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RPWB Represented a Whistleblower who Helped the Federal Government Recoup $1.7 million

ORLANDO, Fla. – The federal government has recouped $1.7 million from a healthcare provider who fraudulently billed Medicare and TRICARE for medical procedures that were not deemed necessary and were performed by an unqualified technician.

In the settlement agreement, Jena Medical Group LLC, as well as several individuals associated with the company, have agreed to repay federal payments to resolve allegations that they violated the False Claims Act by submitting the claims for radiofrequency ablations.

The case began with a whistleblower action brought by a former employee of the company. The whistleblower was represented by RPWB attorneys Chris Tuck, Bobby Wood and Chuck Dukes.  The investigation revealed that the company billed Medicare and TRICARE for radiofrequency ablations that were not medically necessary and were performed by an unqualified technician from January 2018 to December 2020.  Jena Medical also permitted the washing and re-use of catheters that were designed for a single use, thus putting the patients at unnecessary risk.

By law, people with information about fraudulent claims submitted to the government for payment can sue under qui tam, or whistleblower, provisions of the False Claims Act. The act allows such whistleblowers to share in the government’s recovery.

“The False Claims Act gives an additional incentive for people to report fraud perpetrated against taxpayers,” said RPWB attorney Chris Tuck. “In this case, the relator was able to help the federal government recoup a significant amount of money and share in the proceeds. We urge anyone with first-hand knowledge of fraud perpetrated against the federal government to consult with an attorney at RPWB for a confidential case review.”

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    17 RPWB Attorneys Selected for Best Lawyers in America List

    MOUNT PLEASANT, S.C – Seventeen RPWB attorneys were selected for the 2024 edition of The Best Lawyers in America® list for numerous practice areas including personal injury, product liability, mass tort, class action, qui tam and medical malpractice litigation.

    This marks the seventh consecutive year in which RPWB is the top-listed plaintiff law firm in South Carolina for class action & mass tort litigation.

    RPWB member Kim Keevers Palmer was selected as Lawyer of the Year in Charleston for mass tort and class action litigation. Christiaan Marcum was Lawyer of the Year in Charleston for his product liability work.

    Additionally, three RPWB attorneys were selected for the “Ones to Watch” category that is reserved for younger, up-and-coming lawyers.

    Here is the full list of RPWB attorneys on the 2024 edition of The Best Lawyers in America®:

    Jena L. Borden

    • Mass Tort Litigation / Class Actions – Plaintiffs
    • Product Liability Litigation – Plaintiffs

    James C. Bradley

    • Litigation – Antitrust
    • Mass Tort Litigation / Class Actions – Plaintiffs

    Michael J. Brickman

    • Antitrust Law
    • Litigation – Securities
    • Mass Tort Litigation / Class Actions – Plaintiffs

    Nina Fields Britt

    • Antitrust Law
    • Mass Tort Litigation / Class Actions – Plaintiffs

    Elizabeth M. Burke

    • Mass Tort Litigation / Class Actions – Plaintiffs
    • Personal Injury Litigation – Plaintiffs
    • Product Liability Litigation – Plaintiffs

    J. David Butler

    • Personal Injury Litigation – Plaintiffs
    • Product Liability Litigation – Plaintiffs

    Jerry Hudson Evans

    • Mass Tort Litigation / Class Actions – Plaintiffs
    • Product Liability Litigation – Plaintiffs

    Gregory A. Lofstead

    • Mass Tort Litigation / Class Actions – Plaintiffs
    • Product Liability Litigation – Plaintiffs

    Christiaan Marcum

    • Mass Tort Litigation / Class Actions – Plaintiffs
    • Product Liability Litigation – Plaintiffs

    Kim Keevers Palmer

    • Mass Tort Litigation / Class Actions – Plaintiffs

    Charles W. Patrick, Jr.

