Georgia Trial Lawyer Blog

Two years ago Medicare implemented a whistleblower hotline in Miramar, Florida with the sole purpose of cracking down on Medicare and Medicaid fraud. In May, the hotline lit up with Miami senior citizens claiming that their bills listed treatments that they never received.

The Miami Herald has the story.

The calls led to the arrest of Feliberto Ramos, the owner of Miracle Group Rehabilitation Center, for falsely billing Medicare for $3.1 million. In total, Medicare paid Ramos $1.9 million on rehabilitation claims that were never provided to patients. Ramos was ultimately convicted of fraud and received a three year sentence.

Until recently, only three people were manning the hotline which is run by company called SafeGuard. Now, the hotline has about 15 operators and 15 investigators to combat the multibillion dollar Medicare fraud problem in south Florida.

Most of the calls concern false billing. Approximately 15% are for services and goods that were never provided such as mental-health counseling, physical rehabilitation, wheelchairs and medical supplies. The most compelling calls are forwarded to the investigative team. Ultimately, the FBI and federal agents are alerted to the fraud, and in cases like Ramos, arrests are made.

The Medicare hotline is one more tool in the government’s war against Medicare fraud.

The greatest defense, however, is the millions of Americans who work in the health care industry. Our whistleblower attorneys can help health care employees report Medicare fraud and other fraudulent healthcare billing practices by filing what’s known as a qui tam lawsuit. A qui tam suit is a civil action that is filed on behalf of the U.S. government to recover the stolen funds. In many cases, a whistleblower can recover a significant amount of money when the government recovers from the fraudulent provider.

A nurse at the Satilla Regional Medical Center in Waycross, Georgia filed a qui tam action against the hospital in 2007 for allegedly defrauding Medicare and Medicaid. Recently, the Department of Justice announced that it will be taking over the case.

Georgia Public Broadcasting has the story.

A qui tam law suit is when an individual sues a business for defrauding the government by filing a false claim. Qui tam law suits are most commonly filed in connection with health care fraud although virtually any type of company may be sued. To succeed in such a law suit, a whistle blower needs independent and direct knowledge that a business has defrauded the government. Whistleblowers are typically employees of the business being sued, since generally only employees are privy to such information.

If a qui tam suit is successful, a whistle blower can expect to be awarded 25 to 30 percent of the amount that is recovered. However, in some cases, the government will decide to take over the case. In those situations, a whistle blower can expect to earn 15 to 25 percent. It is not uncommon for whistle blowers to recover millions of dollars especially if the fraud was pervasive or if the law suit concerns a large corporation.

In the recent Waycross hospital case, the nurse filed suit after she saw a doctor puncture an artery of a patient during surgery and then abandon the patient. That patient later died. U.S. District Attorney Ed Tarver announced that his office was taking over the case after discovering that the hospital’s actions may have been profit-driven. According to Tarver, the hospital knew the doctor in question was not credentialed to conduct that type of surgery but allowed the doctor to do so anyway. The DOJ also believes that Medicaid and Medicare paid for treatments that were unnecessary.

Aside from unnecessary treatments, a qui tam action may be proper anytime an employer over charges, bills for something that never existed, produces inferior goods, or uses false or stolen identities in order to defraud the government out of money.

Our whistle blower lawyers are able to help employees and individuals file suit against companies that defraud the government. We understand that many employees are hesitant to speak out against their employer; however, it is important for employees to know that federal law protects whistle blowers from retaliation by their employers.

Experts estimate that Medicare fraud costs the nation $60 billion annually despite tough whistleblower laws. They also predict that this number will continue to grow.

The story in Georgia is no different. In one recent Georgia case, an Athens psychologist was convicted after swindling Medicaid out of more than $550,000. The Atlanta Journal Constitution has the story.

One reason for the tremendous amount of fraud, and why it keeps growing, is that there are simply too many businesses and individuals who cheat the government for law enforcement to handle. In response, Congress and various states, including Georgia, passed powerful whistle blower laws which allow an individual to bring suit against a company that files a false claim with the government. While anyone may bring such a suit, employees are often in the best position to disclose the fraud.

