In March, 2017, a whistleblower case in Florida with three unusual characteristics concluded with the awarding of triple damages, turning the over-$115 million award into $347 million. While the damages figure is certainly astonishing because it is much larger than average, the high award is not the only reason that the case was out of the ordinary.
Florida Nursing Homes Guilty of False Claims
A registered nurse who consulted between January and May of 2011 at two different nursing homes run by CMC II, LLC, and related parties, blew the whistle in this case. Angela Ruckh claimed that the various parties involved in the wrongdoing intended to defraud the U.S. and the state of Florida of funds provided by Medicaid, Medicare, and TRICARE.
Specifically, Ruckh alleged that the business model employed by CMC II resulted in pressure on employees to establish targets for profit-raising reimbursement rates at all of the 53 skilled nursing facilities in Florida operated by CMC II and related parties. This pressure meant that the records were falsified in various ways, such as by overstating the medical needs of residents and correspondingly overstating the levels of care they received. Ruckh also claimed that written care plans were not in place, which led to inadequate staffing and insufficient patient care. Not completing written care plans for Medicaid residents is a violation of both federal and Florida regulations.
In February, 2017, a jury declared CMC II liable for over $115 million. The judge proceeded to triple the damages to $347 million. Even though the U.S Department of Justice had declined to intervene in the case, Ruckh and her lawyers brought the case. For her trouble and persistence, she could receive a whistleblower award of over $104 million. That is, unless the defendants are successful in their post-trial motions now before the Court. Their motion to stay execution of the judgments was granted pending disposition of other motions.
Why Was the Case Rare?
Most FCA cases are settled before they come to trial. However, this case, which went all the way through the trial process, also received a jury verdict. These two facts, plus the enormous award, make the case a rare bird.
It often happens that insiders are the ones who are best suited to become whistleblowers. Because they know what should and should not be happening, they can see the gaps in compliance when it comes to the laws regulating claims and billing for Medicare, Medicaid, and TRICARE patients. As in this case, professionals notice whether appropriate services are actually being provided, whether such services are medically necessary, and whether false claims are being submitted.
Working with whistleblowers tirelessly to shed light on fraudulent practices.
If you think you have the facts needed to bring a whistleblower case, the experienced whistleblower attorneys at the Louthian Law Firm can review your case and help you file the appropriate disclosure statement. Under some circumstances, the government will intervene, or join in your lawsuit.
Your chances of succeeding are greater if your whistleblower claim is substantive, clear, and to the point. Because of this, meeting with a qualified whistleblower attorney can increase your chances of winning. The Louthian Law Firm can help you form your claim so that the government will be more inclined to intervene in your case; government intervention can sometimes increase the chances of recovering reward money. Even if the government decides not to intervene, it could still be a good idea to pursue your case without government involvement. Our strong support system can assist you through every step of the process.
For a free, confidential evaluation of your case, call the Louthian Law Firm today at 1-803-454-1200 or, if you prefer, you can fill out our online contact form.