Whistleblower Recoveries During the Obama Administration, 2009-2016 in Review

The Obama-era saw over thirty-one billion dollars in whistleblower recoveries under the False Claims Act. That’s thirty one followed by nine zeros. Sounds like a lot right? It is, and there are a number of reasons this area of law has become so lucrative. Enormous government contracts and structural and complex payment systems like Medicare mean big opportunities for private entities to take advantage.

Keeping in mind that these lawsuits often take years to wind their way through the legal system, the DOJ under the Obama administration continued the fight against fraud against taxpayers.  Well over half of all recoveries were against companies in the health care field, which probably should come as no surprise as health care is now the single largest federal expense.  Next in line was the financial sector in the wake of the financial crises.  Rounding out the list were procurement contractors and “other,” which  consisted of everything from oil and gas companies and a for-profit education group.   In many cases, including the largest recoveries, the fraud was committed by companies that are household names- like GlaxoSmithKline, Pfizer, Johnson & Johnson, Bank of America, Wells Fargo, Northrop Grumman, BP, and the list goes on.

When it comes to the False Claims Act, like any good auditor, the rule is to “follow the money.”  After running on populist rhetoric, it should be interesting to see how the Trump administration’s DOJ handles fraud committed against taxpayers.   For a more detailed list of companies hit by the FCA, a link to the DOJ’s significant fraud settlement list is below:

https://www.justice.gov/opa/press-release/file/918366/download

Kmart Settles Whistleblower Lawsuit

In 2008, pharmacist James Garbe, of Northwest Ohio, sued Kmart in federal court for overbilling Medicare Part D patients for their prescriptions.  According to the DOJ, Kmart charged one price to cash customers, but a far HIGHER price to the government for the same drugs.

In December of 2017, Kmart settled the lawsuit for a total of $59 million dollars, which was a small fraction of their overall potential liability.  This sum is to be split between the federal government, multiple states who were also defrauded in the scheme, the relator, and Mr. Garbe’s attorneys. A link to the DOJ’s news release on the settlement is below:

https://www.justice.gov/opa/pr/kmart-corporation-pay-us-323-million-resolve-false-claims-act-allegations-overbilling-federal

 

What Happens To People Who Rip Off The Government? Qui Tam Basics.

Well, if you’re a company, you may be sued under the federal False Claims Act, 31 USC 3729, et seq.  Also called the “qui tam” or “whistleblower” law, these statutes were originally passed during the Civil War due to widespread fraud in the North performed by government contractors.

This law has seen several changing iterations over the last 150 years or so, but the basics remain the same- the law allows a whistleblower (or “relator”) to report the suspected fraud to the government by filing a lawsuit under seal (or temporarily without the suit being a matter of public record).  The federal government, via the Department of Justice (DOJ), decides if it wants to join in the lawsuit and pursue it.  Whether the government jumps on board or not, the whistleblower can choose to continue the suit on his or her own.

Whether the DOJ pursues the case or not, the whistleblower is entitled to a percentage of the ultimate recovery, up to 30%, plus attorney fees.  Since some of these cases can be in the hundreds of millions of dollars, the payouts can be big.

All that said, these are usually complex cases against extremely powerful defendants, defendants that have the wherewithal to cheat the American taxpayer out of enormous sums of money and defend against these cases with out-sized resources.  These days, these defendants increasingly seem to include tax cheats and health care companies engaged in Medicare and Medicaid fraud.   After all- that’s where the big money is.

Mega Mistakes: Lawsuits Against the Ohio Lottery Commission

Big Ticket Items:

If you are like roughly 50% of the rest of Americans, then “winning the lottery” is a cornerstone of your retirement strategy.  Of the $70 billion or so worth of tickets (Americans spend more on lotto tickets every year than the individual GDPs of 118 countries), $2.7 billion is spent by Ohioans.  That’s a lot of scratch-offs.  And yes, you read that right, Americans spend more on the lottery than MOST countries produce.

Who Gets a Share in the Office Pool?