In order to bring a successful qui tam action, an employee must have independent and direct knowledge of the government being defrauded by their employer. The whistleblower employee is typically entitled to 15 to 30 percent of the money recovered. In qui tam actions involving large businesses, it is not uncommon for the employee bringing the suit to recover millions of dollars.

It is important to understand that fraud can come in many forms. Some employers defraud the government by over billing for services or goods, billing for services or goods that never existed, or by producing inferior goods. In the health care setting, a health provider may also defraud the government by prescribing unnecessary prescriptions and procedures or even by stealing someone else’s identifying information and claiming that person as a patient for Medicare purposes.

In the recent Athens case, the convicted psychologist submitted thousands of claims for therapy work he never performed for real patients as well as for people that he never treated. Although this case was investigated by the Georgia Attorney General's office and federal officials, a whistleblower complaint could have been brought if timely filed by an employee or other insider with knowledge of the fraud.

Our whistle blower attorneys are able to help individuals report their employers for filing false claims with the government. Many times employees are hesitant to blow the whistle due to fear of reprisal by their employer. However, federal law protects whistle blowers against retaliation for investigating or prosecuting a potential qui tam claim.

AT&T has recently come under fire for allegedly failing to pay certain employees for overtime as is required by federal law.

In a Georgia lawsuit filed last month, AT&T employees claimed that the company broke the law by classifying first-level managers as exempt from overtime pay. Such lawsuits have increased in Georgia and around the country due to a change in federal regulations as well as a struggling economy.

The Atlanta Journal Constitution has the story.

Overtime pay is codified in the Fair Labor Standards Act. The main issue in the majority of overtime lawsuits is how a company classifies its workers. Generally, whether an employee must receive overtime hinges on their job functions and whether their job is exempt. Employees who work in an administrative, executive or professional function are generally exempt. Computer workers, those in outside sales, or workers who are highly compensated are also generally exempt. Each category also has its own requirements for exemption to apply.

Among the grayer areas of this law is how to classify managers. For an executive exemption to apply, the employer must show that an employee’s principal role is to manage a customarily recognized department or subdivision of the business. The company must also show that the employee manages at least two full-time employees and be able to weigh in on the hiring or promotion of lower level employees.

In the Georgia AT&T case, plaintiffs argued that AT&T classified first-level managers as exempt even though their jobs largely involved non-managerial duties.

The Georgia AT&T case is part of a recent trend of overtime lawsuits against major corporations. In 2004, the Department of Labor adjusted regulations which caused some workers who were previously exempt to become misclassified. This factor combined with a poor economy has sparked an increase in the number of overtime lawsuits which experts predict will continue to grow.

Our attorneys have successfully handled cases in which employees were wrongfully denied overtime pay. As this article suggests, the FLSA is an incredibly complex and intricate law. However, it is also a very worker-friendly law. The law allows an employee two years to bring a suit against his or her employer for violating overtime laws. This time period is extended to three years for willful violations. Furthermore, successful plaintiffs can recover significant monetary damages including back pay, liquidated damages, attorneys’ fees and court costs.

Our firm was recently hired to represent the owner of a small heating and air conditioning business after an employee of BellSouth Advertising and Publishing Corporation fraudulently entered him into a contract.

We brought suit against BellSouth Advertising and Publishing (BAPCO) and its employee in October alleging identity fraud and forgery. We hope that this lawsuit will hold BAPCO accountable for any fraudulent practices and act as a stark reminder to corporations that their customers have rights and should be treated fairly.

In our experience, it is not uncommon for large corporations to take advantage of small business owners and individuals through either outright fraud or covering up the tracks of their criminal employees. Georgia law provides defrauded customers with several legal avenues to punish corporations and their employees for unfair practices. Under these laws, a defrauded plaintiff may be entitled to a significant monetary award.

Our client's business was harmed by the fraudulent acts described in our complaint against BAPCO. We hope to be able to help our client recover his damages in this case, and perhaps help deter large businesses from taking advantage of their customers in the future.

