Here are stories of whistleblowers in a variety of circumstances who were represented by Phillips & Cohen attorneys. These whistleblowers exposed Medicare fraud, defense contractor fraud as well as Wall Street fraud.
The decision on whether to file a False Claims Act (qui tam) lawsuit or a whistleblower claim with the US Securities and Exchange Commission or Commodity Futures Trading Commission whistleblower programs is never an easy one, despite the reward and job protection whistleblower laws offer.
But many people decide to become a whistleblower because it’s the right thing to do or because they fear that the wrongdoing could cause others to suffer harm.
Sometimes it’s helpful for those who are considering becoming a whistleblower to read about the experiences of other whistleblowers. It’s also helpful to talk to lawyers who have extensive experience with whistleblower cases. With more than 30 years experience of handling only whistleblower cases, Phillips & Cohen helps prepare clients to know what to expect before a whistleblower case is filed and can provide advice on how best to meet the challenges that may arise.
Whistleblower advice from a whistleblower who was represented by Phillips & Cohen has good advice for those trying to figure out whether and how to proceed. This website has many other tips for whistleblowers to consider.
One of the best-written books about qui tam whistleblowers is Giantkillers: The Team and the Law That Help Whistle-blowers Recover America’s Stolen Billion by Henry Scammell. The book focuses on several whistleblowers and their qui tam cases, a number of which were brought by Phillips & Cohen attorneys.
Gloria Pryor, Michael Payne and Melissa Church worked at an Adventist Health System hospital in North Carolina in various administrative capacities. Together the three employees, represented by Phillips & Cohen, brought a qui tam lawsuit alleging Adventist paid doctors for improper referrals to the hospital system. Adventist paid the government $118.7 million in 2015 to settle the lawsuit. Read their story in Health System Specialist’s feature on whistleblowers.
Robert Baker was a revenue manager in Community Health Systems’ Tennessee headquarters who alleged in a qui tam lawsuit that CHS was engaged in a scheme that improperly increased federal Medicaid payments to its three New Mexico hospitals. CHS paid a total of $75 million to the government in 2015 to settle the whistleblower lawsuit, which Phillips & Cohen LLP filed on Baker’s behalf. Read about his experience as a whistleblower in Healthcare Finance Specialist.
Dr. Michael Mayes blew the whistle on kickbacks paid to doctors by three medical labs and a healthcare marketing company. He provided important testimony at trial that resulted in the former CEO of Health Diagnostic Laboratory and the owners of the labs’ marketing partner, BlueWave, being ordered to pay $114 million in civil damages and penalties. Read the story of Dr. Mayes, published by The State, a Columbia, SC, newspaper.
David Barbetta alleged in a whistleblower lawsuit that DaVita paid doctors hidden kickbacks as a way to get patient referrals for its dialysis clinics and to reduce or eliminate competition from other dialysis centers. DaVita paid $400 million to the federal government and various states to settle the case. Read his story from The Denver Post.
Matthew Burke was a former sales executive for GlaxoSmithKline whom Phillips & Cohen represented along with another Glaxo whistleblower in a qui tam case alleging off-label marketing. Their whistleblower case was responsible for most of Glaxo’s $3 billion settlement in 2012. The Glaxo settlement is the largest False Claims Act settlement ever and the nation’s largest healthcare fraud settlement. Read his story from Lawdragon.
John Kopchinski was a former pharmaceutical sales representative who brought a qui tam case against Pfizer Inc., alleging the pharmaceutical company was engaged in off-label marketing of Bextra, a pain-killer, in dangerous doses and for unsafe uses. As a result of his case, Pfizer paid $1.8 billion in civil and criminal penalties as part of a $2.3 billion Medicare fraud settlement with the government. Read his story by Reuters.
Julie Darity was a former contracts administrator for C.R. Bard, a multinational medical device company, who pursued a qui tam lawsuit after her complaints made internally about alleged kickbacks to doctors were ignored. Bard paid the federal government $48.2 million, and Darity received a reward of 21 percent of the recovery. Read her story from The Macon Telegraph.
When Joseph Gerstein was medical director for Tufts Associated Health Maintenance Organization, he received a sales pitch from two TAP representatives that rubbed him the wrong way. Enraged by the “blatantly illegal” sales pitch, Gerstein opted to file a whistleblower lawsuit against the company. That lawsuit lead to an $875 million settlement, which was at the time the largest healthcare fraud case ever. Read more about Gerstein’s story as covered by the Chicago Tribune.
Robert E. McCaslin Jr. was a hospital employee who exposed a hospital’s practice of billing Medicare and Medicaid for the treatment of patients who weren’t covered by the federal health programs. McCaslin received a whistleblower reward of $3 million based on the $15 million settlement Harris County Hospital paid to the government to settle his qui tam case. Read his story from the CBS Evening News.
Judith King was a registered nurse whose qui tam case alleged Sharp Memorial Hospital had defrauded Medicare by filing fraudulent claims for reimbursement for costs associated with its heart and kidney transplant centers. The hospital paid the government $6.2 million to settle the case. King received 20 percent of the government’s recovery as a whistleblower reward.
Michael Lissack was an investment banker who revealed Wall Street’s practice of “yield burning” in the municipal bond market. His cases against various investment banks helped the government recover more than $200 million. Read his story from The New York Times.
James Alderson was a former hospital executive who uncovered Medicare fraud by the nation’s largest for-profit hospital chain and the country’s largest hospital management company. Alderson shared in two separate awards for his information and work on the case, which was a substantial part of HCA’s $1.7 billion settlement, a record at that time. Read his story from The New York Times.
Emil Stache was a manager for a defense contractor that was defrauding the Pentagon. The government recovered $88 million as a result of Stache’s whistleblower case, and he received a whistleblower reward of 21.5 percent of the recovery. Read his story as told to a Senate subcommittee.
Dr. Paul Michelson was an eye surgeon who brought the first qui tam case under the 1986 False Claims Act Amendments. He filed his lawsuit against an eye clinic and a fellow surgeon alleging Medicare fraud, which they paid the government $355,000 to settle. Read his story as told to a Congressional subcommittee.