When Inside Knowledge Is a Handicap to a Whistleblower

Here’s a riddle: The whistleblower is a former employee of the defendant, with inside knowledge of the operations at the heart of his qui tam suit.  How can that inside knowledge be a handicap in pressing his claim?  A June 21 decision by a Massachusetts federal court provides an answer and an …

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Court Rejects Qui Tam Attack on Standard On-Call Contract

On June 10 the Third Circuit affirmed a lower court’s dismissal of a physician’s qui tam action against Pottstown Memorial Medical Center (PMMC) for violating the Anti-Kickback Statute (AKS) and False Claims Act (FCA).  And it’s a good thing because the basis of his claim was an on-call coverage arrangement …

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8th Cir. Rejects Dr.’s Grab-Bag Retaliation Suit

Dr. Alaa Elkharwily lost his job at Albert Lea Clinic, but he didn’t go quietly.  He sued the clinic and eight related organizations and individuals alleging just about everything a terminated doctor can allege in Minnesota: defamation and violation of the Minn. Vulnerable Adults Act, EMTALA, the Minn. …

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Qui Tam Defendant’s Confidentiality-Breach Counterclaim Fails

What if a whistleblower discloses the protected health information (PHI) of privately insured patients in making the claim that his employer submitted false Medicare claims?  And what if that violates a confidentiality agreement the whistleblower signed with the employer?  Does the employer have a counterclaim …

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Supremes Hear Argument on Implied Certification Theory

On April 19 the U.S. Supreme Court heard oral argument in Universal Health Services v. U.S. ex rel. Escobar.  That’s the case in which the First Circuit upheld a whistleblower suit brought against a mental health clinic that had treated their daughter.  Their theory is that the clinic’s reimbursement …

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OK to Exaggerate How Long Patients Need Device

Today’s riddle:  Why would a federal court approve a medical device manufacturer’s practice of persuading physicians to exaggerate the period of time Medicare patients need their devices?  The answer is so simple that you’ll be embarrassed that you didn’t get it right away. Whistleblower Jeffrey …

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