Pate & Brody is an accomplished Georgia law firm with offices in Atlanta, Macon, Madison and Savannah. Our lawyers are dedicated to pursuing justice for crime victims, people who have been defrauded by deceptive business practices, or injured through the fault of others. Our lawyers have been recognized on the list of Georgia's "Super Lawyers", and included among Georgia's "Legal Elite" by Georgia Trend Magazine.

Medicare covers more than 46 million Americans who are elderly or disabled and pays out nearly $500 billion annually. However, Medicare fraud costs taxpayers around $60 billion a year and has become what many have described as the most profitable crime in America.

60 Minutes ran a recent story on the issue.

Authorities admit that deceiving the government with false Medicare claims is quite easy. Typically, an offender will attain a list of Medicare patients with their names, social security numbers and birth dates. The offender will then open a phony store front that claims to be a pharmacy, clinic or medical supply store and simply bill Medicare for items and services that never existed.

Under the law, Medicare must pay the claim within 15 to 30 days. Since Medicare only has a few auditors, much of the fraud simply goes undetected. When inspectors are sent to investigate a suspicious claim, they generally do so after the checks have been delivered. By that time, the phony business has usually been abandoned and the offender has moved onto a new phony business. FBI agents say that it’s not unusual for a single fraudster to make $400,000 or more a month.

However, Medicare fraud is not limited to the common fraudster. Doctors have been convicted of Medicare fraud for billing unnecessary prescriptions and procedures. And hospitals have been accused of taking in homeless patients to fill empty beds. Government officials fear the problem will only grow worse as people create new ways to take advantage of the system.

Yet, taxpayers are empowered to stop Medicare fraud through whistleblower laws. Any person who has direct and independent knowledge of Medicare fraud may bring a civil suit on behalf of the government. This is known as a qui tam action. Under federal law, those committing the fraud are liable for each act of fraud between $5,000 and $10,000 and three times the amount of damage that the government sustained. The person who brings the suit is generally entitled to 15 to 30 percent of the amount recovered.

Our whistleblower attorneys have helped several people blow the whistle on government billing fraud and false claims. It is important to understand that Medicare fraud can occur in many different ways including billing for non-existent patients, services that were never performed, giving false information or false certification, kickbacks, upcoding schemes and lack of medical necessity. By blowing the whistle on these practices, a person can help the government put an end to the fraud and attain significant monetary damages.

Pate & Brody is an accomplished Georgia law firm with offices in Atlanta, Macon and Madison. Our lawyers are dedicated to pursuing justice for crime victims, people who have been defrauded by deceptive business practices, or injured through the fault of others. Our lawyers have been recognized on the list of Georgia's "Super Lawyers", and included among Georgia's "Legal Elite" by Georgia Trend Magazine.

On Friday, a Watkinsville, Georgia physician assistant, Ulys Randall Riner, pleaded guilty in Newton County to running a Ponzi scheme in which he stole more than $4.5 million from investors. Prosecutors believe that Riner stole from more than 20 Georgians, and that most of the victims were his friends.

The Atlanta Journal Constitution has the story.

Riner was arrested in 2006 for using a strategy called “factoring” in which he sold fraudulent promissory notes to investors. Specifically, Riner would use the money attained from investors to buy discounted accounts receivables on government contracts. Prosecutors allege that he told the investors that they would receive a full return. He would then sell the promissory notes through his business, Express Factors. He would take that money and pass it on to other companies, and when those companies failed, he used funds from new investors to hide the money that was lost.

Riner was indicted in 2006 on 29 counts for selling unregistered investments and was set to go to trial on October 26. However, he entered a guilty plea on October 23 in which he agreed to pay back $2 million to investors. The plea stated that he will pay $125,000 within 60 days and then $2,000 per month. Investors are set to be paid based on a percentage of what they gave Riner. That amount ranges from $2,000 to $650,000. In addition, he agreed to 17 years on probation with two years in a work-release program. The judge also let Riner plead first offender which may help him keep his medical license.

