united States ex rel. Lisa Wheeler, et al. v. Acadia Healthcare Company, Inc., et al.

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.

Dismissal reversed.