October 1, 2015
Healthcare Fraud
In yesterday’s post, we examined some of the trends in recently unsealed qui tam lawsuits as surveyed by the National Law Review.[1. “September Health Care Qui Tam Update,” The National Law Review, September 21, 2015, http://www.natlawreview.com/article/september-health-care-qui-tam-update] Of the 39 unsealed cases that were surveyed, many involve allegations of wasteful, and even […]
September 30, 2015
Healthcare Fraud
Under the terms of the False Claims Act, an original whistleblower complaint must be filed confidentially under seal within a federal district court. From there, the Department of Justice receives notice of the lawsuit and is afforded an opportunity to investigate the allegations on its own. In about 20 percent […]
September 29, 2015
Healthcare Fraud
In yet another case of illegal kickbacks and unlawful referrals, Florida-based Adventist Health System has agreed to pay $118 million to the federal government pursuant to several successful whistleblower actions filed by former employees of the corporation. Adventist is a non-for-profit healthcare corporation that manages facilities in ten states. According […]
September 28, 2015
Customs Fraud
In a recent settlement under the False Claims Act, two individuals have agreed to pay $435,000 to resolve allegations they “skirted” their obligation to pay duties on aluminum extrusions imported from Chinese aluminum manufacturer Tai Shan Golden Gain Aluminum Products. The defendants, who hail from New Jersey and Texas, will […]
September 25, 2015
False Claims Act Information
As a potential whistleblower, it is important to recognize the common defenses raised by defendants as they attempt to avoid massive penalties, fines, and negative publicity. If you are considering a whistleblower lawsuit, you may be concerned by the prospect of taking on a large, multi-national conglomerate as an individual […]
September 24, 2015
Healthcare Fraud
The False Claims Act – and its companion statute, the Stark Law – expressly forbid hospital corporations from offering any sort of kickback or incentive in exchange for patient referrals or recommendations of certain products. These rules stem from the notion that patients should receive medical advice untainted by a […]
September 23, 2015
Healthcare Fraud
The Columbus Regional Health System, which maintains several hospitals, clinics, and a retirement community in the Columbus, Georgia area, has agreed to pay $35 million to settle allegations that it offered lucrative kickbacks and incentives to physicians in violation of the False Claims Act and Stark Law. Both laws prohibit […]
September 22, 2015
False Claims Act Information
The Department of Justice has been concerned with the rising trends of healthcare, defense, and contractor fraud against the U.S. government. Many of these cases involve large corporate conglomerates with multinational field offices and a global presence. Investigating and prosecuting these complex entities under the False Claims Act and other […]
September 21, 2015
Medicaid Fraud
In today’s case, we look at the Nashville-based nonprofit hospice center Alive Hospice, who is alleged to have admitted patients who did not meet the criteria for hospice coverage, and to have intentionally defrauded the government by submitting claims on behalf of these patients. While Alive Hospice representatives publicly disagreed […]
September 18, 2015
False Claims Act Information
The False Claims Act got its start in the Civil War era after dozens of wayward contractors acquired substantial sums of money from the government despite delivering subpar (or nonexistent) supplies to soldiers. Since then the Act has been applied to virtually every industry in the United States, resulting in […]
September 17, 2015
Healthcare Fraud
State and federal guidelines impose strict billing requirements when it comes to routine eye care. Unlike many private insurance plans, coverage under Medicare or Medicaid generally provides reimbursement for vision services, provided the optometrist engages in medically necessary procedures. Today we’ll review a whistleblower case filed in 2014 against optometrist […]
September 16, 2015
Mortgage Fraud
In yet another mortgage fraud case, Walter Investment Management Corporation (Walter Investment) has agreed to pay over $29 million to resolve allegations it falsely certified residential home mortgages under the Department of Housing and Urban Development’s (HUD) Home Equity Conversion Mortgage (HECM)[1] program. The alleged scheme was uncovered following a […]