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Philips Recalled CPAP, Bi-Level PAP, and Mechanical...
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March 13, 2019
Commodities Futures Trading Fraud
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 […]
March 11, 2019
Healthcare 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 […]
March 6, 2019
Customs 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 […]
February 27, 2019
Healthcare Fraud
Objective Falsity Requirement Under the False Claims Act
Can a False Claims Act case go forward where the only evidence of whether the services at issue were medically necessary are two competing and opposing medical opinions? In a prior blog, we discussed recent holdings in AseraCare I, AseraCare II and Vista Hospice[1]. The main issue addressed in those […]
February 25, 2019
Healthcare Fraud
Differences in Medical Opinion Under the False Claims Act
Courts have recently grappled with the issue of whether a Relator can maintain a case under the False Claims Act (“FCA”) where she retains an expert that says the medical services provided were not medically necessary and the defendant’s medical service provider or its retained expert says the exact opposite […]
February 22, 2019
False Claims Act Information
Whistleblower Rewards: How They Work
The federal False Claims Act (“FCA”) allows an individual with knowledge of fraud upon the federal government, often known as a whistleblower or qui tam relator, to bring a lawsuit on the federal government’s behalf to recover the funds. Many states have adopted similar laws that apply to fraud upon state […]
February 21, 2019
False Claims Act Information
What is a Qui Tam Relator?
In False Claims Act (“FCA”) cases, the qui tam relator is the whistleblower who brings the FCA claims against the company or individual who is committing fraud. Usually a qui tam relator is an insider—typically a current or former employee—who has access to confidential information showing that his or her […]
February 6, 2019
False Claims Act Information
Tennessee Whistleblower Law
The Tennessee False Claims Act (“Tennessee FCA”) mirrors the federal False Claims Act (“FCA”), but it involves claims made to state and local governments in Tennessee, as opposed to the federal government. The Tennessee Medicaid False Claims Act (“Tennessee Medicaid FCA”) applies to any false claims made to Tennessee’s state […]
February 4, 2019
Medicaid Fraud
Medicaid Fraud
Medicaid pays for approximately 20% of all healthcare expenses in the United States, over $600 billion each year. Well over 500,000 healthcare providers, ranging from hospital chains to individual doctors to ambulance helicopter pilots, receive payments from Medicaid every year. Inevitably a few of the providers will try to defraud […]
January 31, 2019
False Claims Act Information
What is Whistleblowing?
The eighteenth-century philosopher, Edmund Burke, long ago cautioned that, “All that is necessary for the triumph of evil is that good people do nothing.” That admonition still holds true today. Whistleblowing involves individuals willing to come forward to stop fraud and other wrongdoing against the government (and by extension, the […]
January 25, 2019
Healthcare Fraud
What is a Kickback Scheme?
Quite simply, a kickback is an inducement – offering or giving something of value in exchange for getting business referrals. Although that type of behavior can be perfectly legal in some segments of the commercial world, it is not permitted when the business that is being referred is paid for […]
January 16, 2019
News
Berger Montague Elects Michael Dell’Angelo New Member of Firm’s Executive Committee, Elevates Shareholder Ruthanne Gordon to Chief Administrative Officer
Berger Montague is proud to announce that the firm has elected Michael Dell’Angelo as the newest member of its Executive Committee. The firm has also selected Shareholder Ruthanne Gordon to serve as its first Chief Administrative Officer.
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