The Persistence of Fraud and the Flase Claims Act.DOC

Health Care Fraud

CHAPTER II- History and Current Application of the False Claims Act (FCA)

CHAPTER III – Health Care Fraud

What is Health Care Fraud 29

Why is Health Care Fraud Easily Committed 34

Types of Health Care Fraud and Scope of Problem 36

The United States was on Health Care Fraud 55

The Effectiveness of the Responses 66

CHAPTER VI – Recent FCA Developments Legislation 103

Allison Engine Company v United States 108

Chapter VII – Recommendations and Conclusion

APPENDIX A Federal Fraud Statistics Overview

APPENDIX B Fraud Statistics – Health and Human Services APPENDIX C Qui Tam Settlements – U.S Department of Justice

Government Responses

This thesis evaluates the False Claims Act (FCA), particularly its Qui Tam provisions, in the context of the emerging and lucrative health care fraud in the United States, which has gained significant attention in less than twenty years Although the FCA was not initially designed to combat health care fraud, it has become the primary tool for addressing this issue However, existing loopholes and challenges hinder the FCA's effectiveness as a fraud-fighting mechanism Given the rapid increase in health care fraud affecting both government and public sectors, it is crucial for all Americans to be informed about this pervasive issue.

The False Claims Act (FCA), enacted on March 2, 1863, during the Civil War, aims to combat widespread fraud by incentivizing whistleblowers with a share of recovered funds Initially focused on military contractor fraud, the FCA applies to all government contractors and federal programs, addressing any misuse of federal revenue.

Health care fraud impacts millions of individuals and incurs annual costs estimated between $80 billion and $170 billion This criminal activity not only affects taxpayers and government agencies but also highlights significant human factors that compel health care payers to prioritize fraud detection As a result, there is a pressing need for proactive strategies to combat this pervasive issue.

Fraudulent health care providers significantly impact patients by billing for services not rendered and charging for more expensive procedures These providers often perform unnecessary medical services solely to collect insurance payments, and they may falsify medical treatment histories or diagnoses, depleting a patient’s health care benefits This misuse of benefits can jeopardize patients' lives, leaving them vulnerable when legitimate medical care is needed.

The National Health Care Anti-Fraud Association highlights that insufficient access to necessary insurance coverage can severely impact patient care When a patient's medical insurance is exhausted, it can hinder future treatments and, in critical situations, may even result in premature death.

President Abraham Lincoln championed the False Claims Act, which included "Qui Tam" provisions enabling private citizens to sue on behalf of the government against those defrauding it The term "Qui Tam" is derived from a Latin phrase meaning "he who brings an action for the king as well as for himself." Initially, the Act imposed double damages on wrongdoers and a civil fine of $2,000 for each false claim Relators, or those who filed lawsuits, were entitled to receive 50% of the funds recovered by the government through their efforts.

In 1943, Congress amended the Act during World War II to rectify certain abuses within its statutory framework After decades of expanding federal programs and increasing fraud issues, Congress revisited the Act in 1986 to address restrictive judicial interpretations and enhance its effectiveness The amendment stipulated that if the Government had prior knowledge of the allegations, the relator would lack jurisdiction over the lawsuit, even if they possessed independent and direct knowledge of the claims.

In 1986, Congress amended the False Claims Act, recognizing its potential to address health care fraud Since then, the health care sector has emerged as the primary source of cases filed under this legislation.

Since its inception in 1986, the law has seen limited utilization by whistleblowers due to numerous complex obstacles that hindered their success, compounded by judicial rulings that complicated enforcement Additionally, individuals opting to file lawsuits under the 1863 Act faced significant challenges, including the requirement that relators bear all litigation costs, while the Government retained the discretion to intervene in the lawsuit at any time.

(http://www.ashcraftandgerel.com/whistleb.html#Today)

3 White, Esq., Joseph E "Health Care Fraud: Information Sharing Proposals to Improve Enforcement Efforts” Security Management GAOReport (1996).

