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Maryland’s ‘Educational Affiliates’ Agrees to Pay $13 Million to Settle False Claims Act Allegations

Federal Student Financial Aid is the largest provider of funding for American college students in the United States. These funds have paid approximately $150 billion in grants, work-study funds, and financial aid to 13 million students. Like all federal money, these funds come with strings attached and universities are required […]

Wheeling Jesuit University to Pay $2.3 Million to Settle Allegations of Federal Grant Fund Misuse

Unfortunately, fraud within universities is not uncommon, and today’s case highlights a growing trend of grant fund misuse. Located in the mountains of West Virginia, Wheeling Jesuit University has agreed to pay $2.3 million it is alleged to have misused, all of which was provided by the National Aeronautics and […]

Tennessee Hospital Agrees to Settle Allegations of False Billing and Unlawful Practices

Of the various ways in which healthcare providers can violate the False Claims Act, ordering medically unnecessary procedures – particularly those involving the cardiac system – are considered particularly egregious. As opposed to illegal upcoding or kickback schemes, the performance of medically unnecessary procedures actually places patients directly in harm’s […]

Government Accountability Office Alerts Congress to Medicare & Medicaid Eligibility Issues

In fiscal year 2014, American taxpayers footed a $554 billion dollar bill for Medicare and Medicaid – two programs that, while essential in nature, are exceedingly strapped for resources. As one of the hallmark goals of the False Claims Act, authorities have worked diligently to ensure providers are billing correctly […]

D.C. Circuit Court Upholds ‘Implied Certification Theory’ in Recent False Claims Act Case

In yesterday’s post, we explored the concept of implied certification under the False Claims Act – a theory which somewhat eliminates the requirement for explicit false claims activity, but requires evidence that the defendant knew or should have known his activity did not comply with a government contract, but continued […]

Implied Certification Theory in False Claims Act Cases

A defendant may be liable under the False Claims Act on two different theories: the presentment of factually false claims and the presentment of legally false claims. A claim is factually false when a government payee submits information that is untrue on its face and misrepresents the goods or services […]

Federal Government Examines Helicopter Manufacturer Sikorsky Amid Allegations of Fraud

Aside from healthcare fraud, defense contractor fraud remains one of the top forms of waste and abuse addressed by the False Claims Act. Too often, big-budget defense contracts serve as fodder for dishonest companies to inflate and exaggerate costs, resulting in unnecessary spending of an already-strained defense budget. In one […]

Morganti Legal: Canadian Shareholder Files A Lawsuit Against MDC Partners Inc.

TORONTO–(BUSINESS WIRE)–Morganti Legal, announces that investors have filed a shareholder lawsuit against MDC Partners (TSX: “MDZ.A” and NASDAQ: “MDCA”, CUSIP 552697), Miles Nadal, Michael Sabatino, David Doft, and BDO USA, LLP for publishing press release containing alleged Misrepresentations and failing to disclose Material Facts about its business operations and finances […]

Berger Montague Settles Whistleblower Lawsuit Involving AstraZeneca, Cephalon, & BioGen, Inc.; Secures $55 Million on Behalf of Taxpayers

As one of the leading and most successful whistleblower law firms in the United States, Berger Montague is pleased to announce its involvement in a $55.5 million settlement involving three major players in the pharmaceutical industry. This past July, Berger Montague announced the settlement against AstraZeneca, Cephalon, Inc., and BioGen, […]

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 […]