Begelman & Orlow, P. C. Is Proud of Its Commitment to Pursuing Qui Tam & Whistleblower Cases

Our Law Firm, Begelman & Orlow, is a nationally recognized firm, located near Philadelphia, PA. With offices in Cherry Hill, NJ, and Conshohocken PA, we are among the most experienced Qui Tam, False Claims Act and Whistleblower Attorneys in the New Jersey, Pennsylvania and New York region of the United States, as well as across the nation.

We are Qui Tam Lawyers who represent whistleblowers who have undertaken claims on behalf of State Governments and have appeared in Courts not only in Pa., N. J. and N.Y., but Courts on Qui Tam Cases in Federal Courts across the country on motion approved by Federal Judges.

We have listed some of our Qui Tam, False Claims, IRS Whistleblower, SEC Whistleblower and/or Whistleblower Retaliation and/or wrongful termination employment law cases below so that you as a potential Whistleblower Client or Relator can gain some knowledge of the type of Qui Tam, False Claims Act and Whistleblower Retaliation claims we have filed.

If you believe you may have a whistleblower case, please do not hesitate to call and discuss it with our knowledgeable team. We can help you determine if, in fact, you do have a case that may be worth significant money to you.

Retail Pharmacy Fraud: False Claims Act Qui Tam

Our law firm’s client was a Retail Pharmacist who worked the night shift and was required by his employer, a large national retail pharmacy chain to restock drugs not picked up by Medicaid recipients and ordered not toadjudicate or re-credit Medicaid for those drugs. Our client was then required to restock those drugs without lot control so that drugs later dispensed were double billed to the government Medicaid and may have also been subject to recall. Since there was no docket control there was no way of knowing whether the drugs that were double billed to Medicaid were in fact recalled. Our representation of this relator and the case below involving another national pharmacy chain resulted in False Claims Act cases being filed against all of the nation’s major retail pharmacy chains for Failure to re-adjudicate claims and changed the Retail Pharmacy Industry by imposing Corporate Integrity Agreements on those Retail Pharmacy Chains thereby preventing future Medicaid Fraud by these national retail pharmacy chains.

Retail Pharmacy Fraud: False Claims Act Qui Tam

Our law firms client was a Retail Pharmacist who worked the night shift at another major retail pharmacy chain that was the nation’s largest retail pharmacy provider for Medicaid and was also required by his employer, a large national retail pharmacy chain, to restock drugs not picked up by Medicaid recipients and ordered not to adjudicate or re-credit Medicaid for those drugs. Our client was then required to restock those drugs without lot control so that drugs later dispensed were double billed to the government Medicaid and may have also been subject to recall. Since there was no docket control there was no way of knowing whether the drugs that were double billed to Medicaid were in fact recalled. Our representation of this relator and the case below involving another national pharmacy chain resulted in False Claims Act cases being filed against all of the nation’s major retail pharmacy chains for Failure to re-adjudicate claims and changed the Retail Pharmacy Industry by imposing Corporate Integrity Agreements on those Retail Pharmacy Chains thereby preventing future Medicaid Fraud by these national retail pharmacy chains. This action under the False Claims Act led to the nation’s largest Retail Pharmacy Fraud Case and a top twenty False Claims Act settlement. The case also led to precedent setting legal opinions by the Federal Courts located in Philadelphia Pennsylvania and a Corporate Integrity Agreement.

Education Trade School Fraud: False Claims Act Qui Tam, New Jersey Employment Retaliation Claim

Our law firm’s client was an admission coordinator at large trade school with multi campuses located throughout the Northeast Region of the United States including NJ, Pa, and NY. He discovered education fraud against the United States Department of Education. His employer was falsifying records of admission and attendance in order to obtain student loans or retain student loan proceeds. Students who already dropped out of classed were kept on the roster of students by falsifying their attendance to obtain or retain government financial aid. Additionally the school would falsify application for enrollment concerning military registration and economic qualifications for student loans. They were also claiming placement services when jobs were not available in the trades that the students were training for and obtaining student loans to pay for that training.

Pediatric Medical Practice fraud – False Claim Act Qui Tam – Upcoding

Our law firm’s client was an employee of a pediatric medical practice who was falsely miscoding Medicaid patients for follow up visits as initial complex visits and falsely coding regular Sunday visits as emergencies.