The False Claims Act, originally aimed at combatting defense procurement fraud, has evolved to tackle a variety of fraudulent activities across numerous government programs Recently, the health care sector has experienced significant litigation growth under this Act Cases have also emerged in areas such as environmental programs, scientific research, and the financial services industry, highlighting the Act's broader applicability As its impact becomes more evident, policymakers are now exploring the potential of the Act's framework to address issues beyond fraud and assessing whether it fulfills the objectives established by Congress.

Health care fraud poses a major challenge in the United States, significantly impacting the enforcement of the False Claims Act Many health care providers exploit this issue by submitting claims for unknown services from unidentified entities The government mandates that these claims be paid within thirty days, compelling carriers to disburse substantial amounts without adequate verification, thereby exacerbating the problem of fraud in the health care sector.

4 Taxpayers Against Fraud The 1986 False Claims Act Amendments Tenth Anniversary Report 1996 result, large amounts of money are lost to fraudulent claims paid without scrutiny by the carrier

Health care fraud impacts all Americans by increasing out-of-pocket expenses, raising taxes, and leading to lower real wages or layoffs as employers shift health care costs to employees As the health care sector prioritizes profit, it becomes a magnet for criminal activity, making it an easy target for fraud.

Congress and the Executive Branch have made efforts to enact laws aimed at curbing the increasing prevalence of fraud, particularly in healthcare This thesis will examine the effectiveness of the False Claims Act and reveal that the government's efforts to mitigate health care fraud have not met expectations Ultimately, this analysis will offer a critical evaluation of the False Claims Act as the primary instrument for addressing health care fraud and will suggest potential improvements to enhance its effectiveness.

5 Fabrikant, Robert “ Health Care Fraud Enforcement and

Compliance” Law Journal Press Release 21(2007).

6 Sources used in this thesis present potential bias on the subject matter However, these known potential biases are used to give a variety of insight on the discussed topic.

During the Civil War, outraged by extensive fraud against the Government by army contractors, Congress enacted the False Claims Act A key component of the Act was the Qui

The Tam provision was designed to engage private citizens in supporting government efforts to fight fraud Over time, Congress has amended the Act to address various issues that have emerged during its implementation.

In the early 21st century, Qui Tam False Claims Act cases were relatively few; however, a particular type of action became increasingly problematic The Act lacks provisions for cases based on information already known to the government, leading to a rise in opportunistic lawsuits These suits were filed by individuals who contributed no original information, instead relying on plagiarized content from indictments, news articles, or congressional investigations.

Case Examples

Healthcare fraud is a pervasive issue that often goes undetected, making whistleblowers crucial in helping the U.S and state authorities identify and combat these schemes This chapter highlights various healthcare fraud methods and illustrates the effectiveness of Qui Tam provisions in uncovering and prosecuting fraudsters The selected cases provide a comprehensive view of the significant impact of fraud in the healthcare sector, emphasizing the importance of the False Claims Act (FCA) in addressing this critical problem.

• Geographic area in which activity occurred

• Time period from whistleblower complaint to outcome favorable to government

• Amount lost in comparison with amount recovered

• Civil cases turned criminal, and

• Cases leading to other recoveries.

There are hundreds of cases pending involving the health care and pharmaceutical industries and often involve

This article highlights four significant Medicare fraud cases, illustrating the extensive nature of fraud within the healthcare sector The first case is notable as the largest fraud perpetrated by a company, while the second involves the largest fraud committed by an individual The remaining two cases demonstrate how one recovery can catalyze others, showcasing the collaborative efforts of various offices beyond the U.S Department of Justice in combating fraud These cases, which occur in regions prone to fraudulent activities, have resulted in substantial financial recoveries for whistleblowers, emphasizing the incentives for reporting fraud as outlined in Appendix C.

