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Improper ‘Balance Billing’: Examples of a Rising Trend

In yesterday’s post, we introduced an emerging concept known as “balance billing,” which results in skyrocketing medical expenses and increased medical debt for unsuspecting patients. As a brief review, balance billing occurs when a patient seeks treatment from an out-of-network doctor, who then bills the patient for the maximum allowable […]

Emerging Fraud Trends: The Rise of Balance Billing

At Berger Montague, we strive to keep on top of the latest emerging trends in the fraud landscape, particularly when the misconduct drives up the costs of healthcare for policyholders and taxpayers alike. Over the next two posts, we will examine an emerging fraud trend known as “balance billing,” which […]

Judge Orders Near-Maximum Whistleblower Reward; Cites ‘Indispensable Contribution’

One of the key components of the success of the False Claims Act is its ability to incentivize whistleblowers to come forward by offering up to 30 percent of the total settlement in some cases. In today’s post, we examine an interesting holding by the U.S. District Court for the […]

False Claims Act Lawsuit Settled Against South Carolina’s Covan World Wide Movers, Inc.

False claims occur in virtually every aspect of federal contract work. In today’s case, we look at a recent multi-faceted settlement, the details of which have been ongoing for most of 2015, involving relocation services for U.S. military members. The case was brought to light by several employees of the […]

OIG Raises Concerns Over Possible Abuse of Controlled Substances Within Medicare Part D

In yesterday’s post, we introduced a possible correlation between the growth of Medicare spending on highly-addictive prescription drugs and potential Medicare fraud by wayward retail pharmacies. As a bit of review, spending for Medicare Part D administration has increased 136 percent overall since 2006. However, spending for opioids – including […]