This criminal prosecution may also lead to a civil suit against Riner and other responsible parties. Our business fraud attorneys have successfully represented several clients who have fallen victim to Ponzi schemes and other unscrupulous investment practices. In our experience, the criminal justice system may punish the offender and force some restitution, but it often fails to fully compensate a victim of investment or business fraud. A good business fraud attorney will work with prosecutors, law enforcement and investigators to find every possible source of money an offender has to ensure that the victim is fully compensated for his losses in civil court.

Pate & Brody is an accomplished Georgia law firm with offices in Atlanta, Macon and Madison. Our lawyers are dedicated to pursuing justice for crime victims, people who have been defrauded by deceptive business practices, or injured through the fault of others. Our lawyers have been recognized on the list of Georgia's "Super Lawyers", and included among Georgia's "Legal Elite" by Georgia Trend Magazine.

A federal jury awarded a former nursing student of Appalachian Technical College $450,000 for wrongful expulsion.

The Atlanta Journal Constitution has the story.

Sara Castle, 55, was 13 weeks away from graduating from ATC when the school expelled her. Castle complained that she was kicked out for exposing a professor who would dismiss students from class early.

To obtain the degree Castle was studying for, she and her classmates needed 740 hours of training. She argued that the professor’s practices made that 740 hour mark impossible to reach, and as a result, students were not receiving the training they needed to become competent nurses. Upon exposing the professor, Castle alleged that ATC fired the professor and expelled Castle.

The jury deliberated for less than an hour before siding with Castle. The college was represented by the Georgia Attorney General’s Office which is now contemplating challenging the verdict.

The ordeal for Castle has been an emotionally charged journey after dealing with the humiliation of being expelled. She has also had to come to terms with the fact that she will never attain her dream of becoming a nurse.

Pate & Brody is an accomplished Georgia law firm with offices in Atlanta, Macon and Madison. Our lawyers are dedicated to pursuing justice for crime victims, people who have been defrauded by deceptive business practices, or injured through the fault of others. Our lawyers have been recognized on the list of Georgia's "Super Lawyers", and included among Georgia's "Legal Elite" by Georgia Trend Magazine.

Four former employees of American InterContinental University have filed a whistle blower lawsuit against the university on behalf of the federal government. The employees allege fraud that could total more than $100 million in grant money.

The Atlanta Journal Constitution has the story.

The four employees, who worked at AIU’s Dunwoody campus, claim that the university enrolled students who could not read and did not have high school diplomas. The lawsuit also alleges that the university gave recruiters bonuses based on the number of students they enrolled in violation of federal law.

In order for a college to receive certain types of aid, it must have accreditation from an organization recognized by the U.S. Department of Education. In this case, the Southern Association of Colleges and Schools (SACS) gives AIU its accreditation. SACS put AIU on probation in 2006 and 2007 for giving rewards to recruiters and for enrolling students who did not possess high school diplomas. The suit alleges that AIU attempted to deceive SACS prior to its 2007 visit by removing documents that mentioned enrollment quotas. In addition, the four employees claim that the quota system continued even after AIU had completed its probation.

The plaintiffs’ attorney Joseph Wargo believes that the fraud exceeds $100 million in grant money as well as a significant amount in federal loans. AIU has not commented on the allegations but says that it intends to fight the suit.

Pate & Brody is an accomplished Georgia law firm with offices in Atlanta, Macon and Madison. Our lawyers are dedicated to pursuing justice for crime victims, people who have been defrauded by deceptive business practices, or injured through the fault of others. Our lawyers have been recognized on the list of Georgia's "Super Lawyers", and included among Georgia's "Legal Elite" by Georgia Trend Magazine.

The Illinois Attorney General filed suit against Wells Fargo last week for discriminatory and illegal mortgage lending practices against blacks and Latinos.

CNN.com has the story.

Lisa Madigan, the Attorney General of Illinois, believes that Wells Fargo has turned Latino and African-American communities into hotbeds of subprime lending. She stated that the high foreclosure rates in these communities are a direct consequence of the illegal practices committed by Wells Fargo. Madigan also alleged that white borrowers with equivalent incomes were typically given lower-cost loans.

