Legal Insights & Articles

The Michigan Whistleblowers’ Protection Act

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, unless the employee [...]

By | 2019-03-27T12:57:26+00:00 September 5th, 2018|False Claims Act Information|

What are Anti-Kickback Safe Harbors?

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 healthcare program.[i] Congress enacted the AKS in 1972, and its primary purpose is “to protect patients and the federal health care [...]

By | 2019-05-15T11:00:46+00:00 August 31st, 2018|Healthcare Fraud|

How to Report Dentist Medicaid Fraud

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 defending the Medicaid [...]

By | 2019-06-24T09:14:39+00:00 August 27th, 2018|Medicaid Fraud|

Nevada False Claims Act

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, does any of [...]

By | 2019-06-06T09:10:39+00:00 August 24th, 2018|False Claims Act Information|

Isn’t Whistleblower Just a Fancy Word for Tattletale?

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 will get hurt? What [...]

By | 2019-03-27T13:00:43+00:00 August 22nd, 2018|False Claims Act Information|

Can Whistleblowers Remain Anonymous?

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 of retaliating [...]

By | 2019-05-13T11:05:13+00:00 August 21st, 2018|False Claims Act Information|

Upcoding Medical Billing

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 provider receives additional [...]

By | 2019-05-16T10:29:54+00:00 August 20th, 2018|Healthcare Fraud|

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

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 the AKS. See [...]

By | 2019-05-15T10:57:09+00:00 August 16th, 2018|Healthcare Fraud|

What Pennsylvania Laws Protect Whistleblowers?

The broadest whistleblower protection comes, appropriately enough, from a statute known as the Pennsylvania Whistleblowers Act. 43 P.S. §§1421 et seq. In pertinent part, the statute provides that: “No employer may discharge, threaten or otherwise discriminate or retaliate against an employee regarding the employee’s compensation, terms, conditions, location or privileges of employment because the employee [...]

By | 2019-03-27T13:01:06+00:00 August 15th, 2018|False Claims Act Information|

Remuneration Under the Anti-Kickback Statute Includes Intangible Economic Benefits

The Anti-Kickback Statute (“AKS”) prohibits anyone from: “solicit[ing] or receiv[ing] any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind . . . in return for referring an individual to a person for the furnishing . . . of any item or service for which [...]

By | 2019-05-15T11:02:29+00:00 August 14th, 2018|Healthcare Fraud|
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