    • Mass Tort Litigation / Class Actions – Plaintiffs
    • Product Liability Litigation – Plaintiffs

    Thomas D. Rogers

    • Medical Malpractice Law – Plaintiffs
    • Personal Injury Litigation – Plaintiffs

    A. Hoyt Rowell III

    • Health Care Law
    • Mass Tort Litigation / Class Actions – Plaintiffs

    T. Christopher Tuck

    • Mass Tort Litigation / Class Actions – Plaintiffs
    • Product Liability Litigation – Plaintiffs
    • Qui Tam Law

    Edward J. Westbrook

    • Mass Tort Litigation / Class Actions – Plaintiffs

    Kenneth J. Wilson

    • Personal Injury Litigation – Plaintiffs
    • Product Liability Litigation – Plaintiffs

    Robert S. Wood

    • Mass Tort Litigation / Class Actions – Plaintiffs
    • Product Liability Litigation – Plaintiffs

    Ones to Watch – Designation for younger attorneys

    D. Charles Dukes

    • Antitrust Law
    • Commercial Litigation
    • Mass Tort Litigation / Class Actions – Plaintiffs
    • Personal Injury Litigation – Plaintiffs
    • Product Liability Litigation – Plaintiffs

    Theodore Hargrove II

    • Commercial Litigation

    Matthew A. Nickles

    • Personal Injury Litigation – Plaintiffs
    • Product Liability Litigation – Plaintiffs

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      With Sixteen Attorneys Named to Best Lawyers List, RPWB is the Top-Listed Product Liability and Class Action Law Firm in the State

      Sixteen RPWB attorneys were selected for the 2023 edition of The Best Lawyers in America® list for numerous practice areas including personal injury, product liability, mass tort, class action and medical malpractice litigation.

      This marks the sixth consecutive year in which RPWB is the top-listed plaintiff law firm in South Carolina for both product liability litigation and class action & mass tort litigation.

      RPWB member Beth Burke was selected as personal injury lawyer of the year in Charleston, South Carolina. In addition to working on medical malpractice and personal injury cases, Burke serves in the leadership of the national lawsuit against 3M for supplying military personnel with defective earplugs. She also represents Marine Corps veterans who developed cancer and other serious conditions after consuming contaminated water at Camp Lejeune between 1953 and 1987.

      Beth Burke is personal injury lawyer of the year in Charleston, S.C.

       

      Here is the full list of RPWB attorneys on the 2023 edition of The Best Lawyers in America®:

      Mount Pleasant, S.C.

      Nina Fields Britt – Mass Tort/Class Actions Litigation

      Beth Burke – Mass Tort/Class Actions, Personal Injury & Product Liability Litigation

      Jerry Evans – Mass Tort/Class Actions & Product Liability Litigation

      Kim Keevers Palmer – Mass Tort/Class Actions Litigation

      Greg Lofstead – Product Liability & Mass Tort/Class Actions Litigation

      Christiaan Marcum – Mass Tort/Class Actions & Product Liability Litigation

      Tom Rogers – Medical Malpractice Law & Personal Injury Litigation

      Hoyt Rowell – Healthcare Law & Mass Tort/Class Actions Litigation

      Chris Tuck – Mass Tort/Class Actions, Product Liability Litigation & Qui Tam Law

      Ed Westbrook – Mass Tort/Class Actions Litigation

      Bobby Wood – Mass Tort/Class Actions & Product Liability Litigation

      Charleston, S.C.

      Michael Brickman – Antitrust Law, Mass Tort/Class Actions & Securities Litigation

      Charles Patrick, Jr. – Mass Tort/Class Actions & Product Liability Litigation

      Aiken, S.C.

      Dave Butler – Personal Injury & Product Liability Litigation

      Ken Wilson – Personal Injury & Product Liability Litigation

      Edwardsville, Ill.

      Jena Borden – Mass Tort/Class Actions & Product Liability Litigation

      Ones to Watch

      Three younger attorneys at the firm are recognized as “Ones to Watch,” a distinction for up-and-coming attorneys.

      • Chuck Dukes is listed for antitrust law, commercial litigation, mass tort/class action litigation, personal injury litigation and product liability litigation.
      • Matt Nickles is honored for personal injury and product liability litigation.
      • TAC Hargrove was selected for commercial litigation following his work on litigation associated with the failed V.C. Summer nuclear expansion project.