Case #1 (Medicare Fraud) Columbia/HCA

In 2001, the Department of Justice filed a lawsuit against Columbia/HCA Healthcare Corporation and Quorum Health Group, two major national hospital chains, for allegedly defrauding the Medicare program and other federally funded health insurance programs Columbia operates around 320 hospitals, while Quorum manages about 250 The case involved over 200 hospitals across approximately 37 states The complaint stated that since 1984, Columbia/HCA and Quorum had made false statements in their annual cost reports to fiscal intermediaries responsible for processing Medicare cost reports for the government.

130 U.S JOINS LAWSUIT AGAINST COLUMBIA AND QUORUM HOSPITAL

CHAINS" US Department of Justice October, 1998

FindArticles.com 08 Jul 2008 http://findarticles.com/p/articles/mi_pjus/is_199810/ai_2873269196 should receive reimbursement of costs that the hospitals knew were unallowable 131

The lawsuit against Columbia/HCA and Quorum alleges that the companies concealed reserve cost reports, which included unallowable costs, from government auditors It claims these reports were prepared to reserve funds for potential repayments to the government if the unallowable costs were discovered This legal action follows extensive investigations into fraudulent activities at these companies, asserting that hospitals consistently inflated expenses in their reports to the government to boost their compensation from the Federal Medicare program.

FindArticles.com 08 Jul 2008 http://findarticles.com/p/articles/mi_pjus/is_199810/ai_2873269196

Healthtrust, a for-profit hospital chain now owned by

Columbia, and Quorum Health Resources, a subsidiary of Quorum that is the country's largest manager of not-for- profit hospitals

A lawsuit unsealed in Federal District Court in Tampa, Florida, originated from a whistle-blower's complaint filed in 1993 The Justice Department subsequently investigated the case and sought to join the litigation Previously, criminal charges had been filed against four executives from Columbia for their roles in preparing cost reports for a Florida hospital At the time of the investigation, Quorum, which had been part of the Hospital Corporation of America (HCA) until the late 1980s, was also scrutinized for potential irregularities in its cost reports before being acquired by Columbia in 1994.

This litigation highlights the significance of the Federal cost-reporting system, which facilitates billions of dollars in reimbursements from the Government to hospitals and healthcare providers Through this system, various costs related to patient care are accounted for and reimbursed.

In a lawsuit, the Government accused companies of deliberately misrepresenting costs to inflate reimbursement rates from programs like Medicare and to obtain payments for ineligible expenses While the exact amount sought by the Government from the two companies remains unspecified, it is noted that federal health programs have suffered damages amounting to millions of dollars due to this fraudulent scheme.

The government's supporting evidence relied heavily on second sets of cost reports and worksheets from hospitals, which showed significantly lower expenses than those submitted to the government A substantial amount of this information was seized by the government during a civil investigation into the cost-reporting practices of two companies In an internal communication to its employees, Columbia acknowledged the issues surrounding these discrepancies.

137 Department of Justice Immediate Release April 23 2001.

On April 23, 2001, the Department of Justice announced that the issues raised in the lawsuit were not new; however, their involvement could significantly contribute to resolving the ongoing dispute The statement emphasized that the government's participation in the lawsuit is expected to enhance the ability to achieve a resolution.

James E Dalton Jr., President and CEO of Quorum, emphasized the company's commitment to submitting honest claims to the government, stating that they have consistently endeavored to adhere to all applicable regulations He expressed pride in Quorum's dedication to rigorous honesty and high ethical standards, which he believes are reflected in the behavior of their management and associates daily.

The lawsuit was filed under seal by James F Alderson, who is the former chief financial officer of North Valley

The hospital in Whitefish, Montana, operated by Quorum, is currently involved in a legal case Alderson's attorney stated that their client was instructed to submit detailed cost reports to the government and create an additional document known as a reserve report.

142 "U.S JOINS LAWSUIT AGAINST COLUMBIA AND QUORUM HOSPITAL

On July 8, 2008, FindArticles.com reported that the documents revealed accurate information regarding the true expenses Mr Alderson was dismissed after refusing to comply with instructions from his lawyers The legal team stated that the investigation uncovered substantial evidence of fraud, indicating that the final claims against the companies would be significant.

