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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 […]

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 […]

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 […]

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 […]

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 […]