Legal Insights & Articles

Medicare Would “Likely” Not Pay for Hospice Care for Deceased Patients

If one reads between the lines of a May 7, 2019 opinion from the U.S. Court of Appeals for the Fifth Circuit (covering Texas, Louisiana and Mississippi), it appears that the court comes to the seemingly unremarkable conclusion that Medicare would not intentionally pay for hospice care for patients who are dead: “Relators claimed [...]

By | 2019-08-06T14:28:49+00:00 August 6th, 2019|False Claims Act Legal News|

What is the Foreign Corrupt Practices Act?

The Foreign Corrupt Practices Act (“FCPA” or “the Act”) (15 U.S.C. §§ 78dd-1, et seq.) is a 1977 federal statute passed to enhance financial transparency among American companies. The FCPA was passed in response to investigations conducted by the Security and Exchange Commission (“SEC”) in the early 1970’s that found bribery directed towards foreign [...]

By | 2019-08-01T15:38:58+00:00 August 1st, 2019|SEC Fraud|

Government Joins Case Involving Drug Manufacturer’s Illegal Payments of Patient Co-Pays on Expensive Drug

The Department of Justice, with the Office of the United States Attorney of the Eastern District of Pennsylvania, recently joined a lawsuit filed by private whistleblowers against Mallinckrodt ARD LLC, a drug manufacturer. The Government’s complaint was filed on June 4, 2019, although the case had initially been filed in 2012. The case alleges [...]

By | 2019-06-17T15:43:54+00:00 June 17th, 2019|False Claims Act Legal News|

Court Rewards Relators’ Extraordinary Contribution to False Claims Act Litigation by Awarding 28.5% Relator Share

In U.S. ex rel. Bibby v. Wells Fargo Bank, N.A., 369 F. Supp. 3d 1346 (N.D. Ga. 2019), the district court that had handled the False Claims Act (“FCA”) litigation for the last seven years of its thirteen-year history rejected the Government’s attempt to limit relators to the minimum statutory share and instead awarded [...]

By | 2019-06-14T09:53:34+00:00 June 14th, 2019|False Claims Act Legal News|

Utah False Claims Act

Utah has enacted a False Claims Act (“Utah FCA”), Utah Code Annotated sections 26–20–9.5 et seq.). The Utah FCA prohibits parties from “enter[ing] into an agreement, combination, or conspiracy to defraud the state by obtaining or aiding another to obtain the payment or allowance of a false, fictitious, or fraudulent claim for a medical benefit.” Utah Code [...]

By | 2019-06-12T10:30:36+00:00 June 12th, 2019|False Claims Act Information|

What is Cost Report Fraud?

Cost report fraud occurs when nursing homes, hospitals, and other healthcare providers for patient care falsely submit claims to the government for reimbursement. Medicare Part A healthcare providers that are paid under the fee-for-service based system can abuse federal government funding by: Inflating their patient care costs; Seeking reimbursement from the government for costs [...]

By | 2019-06-10T10:56:00+00:00 June 10th, 2019|Healthcare Fraud|

What is Phantom Billing?

Medicare fraud broadly refers to any individual, company or corporation who acts intentionally to steal money from the federal government. “Phantom billing” is a specific kind of Medicare fraud, as well as the most common. Phantom billing occurs when healthcare providers submit claims for reimbursement to the government for services or procedures they did [...]

By | 2019-06-05T10:15:38+00:00 June 5th, 2019|Healthcare Fraud|

What is an Organizational Relator?

Under the False Claims Act (“FCA”), an organizational relator is a person with knowledge - typically a current or former employee - of a company involved in defrauding the federal government. The FCA incentivizes relators to come forward and report fraudulent activity by enabling the relator to claim a portion of the recovery if [...]

By | 2019-06-03T11:44:26+00:00 June 3rd, 2019|False Claims Act Information|

The CFTC Whistleblower Program

What is the CFTC? The U.S. Commodity Futures Trading Commission (“CFTC”) is an independent government agency that regulates US futures and options markets. The CFTC’s Division of Enforcement investigates violations of the Commodity Exchange Act (“CEA”) and other CFTC regulations, including fraud, market manipulation, disruptive trading practices, and trade practice violations. The Division of [...]

By | 2019-05-30T14:12:16+00:00 May 30th, 2019|Commodities Futures Trading Fraud|
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