Qui Tam Report Reveals Eye-opening Facts about Healthcare Cases

(This post is written by attorney James Young.)

A recent review by the Mintz Levin firm took a look at 60 healthcare related qui tam cases that were unsealed between December 2017 and January 2018. The results of their review are both typical and maddening. The government intervened in only 14 percent of those unsealed cases.

This of course means that among the cases which get unsealed, a great majority are declined by the government. More than half of the cases (32) were dismissed, though it is unclear if there were settlements, first to file issues, or other indicia suggesting some positive aspect to the case filing.

Almost half of the unsealed cases were filed in the Middle or Southern Districts of Florida, both of which are among the busiest districts in the country.  The next most popular venue was Central California.

Larger defendants like pharmaceutical companies, hospitals, and healthcare systems were the most frequently targeted types of defendants, with each accounting for nine of the 60 unsealed cases. Seven cases were brought against physicians and physician practice groups, six against home health and hospice providers, and five against outpatient clinics.

Average time under seal for the cases was 700 days, which is a good bit shorter than the historical average of 880 days.

Perhaps the most interesting takeaway from the analysis is the relator’s position in relation to the defendant. More than half (57 percent) were current or former employees, while subject matter experts brought about 10 percent or seven out of the 60 cases.

The takeaways here are pretty clear, these cases are: 1) challenging, 2) long lasting, and 3) best brought by people with inside knowledge.

The analysis by Mintz Levin did not account for the degree of experience of relators’ counsel.  We pride ourselves in working hand-in-hand with our clients to prepare intervention worthy cases.
Our filings are supported by a highly organized disclosure statement which includes a detailed narrative of the allegations, a chronology of the events, an analysis and application of the relevant regulations or billing guidelines to the facts, witness lists and evaluations, locations and indices of known evidence, and other tools developed by our investigators during their time building similar cases in the FBI.

There are clearly no guarantees in filing a qui tam complaint, but it only makes sense to choose a firm that gives you the best chance.