Mary Inman

Two Theories, One Case

Medicare pays a Medicare Advantage plan a monthly amount for each member, adjusted by a risk score built partly from the member’s diagnoses. The government later alleged that from 2008 to 2013 Freedom Health submitted, or caused others to submit, diagnosis codes the medical records did not support, inflating Medicare’s payments for two Florida plans.

A plan seeking to expand its service area had to pass Medicare’s review of its provider network. The government alleged that in its 2008 application to expand into new Florida counties and other states in 2009, Freedom Health misrepresented the scope and content of its network of physicians, specialists and hospitals.

For more than a year, Sewell kept working at the company while serving undercover as an F.B.I. informant. He amended his complaint in 2011 and again in 2013.

The $32,445,593 Resolution

Sewell died in 2014, before the case resolved.

His brother, David, carried the case forward, and Inman represented him as well. On May 12, 2017, David Sewell and the government told the court that the case had settled, and on May 26 Judge Mary S. Scriven dismissed it and unsealed the complaints.

On May 30 the Justice Department announced that Freedom Health and related entities would pay $31,695,593 and that the company’s former chief operating officer would pay $750,000 for his alleged role in the network scheme, a total of $32,445,593. About $16.7 million of the company’s payment resolved the risk-adjustment allegations and $15 million the network allegations.

Freedom Health and Optimum HealthCare also entered a corporate integrity agreement with the Office of Inspector General of the Department of Health and Human Services, in effect from May 11, 2017, to December 5, 2022. It required an independent reviewer to confirm the accuracy of the plans’ provider networks whenever they added to their service areas or offered new plans.

By then Inman had moved from Phillips & Cohen to Constantine Cannon, which served as co-counsel in the case. In 2019, working with the family’s lawyers, David Sewell brought his brother’s story to The New Yorker.

Houlton, Maine

Inman grew up in Houlton, Maine, near the Canadian border; her grandmother, a county clerk of court, was an early mentor. She graduated from Bowdoin College in 1990 and performed at the Maine State Music Theatre before law school.

At the University of Pennsylvania Law School, where Professor Lani Guinier was a mentor, she was an articles editor of the law review and graduated cum laude in 1994. She clerked for Judge D. Brock Hornby of the federal district court in Maine and Judge Norman H. Stahl of the First Circuit, then spent a year at a large commercial firm. A recruiter approached her about the new San Francisco office of Phillips & Cohen, a firm that represented whistleblowers, and she joined it.

London

In July 2017 Inman moved to London to start Constantine Cannon’s international whistleblower practice.

Andrew Patrick had worked from 2010 to 2014 for Pure Collection, an online retailer of luxury cashmere in Harrogate, England, first in its call center and then in its packaging department. Goods shipped to the United States then entered duty-free if they were worth less than $200, but splitting an order into several shipments to stay under that limit was prohibited. Patrick’s suit alleged that Pure Collection systematically split large American orders into packages shipped over several days and falsified bills and invoices so that the packages appeared to belong to separate orders.

Patrick reported the practice to U.S. Customs and Border Protection in 2014 and to the Internal Revenue Service in 2015, then approached Richard Pike in Constantine Cannon’s London office. In 2016 he filed a False Claims Act suit in federal court in Maine, where many of the company’s American customers lived, and the United States intervened. On February 13, 2018, Pure Collection and its acting chief executive agreed to pay $908,100, and Patrick received 18 percent. Inman, Pike and Till Vere-Hodge represented him, with Dan Murphy of Bernstein Shur as counsel in Maine and Molly Knobler of Phillips & Cohen.

In 2019, as a new all-party parliamentary group on whistleblowing gathered evidence, Inman said she hoped it would consider American-style rewards. “Whistleblower financial incentives could more aptly be described as insurance,” she said.

Across Borders

After three years in London, Inman divided her time between Constantine Cannon’s San Francisco and London offices. She has helped whistleblowers bring claims to the Ontario Securities Commission, the Canada Revenue Agency, His Majesty’s Revenue and Customs and Korea’s National Tax Service.

On March 15, 2022, she testified before the Colorado House Judiciary Committee in support of the Colorado False Claims Act and answered questions about protections for whistleblowers. Governor Jared Polis signed the act on June 7, 2022; a private person who brings an action under it may receive up to 30 percent of the proceeds. She has also provided testimony to the European Commission and the UK Parliament.

Teresa Ross and DxID

Teresa Ross managed medical coding at Group Health Cooperative in Seattle. Group Health used DxID, a subsidiary of Independent Health of Buffalo, New York, to search patients’ records for additional diagnoses that could raise risk scores and to ask physicians to add them; DxID was paid up to 20 percent of the additional payments. DxID submitted more than $30 million in diagnosis claims for Group Health, many of which, Ross alleged, were invalid. In 2012 she filed a False Claims Act suit in federal court in western New York against Group Health, Independent Health, DxID and others. Inman represented her.

On November 16, 2020, Kaiser Foundation Health Plan of Washington, as Group Health had become, agreed to pay $6,375,000 to resolve allegations that Group Health had knowingly submitted diagnoses its members’ medical records did not support. In September 2021 the United States intervened against Independent Health, DxID and DxID’s founder and former chief executive, alleging that DxID had coded conditions not documented during patients’ visits and had asked providers to sign addenda up to a year after a visit.

On December 20, 2024, Independent Health agreed to pay up to $98 million, $34.5 million of it guaranteed and the rest depending on its finances, and to enter a five-year corporate integrity agreement requiring annual reviews by an independent review organization; DxID’s founder agreed to pay $2 million. Ross’s share was at least $8,212,500. “It was rough at times, but we got through it,” she said.

Half a Million Diagnoses

Dr. James M. Taylor, a longtime Kaiser Permanente physician, filed a False Claims Act suit against Kaiser in October 2014; Inman and Max Voldman represented him. Ronda Osinek, a former Kaiser employee who had trained physicians on coding guidelines, had filed hers in August 2013. In 2021 the cases were consolidated in federal court in San Francisco, and the United States intervened.

The government alleged that from 2009 to 2018 Kaiser mined patients’ past medical histories for diagnoses it had not yet submitted to Medicare and sent physicians “queries” urging them to add those diagnoses to the records through addenda, often months and sometimes more than a year after the visits. Many of the added diagnoses, it alleged, had “nothing to do with the patient visit in question.” It also alleged that Kaiser set physician- and facility-specific goals, singled out those who fell short, tied bonuses to meeting the goals and ignored concerns raised by its own physicians and by audits from its compliance office. In its complaint the government put the added diagnoses at roughly half a million and the resulting payments at about $1 billion.

On January 14, 2026, Kaiser Foundation Health Plan and four affiliated Kaiser organizations in California and Colorado agreed to pay $556 million, and the relators were to receive $95 million.

Whistleblower Partners

In April 2024 Inman and nine other lawyers left Constantine Cannon and founded Whistleblower Partners, with offices in New York, San Francisco and Washington, D.C.; she heads its international whistleblower practice from San Francisco. She represents whistleblowers under the False Claims Act and the whistleblower programs of the SEC, the CFTC, the IRS, FinCEN and NHTSA.

Her clients include Tyler Shultz, who filed a confidential complaint about Theranos with New York public health regulators in 2014, about a month before he left the company, and Frances Haugen, the source of the Facebook Files. With The Signals Network and Ifeoma Ozoma, who had blown the whistle at Pinterest, she worked on the Tech Worker Handbook, a guide to minimizing the risks of blowing the whistle in the technology industry.

“Once you’ve blown the whistle, you can’t unring that bell,” she said in 2021. “It’s a life-altering event.”