The corporate defendants, previously affiliated with the Hospital Corporation of America, a pioneer in for-profit hospital chains, are implicated in a comprehensive 33-page complaint This legal action alleges various deceptive practices aimed at misrepresenting costs and defrauding federal health programs Notably, the complaint asserts that these companies inaccurately categorized low-reimbursed operating expenses as high-cost capital expenses Furthermore, it claims they created short-term reserves to mitigate potential financial repercussions.

In July 2008, it was reported that government auditors uncovered a misrepresentation by certain companies, leading to a mandate for these firms to repay the funds involved.

Additionally, the suit stated that the companies misidentified capital costs for projects that begun before

In 1990, new regulations established that costs incurred after this date would be reimbursed at a higher rate compared to older costs The reserve reports in this case accurately classified these expenses However, the lawsuit claims that the companies frequently misrepresented non-reimbursable expenses unrelated to patient care, such as marketing, physician recruitment, and hospital televisions, in their filed cost reports These costs were properly identified in subsequent reports Additionally, the companies allegedly manipulated reimbursement calculations to their advantage.

149 Department of Justice Immediate Release April 23 2001. misrepresenting statistics such as time and square- footage 150 But in the reserve reports, those statistics were recorded accurately

In 2001 this case was considered the largest government investigation of Medicare fraud ever Quorum paid 85.7 million dollars to settle the whistleblower lawsuit in 2001.

A judge awarded Alderson twenty four percent of the recovery HCA later paid in unrelated cases 631 million dollars to settle three Qui Tam lawsuits, including

Alderson’s and one brought by John Schilling, another whistleblower.

Recent FCA Developments Legislation

The drafters of the False Claims Act, both initially and in

In 1986, Congress amended the Federal False Claims Act to promote private enforcement actions, incentivizing whistleblowers by offering them attorney’s fees, expenses, and a substantial monetary reward, even if the government intervenes The Qui Tam provisions of the Act have since played a crucial role in recovering fraudulently obtained federal tax dollars, with plaintiffs returning hundreds of millions to the treasury annually However, despite these successes, the rise in health care fraud raises concerns about the effectiveness of the FCA in combating fraudulent activities.

Congress has dealt with the legislation of the FCA many times, in an attempt to make it more effective 178 In order

The Health Insurance Portability and Accountability Act (HIPAA) established a strong foundation for enhancing program integrity in healthcare In his FY98 Budget, former President Clinton introduced several initiatives aimed at combating fraud and abuse In March 1997, he proposed the “Medicare and Medicaid Fraud, Abuse, and Waste Prevention Amendments of 1997,” which built upon HIPAA's provisions and aimed to address vulnerabilities in the Medicare statute that allowed providers to exploit payment systems These amendments mandated insurance companies to report beneficiaries' insurance status, ensuring greater accountability and oversight.

To combat health care fraud and abuse, Congress enacted provisions related to the False Claims Act (FCA) as part of the Deficit Reduction Act of 2005 (DRA), which aims to slow mandatory spending in Medicare and Medicaid Notably, Section 6032 of the DRA mandates that health care entities receiving over five million dollars annually in Medicaid reimbursements must implement policies and educate employees about the False Claims Act and anti-fraud compliance However, these provisions do not extend to fraud within the Medicare system.

Senators Grassley and Durbin are introducing new legislation to address recent federal court rulings that could restrict the effectiveness of the False Claims Act Their initiative, known as the False Claims Act Correction Act of 2007, has garnered support and co-sponsorship from additional Senate members.

Judiciary Committee Chairman Leahy and Ranking Member

Specter Senator Grassley was a sponsor of the 1986

179S 1932 [109th]: Deficit Reduction Act of 2005

Amendments to the False Claims Act emphasize the crucial role of whistleblowers in exposing fraud against the federal government Senator Grassley highlights that these brave individuals have enabled the government to pursue successful cases, resulting in the recovery of tens of billions of dollars otherwise lost to fraudulent activities by contractors and local governments The proposed legislation aims to strengthen the government's ability to recover tax dollars lost to fraud across various sectors, including healthcare, ensuring that recent court decisions do not undermine these efforts.

