Pope McGlamry Represents Whistleblower in Healthcare Fraud

Pope McGlamry participates in the largest pay-to-play settlement against hospital chain Tenet Healthcare with $513 million settlement

Atlanta, GA (October 26, 2016) – Georgia based law firm Pope McGlamry is pleased to have partnered with Wilbanks & Gouinlock to achieve a record taxpayer settlement in national healthcare fraud. The criminal and civil claims relate to a scheme to defraud the United States and to pay kickbacks in exchange for patient referrals.

Whistleblower Reveals National Healthcare Fraud

Tim Morrison, Jay Hirsch, Marlan Wilbanks and Susan Gouinlock assisted in the recovery of $513 million from major U.S. hospital chain Tenet Healthcare Corporation and two of its Atlanta-area subsidiaries: Atlanta Medical Center Inc. and North Fulton Medical Center Inc. The Tenet subsidiaries were charged in federal court with obstructing the lawful government functions of Health and Human Services (HHS) and the Anti-Kickback Statute (AKS), which prohibits payment to induce the referral of patients for services paid for by federal health care programs.

Justice For The Whistleblower & Georgia Taxpayers

Marlan Wilbanks and Susan Gouinlock filed the action in 2009 and associated with Pope McGlamry in 2013, prior to the intervention of the Department of Justice and the State of Georgia to prosecute the civil case against Tenet on behalf of the whistleblower and the taxpayers. Once the Department of Justice intervened in the matter, Pope McGlamry assisted the federal and state governments in prosecuting the case, resulting in Tenet paying $513 million to the federal government, the state of Georgia and the state of South Carolina to resolve criminal charges and civil claims on behalf of the whistleblower and the taxpayers. The whistleblower’s share of the civil settlement under the False Claims Act came to approximately $84.43 million. The Tenet case is the first brought through the assistance of the Criminal Division’s corporate health care fraud strike force and is amongst many active corporate investigations by that organization.

How Tenet Healthcare Corp Manipulated The System

Tenet manipulated the Medicaid system by unlawfully paying bribes and kickbacks to clinics that unlawfully referred more than 20,000 Medicaid patients to Tenet hospitals. These acts included exploitation of undocumented pregnant women, many of whom were told that Medicaid would cover the costs associated with their childbirth and the care of their newborn only if they delivered at one of Tenet’s hospitals. The victims were led to believe that they could not select the hospital of their choice, resulting in many travelling long distances from their homes to deliver at a Tenet hospital.

This false belief put many expectant mothers’ and their unborn babies’ health and safety at risk; oftentimes, victims passed hospitals that could offer them the care they needed at a much shorter distance from their homes.

Representing Qui Tam Lawsuits

“While Pope McGlamry was prepared to present this qui tam lawsuit to a jury, we are pleased that by working closely with the Department of Justice’s Civil Fraud Division and the State of Georgia’s Medicaid Fraud Controls Unit, we were able to recover this money for the taxpayers.”

Tim Morrison of Pope McGlamry.

“We have long been in the business of handling complex cases. There are really very few law firms with the talent and resources in-house to prepare and present a case of this magnitude to a jury. We have built a business model around handling big cases with significant results. In fact, our qui tam/false claims practice is premised on the model of analyzing whistleblower cases and then putting the firm’s resources behind presenting the stories of these egregious acts of fraud to people on a jury. We have expanded our footprint in Columbus with the specific purpose of handling these cases. Judge Land is a well-respected judge and has presided over and managed one of the largest health care fraud cases in the United States. With the willingness and ability of our law firm to take a case to trial, whistleblowers see recoveries, the taxpayers get their money back, and bad-actor corporations are held to account.”