      About Best Lawyers

      Since it was first published in 1983, Best Lawyers® has become universally regarded as the definitive guide to legal excellence. Best Lawyers lists are compiled based on an exhaustive peer-review evaluation. More than 116,000 industry leading lawyers are eligible to vote (from around the world), and we have received more than 17 million evaluations on the legal abilities of other lawyers based on their specific practice areas around the world. For the 2023 edition of The Best Lawyers in America®, more than 12.2 million votes were analyzed. Lawyers are not required nor allowed to pay a fee to be listed; therefore, inclusion in Best Lawyers is considered a singular honor.

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        RPWB is a 2019 U.S. News Best Law Firm

        CHARLESTON, S.C. – Richardson, Patrick, Westbrook & Brickman was named a 2019 Best Law Firm by U.S. News & World Report, recognizing the plaintiff firm for its work on mass torts and class actions, product liability, securities, healthcare law, medical malpractice and personal injury lawsuits.

        With 16 lawyers listed on the underlying Best Lawyers in America list, RPWB was the top-listed plaintiff law firm in the country for its work on mass torts and class actions. RPWB was the top-listed plaintiff law firm in South Carolina for mass torts, personal injury and product liability.

        Four RPWB attorneys were new to the list: Brady Thomas, Chris Tuck, Bobby Wood and Ken Wilson. RPWB founding member Ed Westbrook was named Lawyer of the Year for class actions and mass torts in the Charleston-area.

        Here are the RPWB attorneys named to the 2019 Best Lawyers list:

        Michael Brickman
        Litigation – Securities
        Mass Tort Litigation/Class Actions – Plaintiffs

        Elizabeth Middleton Burke
        Mass Tort Litigation/Class Actions – Plaintiffs
        Personal Injury Litigation – Plaintiffs
        Product Liability Litigation – Plaintiffs

        David Butler
        Personal Injury Litigation – Plaintiffs
        Product Liability Litigation – Plaintiffs

        Blair Hahn
        Mass Tort Litigation/Class Actions – Plaintiffs
        Product Liability Litigation – Plaintiffs

        Greg Lofstead
        Mass Tort Litigation/Class Actions – Plaintiffs
        Product Liability Litigation – Plaintiffs

        Christiaan Marcum
        Mass Tort Litigation/Class Actions – Plaintiffs
        Product Liability Litigation – Plaintiffs

        Kim Keevers Palmer
        Mass Tort Litigation/Class Actions – Plaintiffs

        Charles Patrick
        Mass Tort Litigation/Class Actions – Plaintiffs
        Product Liability Litigation – Plaintiffs

        Terry Richardson
        Business Litigation
        Mass Tort Litigation/Class Actions – Plaintiffs
        Personal Injury Litigation – Plaintiffs
        Railroad Law

        Tom Rogers
        Medical Malpractice Law – Plaintiffs
        Personal Injury Litigation – Plaintiffs

        Hoyt Rowell
        Health Care Law
        Mass Tort Litigation/Class Actions – Plaintiffs

        Brady Thomas
        Mass Tort Litigation/Class Actions – Plaintiffs
        Personal Injury Litigation – Plaintiffs

        Chris Tuck
        Mass Tort Litigation/Class Actions – Plaintiffs

        Ed Westbrook
        Mass Tort Litigation/Class Actions – Plaintiffs

        Ken Wilson
        Product Liability Litigation – Plaintiffs

        Bobby Wood
        Mass Tort Litigation/Class Actions – Plaintiffs

        About RPWB

        RPWB was formed in 2002 as a collective of talented legal minds who focus on complex litigation throughout the United States. The firm is well-respected for its work on mass torts and product liability cases, including mesothelioma lawsuits and pharmaceutical litigation. RPWB attorneys regularly hold leadership positions on class actions and other mass torts across the nation.

        RPWB founding member Terry Richardson was among the first attorneys in the nation to successfully hold asbestos manufacturers liable for causing mesothelioma cancer. Several attorneys at the firm played pivotal roles in the fight against tobacco companies in the 1990s that led to the Tobacco Master Settlement Agreement. Some of those same attorneys are currently assisting six Canadian provinces seeking to recoup public healthcare spending on smoking-related illnesses.