Mental Health Service Provider for Psychologists – Falsely Billing SSI and Medicare for Services Not Rendered

Our law firm’s client was an employee of a non-profit medical health provider who clients were psychologists. The company assisted people of the Latino community with developmental disabilities including mental illness and addiction. This Pennsylvania based company billed both SSI and Medicare for patients who were not seen. All employees were instructed to fill out time sheets with some sheets being fraudulent.

Defense Contractor Using Minority Front and Not Paying Fair Wage. Davis-Bacon Act – False Claim Qui Tam

Our law firm’s client was bookkeeper for a national defense contractor who was not paying prevailing wages to its workers on Federal Government contracts and who were working on a large military base. Contractor was also using a minority front to obtain their contracts. Work sheets were processed to show that employees time were spent working on non-government contracts with the contractor billing the government for full federal project working days.

False Claim Act Qui Tam Violations – Court Reporters Doing Business with Federal Government

Our law firm’s client was a court reporter for a national firm who prepared transcripts that violated government contract standards including characters per page and number of lines allowed.

False Certification Fortune 500 Company Reverse False Claim

Our client was a warehouse manager who related that international Fortune 500 company was paying reduced customs fees because they certified that they had put in place certain safety measures in order to warehouse hazardous chemicals which were imported to major east coast port. These security and safety precautions were certified so that company could reduce customs charges, time getting through customs and other related expenses. These certified precautions which were a part of the federal government contract, were never implemented.

False Billing for Training Grants – Retaliation and Termination

Our law firm’s client was foreman for an international ship builder doing business in the US. Government grants were given as an incentive to train new employees. Grants were partially drawn on a progressive scale as the worker acquired new skills and certification. On a regular basis company would not only falsely certify that the employees passed the required work tests required, but on some occasions provided the test questions in order to draw down grants. Our client complained about this conduct and was subjected to harassment and termination.

Sub-Contractor – Billing Federal Government for Time for Hours in Which No Work Was Being Performed

Our law firm’s client was a guard at a security firm, whose contract called for use of guards to watch over and secure a Federal Government Facility located in Pennsylvania. Our client alleged that he and his coworkers were not being paid for hours worked, but his employer was billing the government for those same hours worked without paying their employees in violation of Federal law.

Medicare Fraud – Medical Supplies – Kickbacks to Doctors

Our law firm’s client was a sales representative for a medical supply company which provided event monitors to patients of doctors who would prescribe them. The company set up kickbacks to these doctors when they prescribed and prepared their patients for medical monitoring. The same medical supply house would also use the same doctors to help defraud Medicare by also billing private insurers at the same time they were submitting claims to Medicare for the same services.

Qui Tam Complaint – Large City Hospital – Non-Licensed Employees Administering Drugs at Their Clinics

Our law firm’s client was licensed practical nurse at one of New Jersey’s largest hospitals. Her complaint alleged that the hospital’s clinics were using non-licensed workers that were administering drugs including methadone to their patients through a government program to aid the poor. Patients had prescriptions for drugs that were to be given by licensed persons as required by state regulations..

False Payroll Certifications – Prevailing Wages

Our law firm’s client was an employee of a contractor who had several contracts with the government to work at one our nation’s largest Air Force bases. The company was falsely certifying that it was paying their workers prevailing wages pursuant to Federal Law and Regulation. In fact, the company was paying its workers their regular hourly rate as if they were working on a non-government job. The government reimbursed the full prevailing wage rate to the employer pursuant to the government contract terms, believing that the prevailing wage was being paid to the employees as certified, however the employer was not passing those wages onto its employees and fraudulently not paying them that prevailing wage.

Online Pharmacy Distributing Drugs Without DEA Numbers

Our law firm’s client was registered Pharmacist working a large online prescription distributor. Federal law requires that in order for prescriptions to be legally distributed and filled by any pharmacy, certain information must be on the actual script. The doctors DEA number is mandatory on all scripts drugs including narcotics. After many objections, our client was terminated for refusing to fill scripts that lacked valid DEA numbers. Company billed Medicare and Medicaid for prescriptions that lacked DEA numbers.

