Legal Insights & Articles

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 |2020-08-25T13:41:52-04:00June 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 |2020-08-24T11:45:21-04:00June 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 |2020-08-24T11:45:51-04:00May 30th, 2019|Commodities Futures Trading Fraud|

Sarbanes-Oxley Act of 2002

Congress passed the Sarbanes-Oxley Act of 2002 (also known as “SOX” and the Corporate Responsibility Act of 2002) in response to high-profile financial scandals in the early 2000s involving publicly traded companies such as Tyco, WorldCom and Enron, which called into question the trustworthiness of corporate financial statements. Its goal is to help protect investors from [...]

By |2020-08-24T11:46:20-04:00May 20th, 2019|SEC Fraud|

United States Supreme Court Unanimously Applies Extended Statute of Limitations under False Claims Act Favorably to Relators

As readers of this blog well know, the False Claims Act allows individuals who become aware of fraud committed against the federal government to bring a lawsuit on the government’s behalf. Although there are a variety of restrictions, the whistleblower (also called a relator) files the case under seal, allowing the government to decide [...]

By |2020-08-24T11:46:54-04:00May 15th, 2019|False Claims Act Legal News|

Court Ruling Supports Employee Use of Company Documents to Report Alleged Fraud

In an April 2019 opinion from the Eastern District of Pennsylvania, the court denied a company’s motion to require its employee to return all documents the employee had taken for purposes of reporting a suspected fraud to the government. In United States ex rel. Behnke v. CVS Caremark Corp., No. 14-cv-824, the court addressed [...]

By |2020-08-24T11:47:23-04:00April 26th, 2019|False Claims Act Legal News|

Duke University Settles Research Fraud False Claims Act Allegations for $112.5 Million

On March 25, 2019, the Department of Justice announced a large settlement with Duke University for False Claims Act (“FCA”) allegations related to fraud in connection with federal grants. Duke will pay the government $112.5 million to resolve allegations that it violated the FCA through the submission of various applications and progress reports based [...]

By |2020-08-24T11:47:54-04:00March 28th, 2019|False Claims Act Legal News|

Whistleblower Awarded More Than $2 Million By Commodity Futures Trading Commission

An individual whistleblower who provided information about fraud to the Commodity Futures Trading Commission (“CFTC”) was just awarded more than $2 million for information that led to both a CFTC action and a related action brought by another federal agency. The whistleblower’s contribution included significant assistance in analyzing complex market data. Two takeaways from [...]

By |2020-08-24T11:48:24-04:00March 13th, 2019|Commodities Futures Trading Fraud|

What is Best Price Fraud?

“Best Price” is a term used in connection with Medicaid reimbursement for brand name prescription drugs. Essentially, a drug manufacturer is required to charge Medicaid no more than whatever its best (lowest) price is to a non-government (or commercial) payor. Because Medicaid does not buy drugs outright and furnish them to patients, the government [...]

By |2020-08-24T11:49:04-04:00March 11th, 2019|Healthcare Fraud|

What is Customs Fraud?

Customs fraud is a catch-all term for frauds committed by companies trying to evade payments that are owed to the federal government in connection with the importation of goods into the United States. While there are many variations, the two major types of payments that are in play for imported goods are “antidumping” duties [...]

By |2020-08-24T11:49:33-04:00March 6th, 2019|Customs Fraud|
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