The legislation enacted during the Civil War in 1863 remains crucial today in the fight against fraud, abuse of government programs, and the misuse of taxpayer dollars A key approach to addressing these issues is to encourage and safeguard whistleblowers who report fraudulent activities Senator Specter emphasizes that this legislation aims to uphold these essential protections and promote accountability within government programs.

The 1986 updates to the FCA are today the government’s weapon against fraud The False Claims Act Correction Act of

2007 would make the following corrections to the False Claims Act as presented by Sen Grassley:

The amendment to 31 U.S.C § 3729 eliminates the requirement for false claims to be presented directly to a government employee, addressing ongoing issues related to this stipulation By holding individuals liable for any false claims concerning government funds or property, the correction facilitates the recovery of government money lost to fraud, waste, or abuse through the False Claims Act (FCA) This change comes in response to the D.C Circuit Court of Appeals ruling in U.S ex rel Totten v Bombardier Corp, 380 F.3d, which highlighted the limitations of the previous requirement.

In the 2004 case of 488, the court determined that false claims made to government grantees, specifically Amtrak, were not directed to a government employee, which ultimately prevented the government from recovering funds lost due to fraud This issue was conclusively addressed by the Supreme Court in 2008.

The recent amendments to the False Claims Act (FCA) clarify the dismissal of parasitic claims based on publicly disclosed information, known as the public disclosure bar Under the revised FCA, such cases can be dismissed unless the relator is the original source of the information Additionally, the amendments specify that only the Department of Justice (DOJ) has the authority to dismiss relator claims on public disclosure grounds, reinforcing that this is not a jurisdictional defense for those who defraud the government.

False or fraudulent claims against non-U.S Government funds managed by the U.S Government are recoverable under the False Claims Act (FCA) This clarification safeguards funds administered on behalf of third-party nations or entities, ensuring they are protected from fraud, waste, or abuse by extending FCA liability to these resources.

The article addresses a division among Circuit Courts of Appeal regarding the conditions under which a government employee can serve as a Qui Tam relator under the False Claims Act (FCA) It aims to clarify the original legislative intent of the 1986 FCA amendments, explicitly permitting government employees to act as Qui Tam relators in specific situations, particularly when they have reported misconduct through their chain of command.

Inspector General, to the Attorney General, and only if no action was taken after 12 months; and

● Makes technical and clarifying amendments to the statute of limitations in FCA cases, as well as technical edits to the Civil Investigative Demands authorized under the current FCA.

Allison Engine Co v United States 183

The Supreme Court recently altered the interpretation of the False Claims Act in a case involving the U.S Navy's 1985 contract with two shipyards for a new fleet of destroyers The shipyards subcontracted the production of essential components, including generators, to various companies, such as the Allison Engine Company, which further outsourced work to General Tool Company and Southern Ohio Fabricators Notably, none of these subcontractors billed the federal government directly; instead, they invoiced the company above them in the production chain, which failed to include these costs in its payment documentation to the government.

As former employees of GTC, Roger Sanders and Roger Thacker worked on the Gen-Set assembly teams and suspected the Gen-

183 ALLISON ENGINE CO., INC., ET AL v UNITED STATES EX REL.SANDERS ET AL 553 U S (2008)

Sets to be defective They filed two FCA actions against their former employee GTC and other government subcontractors Allison, GM and SOFCO in 1995

The False Claims Act holds contractors liable for defrauding the federal government through various subsections Specifically, subsection (a)(1) requires proof that a fraudulent bill was presented to the government However, subsections (a)(2) and (a)(3) do not explicitly state this presentment requirement The key question was whether these subsections necessitate evidence of a false bill being sent to the government or if it suffices to demonstrate that the fraudulent bill was paid with federal funds The Supreme Court concluded that subcontractor claims not submitted to the government cannot serve as the basis for a Qui Tam claim, reflecting a narrowed interpretation of the FCA.