Nursing Home Double Billing Unused Drugs

Our client was a LPN who had evidence of the Nursing Home she was employed at reusing drugs prescribed and paid for by Medicaid after the original patient for whom the drugs were authorized had either been discharged or passed away.

Use of Unlicensed Personnel to Perform Orthodontic Treatment of Medicaid

In New Jersey it is unlawful for non-licensed personnel to provide any treatment involving orthodontic care that requires the unlicensed personnel to put their hands into a patient’s month. In this case an Orthodontist was having his unlicensed staff provide routine care such as replacing bands in the mouths of Medicaid patients. Since the care givers were not permitted to perform those services, the doctor’s charges for that care, which were billed to Medicaid, were unlawful and thus false under the False Claims Act.

Nursing Home Cost Report Fraud

Nursing Homes are paid by Medicare and Medicaid to provide services based on the patients need level determined by an assessment. The reimbursement system is designed to pay for the level of care that is anticipated that the patient will require. The rate that is paid for the services or needs anticipated, known as a ROG is determined by the legitimate costs incurred by the nursing home as reported on an annual cost study. In this case our client reported that the facility in question was reporting the employment of phantom personnel that were not in fact paid or employed. The result of falsely reporting costs on a cost study is an increase of reimbursement and is a false claim under the civil False Claims Act.

Pharmaceutical Manufacturer Best Price Fraud

Our client an executive with a National Pharmaceutical Manufacturer alleged that his employer was not providing the government with the “best price” for the drugs eventually sold by pharmacies to Medicaid recipients. Even though the actual claims for reimbursement are made by retail pharmacies, drug manufacturers are required to provide each state’s Medicaid agency with pricing information such as Average Wholesale Costs and Best Price. As a result of these reports state governments are reimbursed through a rebate system. The charges by these pharmaceutical manufactures however to the government with certain allowed discounts and safe harbors must not be more than the “best price” offered to any other customer of the manufacturer. In this case our client alleged that hidden discounts were being offered to some of the manufacturers best customers and that these discounts were not being reported the government in the “best price” figures from which the rebates were determined.

Orthodontist Billing Fraud for Phantom Patients and Office Visits

In this case our client reported that her employer, an orthodontist, was billing Medicaid for office visits and procedures that never occurred and also for patients that were not even his.

Bariatric Surgical Billing Fraud Billing for Second Surgeon Not Present at Surgery

Our client a Surgical Nurse acted as a surgical assistant during bariatric surgery and was allowed to bill for those services independent of the surgeons charges. The surgeon however, through his medical surgical group also billed for the same services and claimed that his partner acted in that capacity even though the partner was not present during surgery and on some occasions was not even in the country.

Fraudulent Billing for Physician Assistants and Nurse Practitioners at Full Doctors Rate

Doctors are permitted to bill for services of their Nurse Practitioners and Physician Assistants at their rate of reimbursements from government benefit programs as long as the Doctor is present in the office to supervise their Nurse PR actioners and/or Physician Assistants. If the doctor is not present however, while the NP or PA may still treat the patient and charge for that treatment they may only bill and retain compensation from government insurance programs at 85 percent of the Physician’s Rate . In this case the Doctor charged and received proceeds at his full rate for the services of these NR or Pas even though he was not present or in the his office to supervise those providers.

EMT/Ambulance Waiver of Co-Pay for Local Patrons

Our client alleged that his local ambulance EMT service illegally waived copays for local patrons. In doing so the local ambulance violated the law against inducements to encourage use of services the charges for which were to be paid by Medicare or Medicaid.

Hospice Owner Physician Billing Medicare for RPN Services as “Incident to” for Higher Billing

Our client is a registered nurse who relates that her doctor employer is billing false billing Medicare. Procedures that require RPN number codes, were regularly billed as “incident to” in order to receive larger compensation.

Hospice Extending Length of Stays in Order to Fill Beds

Multiple relators- all employees of hospice facility with many branches across the United States.. Professional staff and other care givers were instructed to code Medicare for services not given or necessary. In most instances, patients were kept beyond need in order to bill for their bed and treatment.

False Billing Submitted to HUD for Repairs and Maintenance

Our client is a contractor who works on HUD projects. Recipients of HUD programs and grants were using unlicensed craftsman which violated the rules and regulation of the program and were a condition for payment. Many buildings were left incomplete and unsafe.