “well-versed in insurance contracts and prepared to negotiate language that works for their clients.”1 Read More