The Court's ruling in the Allison Engine case narrows the scope of the False Claims Act, focusing on instances of direct fraud against the government rather than a broader range of private disputes involving government funds While the Supreme Court's decision is significant, critics argue that its impact may be fleeting if Congress moves forward with amendments to the False Claims Act.

Correction Act of 2007, that was proposed by Senator

Administrative and Law Enforcement Programs

The Federal Government has implemented various initiatives and programs aimed at combating and preventing fraud, particularly in the healthcare sector These targeted programs are designed to address fraudulent activities and protect the integrity of healthcare services.

Recommendations and Conclusion

187 Smith, Andrew "Combating Health Care Fraud and Abuse in

Medicare: Legislative Action and New Programs” (April 1998).

Health care fraud is a significant crime that impacts all stakeholders in the U.S health care system, leading to substantial financial losses that the government must address The FBI is allocating considerable resources to combat this issue, establishing specialized units to identify and prosecute offenders Both healthcare providers and insurance companies are involved in fraudulent activities, adversely affecting patients and subscribers through inadequate coverage and inflated medication prices Unless the underlying causes of health care fraud are addressed, the prevalence of these crimes will likely escalate in the future.

Health-care experts highlight the simplicity of Campos Ramirez’s scheme from chapter five, emphasizing the increasing issue of health-care fraud and the urgent need for enhanced theft prevention resources Law enforcement estimates that health-care fraud costs taxpayers over sixty billion dollars annually, with the South Florida region alone billing Medicare more than two billion dollars.

188 Slyvia, M Claire The False Claims Act: Fraud Against the

According to a 2004 report by Thompson, the government spends billions of dollars annually on injectable HIV medications This expenditure is significantly disproportionate, being twenty-two times higher than similar claims nationwide, and does not align with the demographic data for Miami-Dade County, which has a population of two million, as indicated by HHS statistics.

The FCA is considered an important tool in combating health care fraud, yet its effectiveness mirrors the crime issues in Washington DC, where problems are often addressed only when they escalate In Florida, as health care fraud increases, the strategies to combat it are becoming less effective, similar to the growing crime rates in DC Both health care fraud and crime have seen violators become adept at evading detection and exploiting legal loopholes To effectively tackle these issues, the United States must address the smaller, underlying problems contributing to larger fraud cases, or risk an ongoing crisis in health care fraud akin to the persistent crime wave in Washington DC.

189 Medical Fraud a Growing Problem, Carrie Johnson The WashingtonPost June 13, 2008

The overall recommendations of this thesis are as follows:

● Companies should be required to report accurate average sales prices and average manufacturer prices for its drugs covered by federal health care programs.

● An informed and engaged public will aide in the fight against heath care fraud.

● Alternative avenues should be established for filing a claim under the FCA Qui Tam provisions in order to better manage the work load of the Department of Justice.

● A monitoring and evaluation process should be established in order to avoid replicating problems with the FCA legislation and interpretations.

● Fraud prevention should be made a priority to support FCA implementations.

● Agency oversight should be monitored more closely.

● There should be continued administrative improvements

The US can enhance the effectiveness of the False Claims Act (FCA) in combating health care fraud by implementing strategic changes Experts highlight that Medicare's automatic payment system for federally certified suppliers often overlooks fraud, focusing instead on over-billing and unusual treatments To clarify congressional intent, amendments to the FCA should explicitly include states as "persons" or introduce conditional funding that necessitates states to forfeit their FCA defenses A collective effort from both government and state entities is crucial in the battle against health care fraud, alongside educating patients on protective measures Resources like www.whistleblower.com and www.taf.com provide essential insights into health care fraud and the FCA An informed populace, coupled with adequate FBI funding, will significantly bolster the fight against health care fraud.