The lawsuit goes on to complain that Wells Fargo Financial Illinois, a subsidiary, misled borrowers about the terms of their mortgages and misrepresented the pros and cons of refinancing. The suit also claims that Wells Fargo routinely “flipped” loans and confused borrowers with misleading mailings.

Madigan has asked the court to rescind all of the contracts at issue and for Wells Fargo to pay restitution to those who have been afflicted.

Wells Fargo maintains that it practices responsible lending and does not use race as a factor.

Pate & Brody is an accomplished Georgia law firm with offices in Atlanta, Macon and Madison. Our lawyers are dedicated to pursuing justice for crime victims, people who have been defrauded by deceptive business practices, or injured through the fault of others. Our lawyers have been recognized on the list of Georgia's "Super Lawyers", and included among Georgia's "Legal Elite" by Georgia Trend Magazine.

The Georgia Court of Appeals recently had to determine if a defamation suit which alleged that a reporter published a plaintiff’s poor job performance should survive summary judgment. The court found that it should, since a jury could find that there was defamation.

In Gettner v. Fitzgerald, the plaintiff, Gettner, sued VNU Business Media, Inc. for defamation, because of a publication by VNU in which it was revealed that Gettner had been demoted based on poor performance. Gettner also sued his former employer, Fitzgerald & Company, for invasion of privacy, because the CEO told VNU about the nature of the demotion. Gettner claimed that he had been promoted to Executive Creative Director in 2001, but that he did not like dealing with subordinates. As a result, the company allowed him to return to his prior position as Group Creative Director in 2002. His company disputed this, and it claimed that he had been demoted due to poor performance. The company further argued that the company agreed to make it seem that it was Gettner’s decision in order for Gettner to save face. The form given to human resources showed that he had “stepped down.” The company even sent an email to its employees which gave a similar reason.

A reporter with Adweek investigated into the matter. The CEO of Fitzgerald told the reporter that Gettner lacked the qualities of an Executive Creative Director, but he also asked the reporter not to publish that information. In 2003, Fitzgerald had layoffs and let go Gettner. Adweek then released its annual report card for advertising agencies, and it gave Fitzgerald a “C” for management. The report explained this was due to Gettner’s poor performance. When Gettner confronted the reporter, she allegedly claimed to have known that Gettner stepped down voluntarily. Gettner then sued. The trial court granted motions for summary judgment in favor of both VNU and Fitzgerald.

The appellate court examined the four elements that make up defamation. First, the statement must be about the plaintiff. It was obvious that the statement was about Gettner. However, VNU argued it was only an opinion and not a statement of fact, but the court reasoned that the statement in question could be proven false which would make it not an opinion. Second, defamation requires that the statement made was false. Since Gettner put forth evidence that it was false, a jury could find that it was false. Third, the plaintiff must show that it was the defendant’s fault in publishing the statement. The court found that the reporter could have conducted a more thorough investigation, because she failed to verify the information with Gettner and others. Finally, the plaintiff must show some actual injury. VNU did not dispute this element. Thus, the summary judgment in favor of VNU was improper, and the appellate court’s decision will allow a jury to hear the decision.

Pate & Brody is an accomplished Georgia law firm with offices in Atlanta, Macon and Madison. Our lawyers are dedicated to pursuing justice for crime victims and people who have been defrauded by deceptive business practices or injured through the fault of others. Our lawyers have been recognized on the list of Georgia's "Super Lawyers", and included among Georgia's "Legal Elite" by Georgia Trend Magazine.

A Cobb County Superior Court judge awarded $2.5 million to Susan Farhadi, a woman who was defrauded by Vesta Strategies.

The Atlanta Journal Constitution has the story.

Apparently, the lawsuit alleged civil fraud claims, RICO and breach of fiduciary duty. Because Vesta is no longer in business, it is unclear whether the lawsuit was defended, or whether the judge simply made a decision on damages after entering a default judgment against the company.

As the economy continues to worsen, it is likely that we will see more of these frauds come to light. Once the music stops playing, there are never enough chairs to go around.

Our trial attorneys work hard to protect consumers and investors who have been defrauded by unscrupulous businesses in real estate and investment scams. We have had no shortage of calls this year from people who have been victimized in these schemes.

