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February 19, 2015
Healthcare Fraud
Good Shepherd Hospice Inc. to Pay $4 Million Amid False Claims Act Allegations
In today’s case, we explore a somewhat increasing phenomenon of unlawful and fraudulent billing practices pertaining to palliative (i.e., end of life) care. When it comes to palliative care, Medicaid and Medicare enrollees may receive coverage for hospice services as long as certain criteria are met. Namely, there must be […]
February 18, 2015
Healthcare Fraud
ResCare Iowa, Inc. to Pay Over $5 Million to Settle Healthcare Fraud Allegations
Home-based nursing care is considered somewhat of a luxury under government healthcare regulations. This means there are limited circumstances under which programs like Medicare, Medicaid, or TRICARE will reimburse a company for home-based services. Patients must meet strict eligibility criteria prior to receiving reimbursement. Under current guidelines, a medical doctor […]
February 17, 2015
Medicaid Fraud
Community Health Systems Settles Medicaid Fraud Allegations for $75 Million
A recent press release from the Department of Justice alleged that several hospitals within the nationwide Community Health System (CHS) chain made unlawful donations to various county governments in violation of state and federal Medicaid laws. The scheme occurred under New Mexico’s supplemental Medicaid program, which primarily served rural and […]
February 16, 2015
Contractor Fraud
Veteran Construction Associates Settles False Veteran Status Claim
Under the federal False Claims Act, it is unlawful for individuals and businesses to submit claims for reimbursement or funding based on fraudulent, falsified, or exaggerated facts. If a company submits improper claims and evidence shows there was intent to defraud (as opposed to accidental fraud), the business may have […]
February 13, 2015
Healthcare Fraud
Dental Clinic Sea Mar Health Center Settles False Claims Act Allegations
The Washington Attorney General’s Office lauded its 2015 recovery of $3.35 million on behalf of state taxpayers and the state Medicaid program. In today’s case, we explore a 2015 recovery involving the nearly decade-long overbilling scheme alleged to have been perpetrated by a Seattle-area dentists’ office regularly treating both pediatric […]
February 12, 2015
Healthcare Fraud
False Claims Act Defendant Loses Bid to Overrule Oral Settlement Agreement
As we have explored in the past, many False Claims Act lawsuits end in a negotiated settlement between the relator/whistleblower, federal government, and defendants alleged to have committed fraudulent acts of misconduct against U.S. taxpayers. The terms of the settlement – which almost always include a clause disclaiming any liability […]
February 11, 2015
Military Contractor Fraud
Drone Manufacturer Composite Engineering, Inc. Settles False Claims Act Allegations
The False Claims Act is one of the most successful federal statutes when it comes to recouping money lost due to wasteful fraud committed against the government and, as a result, the taxpayers. When it was enacted, soldiers and other participants in the U.S. Civil War were experiencing widespread fraud […]
February 10, 2015
SEC Fraud
Securities Ratings Firm Standard & Poor’s Settles Fraud Charges for $58 Million
In a victory for the Securities and Exchange Commission, the securities ratings firm Standard & Poor’s has agreed to settle claims it fraudulently certified certain mortgage-backed securities as good investments, as well as claims the firm used a certain methodology to calculate risk with regard to commercial mortgage-based securities when, […]
February 9, 2015
Mortgage Fraud
Court’s Analysis Spells Victory for Bibby Relators Following Contested False Claims Act Reward
Over the last few posts, we have engaged in an in-depth look at a relatively rare issue involving confidentiality during the investigative stage of a False Claims Act whistleblower case. The case, known as United States ex rel. Bibby v. Wells Fargo, N.A., has garnered some national attention as the […]
February 6, 2015
Mortgage Fraud
Exploring the Bibby Case: Where Did the Relators Go Wrong?
As we discussed in yesterday’s post, the Eleventh Circuit recently handed down a ruling in a case of first impression: What sort of punishment should a relator face for breaching confidentiality rules during the investigative stage of a whistleblower action? We reviewed the rules of filing under seal and why […]
February 5, 2015
Mortgage Fraud
Filing Under Seal and United States ex rel. Bibby v. Wells Fargo
Over the next three posts, we will explore a recent case handled by the U.S. Court of Appeals for the Eleventh Circuit – a jurisdiction covering Alabama, Florida, and Georgia – involving sanctions against a courageous whistleblower with an apparent misunderstanding of the rules of confidential seals. In today’s post, […]
February 4, 2015
Healthcare Fraud
Trans-Star Ambulance Services Settles False Claims Act Allegations for $948,000
Healthcare fraud is a rampant problem in the United States. Each year, the False Claims Act proves integral in recovering billions of dollars from wayward hospitals, management corporations and physicians. Under the False Claims Act, individuals known as whistleblowers (or relators) can file their own lawsuit on behalf of the […]
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