Legal Insights & Articles

New Hampshire False Claims Act

By Russell Paul The New Hampshire False Claims Act (“New Hampshire FCA”) was first enacted in 2004. It authorizes whistleblowers with knowledge of fraudulent efforts by persons or businesses to obtain New Hampshire state funds or to avoid an obligation to pay New Hampshire state funds to file suit on behalf of the state [...]

By | 2018-09-25T13:34:12+00:00 September 24th, 2018|False Claims Act Information|

Common Types of Pharmaceutical Fraud

By Daniel Miller Pharmacy fraud can take many forms, some of which can be very costly to taxpayers when the pharmaceuticals involved are paid for by government-funded health programs like Medicare or Medicaid. Some of the most common types of pharmacy fraud include: auto-refilling fraud, off-label marketing of drugs, average manufacturer price/best price fraud, [...]

By | 2018-09-20T17:13:02+00:00 September 20th, 2018|Healthcare Fraud|

The Michigan Whistleblowers’ Protection Act

By Daniel Miller The Michigan Whistleblowers’ Protection Act (“WPA”), Mich. Comp. Laws § 15.361-369 (2017), was enacted in 1980. The WPA protects employees, or agents acting on behalf of an employee, who report or are about to report violations of state, local, or federal law to any public body, from retaliation by their employers, [...]

By | 2018-09-05T11:11:19+00:00 September 5th, 2018|False Claims Act Information|

What are Anti-Kickback Safe Harbors?

By Daniel Miller The federal Anti-Kickback Statute (“AKS”) imposes penalties on anyone who, knowingly or willfully, offers, pays, solicits, or accepts remuneration in exchange for referrals or payments for goods or services reimbursable under a federal health care program.[i] Congress enacted the AKS in 1972, and its primary purpose is “to protect patients and [...]

By | 2018-08-31T11:47:39+00:00 August 31st, 2018|Healthcare Fraud|

How to Report Dentist Medicaid Fraud

By Daniel Miller In every state, Medicaid covers comprehensive dental services for all enrolled children. Additionally, almost every state Medicaid program provides emergency dental services to enrolled adults. About two-thirds of the state Medicaid programs additionally cover at least some non-emergency dental services for enrolled adults. See id. Whistleblowers play a central role in [...]

By | 2018-08-27T15:30:20+00:00 August 27th, 2018|Medicaid Fraud|

Nevada False Claims Act

By William Ellerbe The Nevada False Claims Act (“Nevada FCA”) mirrors the federal False Claims Act (“FCA”) but operates at the state level. Enacted in 1999, the Nevada FCA penalizes people who defraud Nevada’s state or local governments. The Nevada FCA imposes civil liability on “[any] person who, with or without specific intent to defraud, [...]

By | 2018-08-24T10:16:26+00:00 August 24th, 2018|False Claims Act Information|

Isn’t Whistleblower Just a Fancy Word for Tattletale?

By Susan Schneider Thomas Imagine the following scenario: You’ve observed some cheating at work that really troubles you. It seems that your supervisor is cheating the government by lying about testing that your company hasn’t really done on its products, even though testing is required under your government contract. Should you report this? Who [...]

By | 2018-08-22T10:06:50+00:00 August 22nd, 2018|False Claims Act Information|

Can Whistleblowers Remain Anonymous?

By Daniel Miller The biggest concern most whistleblowers (aka“Relators”) raise is confidentiality. They want to the do the right thing, but they fear that doing the right thing could cost them their job or their career. These concerns are real. It is widely known that people or companies that defraud the government are capable [...]

By | 2018-08-21T11:59:24+00:00 August 21st, 2018|False Claims Act Information|

Upcoding Medical Billing

By Jonathan DeSantis When a provider treats a Medicare patient, the provider must tell Medicare what services were provided so that Medicare can reimburse the doctor the correct amount. Certain services have higher reimbursement amounts than others –a more serious condition will generally be more expensive for the provider to treat and thus, the [...]

By | 2018-09-25T13:37:30+00:00 August 20th, 2018|Healthcare Fraud|

Anti-Kickback Statute Safe Harbor: Personal Services and Management Contracts

By Russell Paul The Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b) (“AKS”), prohibits anyone from knowingly and willfully offering, paying, soliciting, or receiving remuneration in order to induce reimbursable business under federal or state healthcare programs. The Department of Health and Human Services has enacted safe harbor regulations that define practices that are not subject to [...]

By | 2018-08-16T11:54:37+00:00 August 16th, 2018|Healthcare Fraud|
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