CHARLOTTE, N.C.--(BUSINESS WIRE)--The Rabon Law Firm of Charlotte, NC, and Hoyer Law Group of Tampa, FL, today announced the settlement of what is believed to be the first federal False Claims Act (FCA) lawsuit brought against numerous defendants in one of the largest nationwide Medicare frauds ever involving telemedicine and durable medical equipment. FCA lawsuits are brought for the benefit of the United States to recover money paid out by the Government because of fraud. Under the settlement, the United States will receive $20,332,516 out of assets forfeited pursuant to the criminal plea agreement of Kelly Wolfe, one of the main defendants.
The suit, filed in March 2019 in the U.S. District Court for the Middle District of Florida, was brought by Condra Albright against her former employer, Regency, Inc., and a host of other defendants. The lawsuit alleged that the defendants defrauded Medicare by setting up sham Durable Medical Equipment (DME) storefronts, in several states, that conspired to engage in illicit marketing and sales of DME products such as back, knee, ankle, and wrist braces to senior citizens. The defendants paid kickbacks to marketing companies that in turn had schemed with telehealth companies to obtain sham physician prescriptions for the braces. The sham DME’s then “filled” those medical device prescriptions and falsely billed Medicare. The braces that were delivered were not only cheap, off-the-shelf orthotics, they were medically unnecessary and based on false DME prescriptions. Typically, multiple braces were sent to the affected Medicare beneficiaries, regardless of the lack of actual need.
After the lawsuit was filed, the Department of Justice announced a massive simultaneous nationwide raid on April 9, 2019, led by the US Department of Justice, the FBI, and various federal agencies. The investigation was called “Operation Brace Yourself” and spanned 17 federal districts, involved the execution of over 80 search warrants and numerous arrests for healthcare fraud. The DOJ announced that the fraud schemes – which included the same schemes and defendants identified in the Albright action – caused more than $1.2 billion in losses to United States from false claims submitted through some 130 DME’s. The faction of the conspiracy named in the Albright case was responsible for at least $183 million of the losses.
The Albright case, filed under the qui tam provisions of the False Claims Act, played a crucial part in the success of Operation Brace Yourself, including information that led to the seizures and forfeitures of tens of millions of dollars rightfully belonging to the Government because of the frauds. The number of persons charged nationwide with healthcare fraud under this initiative now stands in the hundreds, and numerous guilty pleas and forfeitures have ensued.
Under the False Claims Act, private citizens with knowledge of fraud being perpetrated against the government may bring a lawsuit on behalf of the government and share in the recovery. Whistleblower lawsuits under the Act are often referred to as “qui tam” lawsuits, which makes reference to a Latin phrase which means to bring a suit “on behalf of the king,” as well as oneself.
Ms. Albright is represented by Chet Rabon, of the Rabon Law Firm in Charlotte, North Carolina, and by Dave Scheer, Jesse Hoyer, and Sean Estes of the Hoyer Law Group in Tampa, Florida.
“Our client, Condra Albright, truly did the right thing here,” said Rabon. “When she determined precisely how the defendants were cheating the Government, she did her duty and reported this to the government and retained counsel to bring this case to recover the ill-gotten gains for the primary benefit of the taxpayers who were harmed,” he continued.
“The False Claims Act is a tremendous tool in recovering money stolen from the taxpayers of our country,” added Dave Scher. “But without the courage of whistleblowers like our client, coupled with incentives provided under the law, most fraud against the Government would go unchecked,” he further noted.
Total recoveries under the federal False Claims Act, since the major amendments of 1986, exceed $64 billion through the end of 2020, with relator share awards approaching $8 billion. The vast majority of funds recovered through verdicts and settlements under the Act derive from whistleblower-initiated civil actions such as this. To date, qui tam cases account for about 72% of all dollars recovered.
Attorney Chet Rabon further commented, “With the size of the annual US Government budget approaching $7 trillion, and the US Government being the largest purchaser of goods and service in the world, by far, opportunities for companies to cheat and defraud the government are rife. The US loses billions of dollars each year to these frauds, in all sectors, including health care, pharmaceuticals, procurement, construction, educational grants and loans, just to name a few.” Sadly, most fraud against the government is neither reported nor uncovered. “Insiders who have evidence of these frauds and who are brave and moral enough to help stop it should contact experienced qui tam lawyers to evaluate their possible case,” Rabon noted.
Incentives in the law that reward whistleblowers are an effective tool to battle the unlawful conduct. Under the False Claims Act, whistleblowers receive between 15% and 30% of the monies the government recovers when these civil fraud cases are resolved by settlement or trial. The False Claims Act is a powerful weapon against fraud on the government, generating more than $15 in recoveries to the taxpayers for every $1 spent on health care fraud enforcement.
Ms. Albright is expected to receive an award of $4,676,479 from the total amounts to be forfeited to the United States in connection with the plea referenced in the Settlement Agreement.
Citation for case: United States ex rel. Albright v. Regency, Inc., et al.
Case No. 8:19-cv-686-T-30AEP (M.D. Fla.)
About the Rabon Law Firm, PLLC
The Rabon Law Firm is headed by attorney Chet Rabon, who has practiced law in Charlotte, NC, for more than 30 years. The Rabon Law Firm concentrates in whistleblower representation in cases nationwide under the Federal False Claims Act and companion state acts, as well as IRS and SEC Whistleblower fraud cases, and has numerous such cases currently under investigation and in litigation throughout the United States. The Rabon Law Firm has been lead or co-counsel in FCA cases that have recovered in excess of $1 billion dollars to the federal and state governments.
About the Hoyer Law Group
Hoyer Law Group fights fraud and advocates for whistleblowers and employees nationwide, with offices in Florida, D.C., Michigan, and California. Click here to learn more about Hoyer Law Group’s whistleblower practice and here for more information about our team.