A ho-hum whistleblower case out of Florida has called into question the constitutionality of a central provision of the False Claims Act.
Obscure as they are, the Latin words "qui tam" have the entire health care industry eyeing what started as a run-of-the-mill federal court case in Florida that morphed into a constitutional challenge of the federal False Claims Act.
The "qui tam" provision in the Act empowers private citizens to sue government suppliers for fraudulent billing. Proponents say such private plaintiff whistleblowers are an essential mechanism against fraud. They brought 18,253 cases since 1986, bringing in $61 billion in settlements and judgments for the government. The law also gives the private plaintiffs 30% of the recovery sometimes.
Opponents say the law unconstitutionally delegates to un-appointed private bountyhunting citizens the federal executive authority to pursue cases.
Clarissa Zafirov, a doctor employed by central Florida physician practice Florida Medical Associates, says she witnessed her employer systematically inflate Medicare reimbursements by putting down false diagnosis codes. She brought a False Claims Act suit in 2019 against Florida Medical and others. Jason Mehta, the Foley & Lardner partner who is lead trial attorney for Florida Medical, says his client denies any wrongdoing and that Zafirov, in her brief employment, misunderstood what she was seeing.
The federal government, as called for by the False Claims Act, reviewed...
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