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The False Claims Act: Go court hopping when shopping for fraud stories

The False Claims Act: Go court hopping when shopping for fraud stories

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health fraud, False Claims Act

Where do you go to find a False Claims Act case?

False Claims Act lawsuits can be brought in federal courts or, in the case of 28 states, Chicago, New York and the District of Columbia, at the state level.

This can make fishing for a fraud case complicated if you just have a suspicion that something funny is going on. Let's say you work in an area where six hospitals are owned by one of the national hospital chains – ripe targets for False Claims lawsuits and frequent losers in court. You would want to check the federal courts in PACER, but you also would want to check for lawsuits filed in each of the relevant states where the hospital chain operates.

California, for example, enacted its False Claims Act in 1987. One of the most famous False Claims Act cases in recent history originated there: the Redding Medical Center unnecessary heart surgery case. Ryan Sabalow provides some great background on the complex case in the Redding Record Searchlight. And Kelly St. John and Mark Martin at the San Francisco Chronicle wrote an interesting piece about the priest who sued Redding Medical Center under the False Claims Act. Here's a taste:

Father John Corapi prepared to die. A cardiologist at Redding Medical Center, Dr. Chae Hyun Moon, had told him he was at death's door unless he had immediate triple bypass surgery. So, Corapi -- once a multimillionaire who tumbled into cocaine addiction and homelessness before becoming a nationally known Catholic priest wrote a will and scheduled emergency heart surgery at a Las Vegas hospital, where a friend promised to take care of him afterward. But as Corapi, 55, lay on a gurney waiting for his chest to be cracked open, the doctor planning to operate looked at his medical records and gave him the shock of his life: He was perfectly fine.

Corapi never had the surgery and, unlike other patients who did actually die following unnecessary procedures, Corapi did not suffer any physical injury as a result of the advice Moon gave him. But, because of the False Claims Act, he was able to sue and to win $2.7 million out of $62.55 million recovered for the federal government. Corapi sued in federal court, but he also brought a case under the California insurance code, which, like the False Claims Act, allows people to sue as a "qui tam" litigant.

One problem for writers who covered the Redding case was that both Corapi's False Claims Act case and another suit were filed under seal.

In practice, this can mean that when you go to review a court file, you will find much of the relevant material has been literally sealed inside a manila envelope. Depending on the court clerk, you can actually see the envelope, but you are barred from opening it. Even if you know that a case has been filed under seal, it is always a good idea to go to the court and ask to see the records. I have been given records that were supposed to be sealed but were, in fact, not hidden from public view at all.

Another route at your disposal – if you work for the handful of media outlets that still retain lawyers – is to sue to break the seal. The New York Times and the medical journal PloS Medicine did in a case brought by patients who had taken hormone drugs and were suing Wyeth. When the judge agreed, the resulting documents became a treasure trove for reporters as part of the Drug Industry Document Archive.

Next: Who might be making a false claim on your beat?

Related Posts:

The False Claims Act: The law that makes fraud whistles blow

Photo credit: stevendepolo via Flickr

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