With so much money flying around, it seems like there would be a lot of litigation involving lottery claims.  Well- there is.  Sort of.  Most lawsuits seem to involve office pools with a set of facts similar to the following:

Jim, Bob, and Jane all work at Company X.  The three have been in an office lotto pool for years.  One day, Jim finds out he bought the winning ticket, but only Jim and Jane chipped in money that day since Bob was out sick. Jim and Jane claim the prize and leave Bob out of it.  Bob sues Jim and Jane on the grounds that he should be entitled to a share of the award.

Under Ohio law, these kinds of suits can be brought in your local county court and the judge or jury can decide who the rightful prize-winner/s are based on past conduct, written agreements or records, etc.

Suing the Ohio Lottery Commission (OLC)

However, it is exceedingly rare for lottery players to sue the Ohio Lottery Commission, but it does happen.  In fact, since 1975, only 88 lawsuits have been brought against the OLC, and many of those suits were unrelated to gaming.  These suits must be brought in the Ohio Court of Claims, a special court set up specifically to handle claims against Ohio’s State agencies.

Here is a list of the more interesting cases from the last twenty years or so:

Demetriades v. OLC, 2017-00705

Plaintiff purchased ticket and wins $500, then promptly loses ticket.  In an incredible example of selectively optimistic memory, plaintiff remembers that prize was worth $500,000 and sues the OLC.  OLC is able to recreate records of ticket and proves that it was only worth $500.

Estate of Keefe v. OLC, 2017-10035

Plaintiff wins 5 million dollar jackpot.  Clerical error on OLC’s claim form states that the prize was 6 million dollars.  Plaintiff paid 5 million, sues OLC for an additional 1 million on theory that claim form signed by OLC employee amounted to a contract.  Result?  OLC wins, contract for payout forms at time of purchase of ticket and ticket holder is only entitled to the actual prize certified by the director of the OLC.  Winner died during the case, apparently heartbroken for only having 5 million dollars instead of 6 million.

Maffett v. OLC, 2004-09967; Freiling, et al v. OLC, 2003-11275; Constani et al v. OLC, 2003-11615

These three cases were filed shortly after a widespread ticket misprint made apparent winners in the amounts of $2,500, $50,000, and $2,000,000 respectively.

All three ticket buyers were denied their claims and offered a refund of their ticket price.  All three sued and lost for the same reason- misprinted tickets are invalid under Ohio law.  Not to worry, the OLC refunded the price of the ticket.  No word on whether any of them spent it on another ticket.

Dabaja v. OLC, et al., 2012-08567

Four people claim all claim to have purchased one 2 million dollar winning ticket and submit claim forms.  Plaintiff sues the OLC and his co-claimants, who happen to be his ex-wife and two of his family members, to be declared the winner (like Highlander, he believed there could be only one).

Other claimants fail to answer the lawsuit and Plaintiff settles the case and goes home with his lump sum payment (about $700,000).  Unclear if Thanksgiving was awkward at the Dabaja household.

Palmer et al., v. OLC, 2002-0778; ORC 3770.07(D)

Creditors had a court-ordered structured settlement agreement with a lotto winner which paid the creditors a percent of lottery annuity payments.   The OLC was aware of the structured settlement between the winner and the creditors.  Lotto winner defaulted on her payments to creditors and creditors sue OLC for failing to make payments directly to the creditors.

The result was judgment for the OLC- the rights of a prize winner are NOT assignable, garnishable, attachable, unless by a court order for payment of child support or to an estate.  It says so right in the statute.  A court can otherwise determine who is the rightful prize winner/s (for example, multiple claimants in an office pool), but courts are not entitled to assign a winner’s rights to anyone else once the winner is determined.  The creditors in this case happened to be lawyers, so of course no real harm was done.

 

Final Thoughts

What’s the lesson here?  There isn’t one, but as a legal concept “the lottery” is an interesting foray into contract formation.  Just remember- if you’re in an office pool, keep a record of your agreement and participants, and don’t tell off your boss before you get your prize money in hand. Also- think about hiring an accountant and a lawyer before you run off and buy that gold-plated jet ski.  Good luck!