        In addition to national litigation, RPWB also represents individual people in many practice areas, including: catastrophic personal injury, truck accidents, railroad accidents, construction defects, medical malpractice, mesothelioma and other occupational lung disease, whistleblower & qui tam, nursing home abuse, pharmaceutical drugs and medical device cases.

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          The Role of the Whistleblower: A look at qui tam litigation

          By Chuck Dukes

          Qui tam litigation allows private citizens, like you, to join in the battle against government fraud. Every year, many of our public institutions—from the military to Medicare—are plagued by fraud. Astonishingly, it’s estimated that nearly 10% of all federal spending, or $350–$400B per year, is lost due to fraud.

          And by and large, qui tam litigation has proven to be the most effective weapon there is to fight against government fraud. DOJ statistics show that from 1986–2017, more than 70% of the federal government’s total recovery for fraud has come through qui tam litigation, which led to over $40 billion being restored to the federal treasury.

          QUI TAM LITIGATION UNDER THE FALSE CLAIMS ACT

          Practically speaking, qui tam litigation is the procedure through which a private individual, commonly known as a “whistleblower,” files a lawsuit on behalf of the government to recover public funds. If the lawsuit is successful, the whistleblower is entitled to a share of the recovery.

          Modern qui tam practice began in 1863 when Congress enacted the False Claims Act (“FCA”) in response to rampant fraud being committed against the government during the Civil War.  The FCA prohibits anyone from knowingly committing fraud against the United States through the submission of false or fraudulent claims. Importantly, the FCA also includes qui tam provisions that allow private citizens to file suit on behalf of the United States to recover public funds. These whistleblowers, or “relators” as they are referred to under the statute, are individuals who have witnessed or have personal knowledge of fraud being committed against the government.

          COMMON TYPES OF GOVERNMENT FRAUD

          Today, most qui tam cases are filed against healthcare providers, financial institutions, or defense contractors for submitting false or fraudulent claims to the government for reimbursement. Qui tam cases involving healthcare fraud are the most common, and usually provide a majority of the government’s annual recovery under the FCA. These cases restore billions of dollars to our Medicare, Medicaid, and TRICARE programs every year, and save those programs billions more by deterring others from committing similar frauds.

          Fraudulent billing schemes are most prevalent in the medical industry and typically involve doctors, hospitals, or laboratories that (1) bill for medical services that were never performed, (2) bill for services that were not medically necessary, or (3) upcode for medical services or equipment. These schemes are typically uncovered by doctors, nurses, accountants, administrators, or billing specialists who have first-hand knowledge of the fraud and may have been reprimanded, or even fired, for trying to expose it.

          Lately, a surge of qui tam cases have also been filed for violations of the Stark Act and/or Anti-Kickback Statute, laws that generally prohibit doctors from receiving kickbacks for referring Medicare or Medicaid patients to other healthcare providers. These cases are typically filed by physicians who have rejected similar financial arrangements, nurses who become aware of the referral scheme, or by healthcare administrators with access to physician compensation matters who, during the course of their work, discover an illegal arrangement.

          HOW WHISTLEBLOWERS ARE COMPENSATED

          More often than not, qui tam cases involve hundreds or even thousands of false claims, so awards can be substantial. Defendants who are found liable for violations of the FCA face treble damages; civil penalties ranging from $10,957 to $21,916 per false claim; the government’s litigation costs; and the whistleblower’s expenses, attorneys’ fees, and costs.  

          For their efforts in exposing government fraud, whistleblowers are entitled to 10–30% of the government’s total recovery in the case. If the government has intervened, the whistleblower’s share is 15–25% of the total recovery. If the government has not intervened, that share can climb to 25–30%. In 2017, the average share was over a million dollars, with more than $390 million being awarded to whistleblowers collectively. Since 1986, whistleblowers have been awarded over $6 billion for their help in rooting out government fraud.

          But invariably qui tam cases involve complex issues, are fiercely contested by deep-pocketed defendants, and require extensive discovery and costly expert testimony to prove. So if you have witnessed government fraud at work and are considering a qui tam case, be sure to contact a law firm like RPWB that has the knowledge, experience, and financial resources that qui tam litigation demands.

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