A July Washington Post article highlighted the significant backlog at the Department of Justice, where 900 active false claims cases are currently under investigation, contributing to the prolonged duration it takes for these cases to reach their final resolution.

190 Medical Fraud a Growing Problem, Carrie Johnson The Washington Post June 13, 2008

191National Health Care Anti-Fraud Association

The National Health Care Anti-Fraud Association, in collaboration with the Justice Department, is actively investigating new cases under the Federal False Claims Act These investigations are conducted promptly, often before the resolution of earlier cases, highlighting the urgency and efficiency in addressing healthcare fraud.

The Department of Justice processes around 350 cases annually, effectively matching the number of incoming cases with those resolved This balance highlights the department's efficiency in managing its caseload.

The Department of Justice is overwhelmed with false claims cases, while the understaffed Civil Division struggles to manage the workload Currently, the litigation branch responsible for these cases only handles around 100 investigations each year and dedicates its efforts to processing approximately 425 cases annually, resulting in significant delays.

300 cases rolling over to the next fiscal year.

Gregory G Katsas, Attorney General for the Civil Division of the Department of Justice, emphasized the department's diligence in handling fraud cases, citing $20 billion in recoveries since the False Claims Act was amended in 1986 Notably, nearly $7 billion of this amount has been recovered since fiscal 2005 Of the total, $12 billion has come from whistle-blower cases pursued vigorously by Justice Department attorneys, with significant contributions from whistle-blowers and their legal representatives Additionally, over $2 billion in rewards has been distributed to individuals who initiated cases under the False Claims Act.

Despite the Department of Justice successfully recovering significant amounts of money annually, fraudulent activities persist, highlighting potential loopholes in the False Claims Act or the DOJ's investigative processes The increasing number of fraud cases initiated each year raises concerns among lawmakers and nonprofit organizations, particularly as many cases are linked to escalating healthcare payouts and the privatization of government functions, which create new opportunities for defrauding taxpayers.

Since 2001, employees have filed between 300 and 400 civil cases annually against their employers for allegedly defrauding the government However, the review process by Justice Department lawyers is lengthy and conducted under seal, often leaving whistle-blowers waiting over 14 months for updates on potential government involvement Approximately 75% of these cases are dismissed, with the government citing a lack of merit in most claims Consequently, many disputes remain unresolved for years as investigations continue Justice spokesman Charles Miller emphasized that decisions to intervene are based on merit rather than political considerations, aligning with the department's overall record in whistle-blower cases.

Patrick Burns, a spokesman for Taxpayers Against Fraud, emphasized that even without new cases, the Department of Justice could take up to 10 years to resolve its backlog, resulting in significant financial losses He advocates for increased funding to support whistle-blower cases and their legal representatives, highlighting the importance of addressing these unresolved issues.

Critics contend that the delays in addressing supplier overbilling issues are partly due to the slow response from the Justice Department and the federal agencies it represents This foot-dragging has particularly affected investigations into suppliers that may have charged the government excessively for equipment, food, and other necessities The involvement of Justice is crucial in expediting these matters.

193 Backlog Of Cases Alleging Fraud Whistle-Blower Suits Languish at

Justice; Washington Post Staff Writer Carrie Johnson; Wednesday, July 2, 2008; Page A01A

194Backlog Of Cases Alleging Fraud Whistle-Blower Suits Languish at Justice; Washington Post Staff Writer Carrie Johnson;

On July 2, 2008, the Justice Department highlighted the challenges in unraveling complex fraud schemes, indicating that cases they decline often result in minimal or no financial recoveries.

Tiêu đề	The Persistence of Fraud and the False Claims Act
Tác giả	Renita K. Speight
Người hướng dẫn	Lisa Jaeger, Dorothea I. Wolfson, Ph.D., Dan Guttman
Trường học	Johns Hopkins University
Chuyên ngành	Government
Thể loại	thesis
Năm xuất bản	2008
Thành phố	Baltimore

Định dạng
Số trang	133
Dung lượng	415,5 KB