Defendant's Attorney: Jennifer Lyn Weaver

Description: Asheville, North Carolina qui tam lawyer represented the Plaintiff who sued in fraud theories.

Congress enacted the False Claims Act in 1863 to provide a mechanism for the
government to redress fraud in government procurement during the Civil War. Congress
substantially strengthened the Act with the passage of the False Claims Act of 1986, and
further strengthened it with the Fraud Enforcement and Recovery Act of 2009. The False
Claims Act incentivizes whistleblowers, deemed “relators,” to come forward when they
become aware of fraud against the government, and to protect them from retaliation when
they do.

The False Claims Act is a powerful tool for recovering taxpayer dollars to the public
fisc. It punishes companies that have committed fraud in government contracts and serves
an important function in deterring other companies from doing the same. In the fiscal year
ending September 30, 2023, alone, the Department of Justice reported over $2.68 billion
recovered through False Claims Act settlements and judgments. Fully two-thirds of that
amount was collected from healthcare companies. Employees in the healthcare industry,
including frontline workers who provide direct services to patients, are often in the best
position to observe these fraudulent billing practices. Lisa Wheeler, formerly the Assistant
Medical Director at Acadia Healthcare Company’s Asheville, North Carolina clinic, was
one such worker.

Acadia contracted with the government under Medicare, Medicaid, and other
government-funded healthcare programs to render methadone-assisted treatment to
patients suffering from opioid use disorder. The payment plans for these addiction
treatment programs required Acadia to provide patients therapy and counseling, in addition 4
to methadone treatment. Wheeler became aware that Acadia was not providing the requisite
therapy and counseling. Instead, Acadia was falsifying medical records—fabricating fake
therapy notes from whole cloth—and relying in part on these falsified records to submit
claims to the government for payment. Wheeler filed a complaint against Acadia alleging
a number of violations of the False Claims Act. After the government declined to intervene
in the case, Wheeler amended her complaint.

Outcome: Dismissal reversed.

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Defendant's Experts:

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