If you have lost money as the result of fraud, it is very important that you act quickly. It is the only way to try to recover money that may otherwise be gone for good.

Golden West Financial, the mortgage lender acquired by Wachovia Bank in 2006, is being investigated by the United States Department of Justice for fraudulent mortgage lending practices. The "preliminary investigation" was reported by the Associated Press and picked up by many news outlets, including Forbes.

The gist of the investigation appears to be allegations that the company engaged in predatory lending practices by misrepresenting the terms of certain loans, falsifying documents and persuading borrowers to obtain loans that were clearly inappropriate for them.

Our firm has been involved in many mortgage fraud investigations. We have represented both victims of fraudulent mortgage practices and those charged with being involved in mortgage fraud, including attorneys, mortgage brokers, real estate agents, appraisers, "straw purchasers," and investors.

These cases can be very complex to prosecute and to defend. If you think you were the victim of fraudulent mortgage practices, or have been charged with a mortgage fraud related offense, you may contact our lawyers for a free initial consultation to discuss your case. We have helped many people caught up in this mortgage mess, and we may be able to help you.

This week, Bank of America agreed to pay approximately $8 billion to assist over 400,000 people with troubled mortgages. The settlement is the Bank's attempt to resolve claims that Countrywide, recently acquired by the Bank, used deceptive mortgage lending practices.

The Atlanta Journal Constitution has the story.

Eleven states should benefit from the settlement, but Georgia was not one of them. Apparently, the Georgia Attorney General did not participate in the lawsuit.

Regardless, this is a positive step for many people who were victimized by deceptive lending practices and sold mortgages that they could not afford. Perhaps other lenders will follow suit and help homeowners negotiate more favorable mortgages so they can stay in their homes.

Our firm also helps homeowners victimized by the fraudulent sales practices of many over-eager mortgage brokers and lenders. If you believe that you were deceived into applying for a mortgage that you could not afford, you may contact our office to see if you have a claim for fraud against the mortgage broker or lender.

It looks like big banks were using aggressive sales tactics to push more credit card debt to consumers. The allegation is coming from people who actually worked for the banks in their credit card departments.

CNN has the story. According to the report, one former bank employee actually called these sales practices "a great big con."

Basically, the former bank employees are alleging that their bosses were getting them to advance money with hidden fees to the people who were already in financial trouble. Many times, large cash advances were used as down payments on homes, a practice that would usually be inconsistent with the borrowers' disclosures on loan applications and therefore fraudulent.

Federal legislation has been proposed to curb the use of such aggressive marketing and to force the banks to disclose teaser and hidden rates more clearly. Unfortunately, the legislation has not stopped card issuers from pushing some unsuspecting consumers to take on more debt than they can afford without understanding the escalating interest rate.

Perhaps the recent credit crisis will put an end to these tactics without the need for legislation. Until then, if you believe you have been trapped into a credit card deal through aggressive marketing or deceptive sales practices, you may contact our firm to discuss your situation with one of our consumer protection attorneys.

The lenders are finally getting some heat for their role in the rampant mortgage fraud that has forced many Americans into foreclosure.

Indiana has joined a number of other states in suing Countrywide for deceptive and fraudulent lending practices relating to residential mortgages. Reuters has the story.

Several other states are already pursuing Countrywide, although Georgia is conspicuously absent from the list. The states that have sued are focusing on Countrywide's deceptive and misleading sales practices for residential mortgages. Among other things, the lawsuits allege that Countrywide brokers were knowingly completing false loan documentation to get borrowers approved for loans they simply could not afford.

It will be interesting to see what happens to Countrywide (now owned by Bank of America) as a result of these lawsuits. The State of Washington has already threatened to revoke their lending license.

Our firm has been involved in numerous Georgia mortgage fraud cases. We have seen lenders, brokers and investors push people into deals that were not fair and that they could not afford. Hopefully, these state lawsuits will provide some relief. If not, there is always the option of pursuing the lenders and brokers on an individual basis, if the facts show clear deception.