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February 6, 2014
General
Department of Justice to Intervene in Eight False Claims Act Lawsuits
For those who may be unfamiliar with the procedural jumpstart of a False Claims Act lawsuit, these cases are filed by an individual plaintiff who has firsthand, original knowledge of facts tending to suggest fraud. Plaintiffs are usually current or former employees, but can also be customers, clients, or patients […]
February 5, 2014
General
Fourth Circuit Orders $24 Million False Claims Act Verdict Despite No Damages Proven
The U.S. Constitution prohibits the imposition of excessive civil fines and penalties. In general, the civil side of the law is concerned with making plaintiffs “whole” again and restoring the (financially) damaged party to the place it would have been in but for the defendant’s action or inaction. Civil verdicts […]
February 4, 2014
General
The False Claims Act: A State Perspective
The federal False Claims Act, which has been around since the Civil War era, receives plentiful coverage through the media and blogosphere. However, few people realize that a majority of U.S. states have enacted similar or identical legislation to protect their citizens from fraud on the local level. It is […]
February 3, 2014
General
South Florida Senior Citizens Work to Stop Medicare Fraud
Fraud against Medicare and Medicaid is a growing problem that cost U.S. taxpayers over $68 billion last year. Amid growing concerns about this crime, Florida’s senior population has decided to band together in order to patrol and deter this type of misconduct. The False Claims Act is routinely implemented in […]
January 31, 2014
General
United States Intervenes in Whistleblower Lawsuit Alleging Improper Background Checks
The United States Department of Justice opted to intervene in a whistleblower case, filed in 2011, alleging faulty background checks performed by a private government contractor, United States Investigations Services, LLC (USIS). In the original whistleblower complaint, filed by former USIS employee Blake Percival, allegations suggest that USIS failed to […]
January 30, 2014
General
New York City Settles Medicaid Fraud Allegations
The False Claims Act is designed, in part, to protect taxpayers from paying for services reimbursed by Medicare or Medicaid that either did not take place or did not conform to Medicaid and Medicare guidelines. One common example of non-conformation involves submission of claims for medical services performed by a […]
January 29, 2014
General
Nationwide Physical Therapy Providers Found to Be in Violation of the False Claims Act
When a medical services provider agrees to work with patients receiving Medicare or Medicaid, it must abide by certain guidelines and rules with regard to the services offered to that patient. Of course, medical services must meet industry standards and be performed by a licensed physician. In addition, Medicare or […]
January 28, 2014
General
The Threat of Securities Fraud: A Global Perspective
In recent years, Congress expressed interest in mimicking the federal False Claims Act in an effort to identify, punish, and deter acts of fraud against taxpayers, investors, and the federal government as a whole in other areas. As a result, the 2010 Dodd Frank Act, which was drafted to implement […]
January 27, 2014
General
False Claims Act Allegations Result in Settlement Involving Ambulance Provider
According to statistics, the False Claims Act is integral in punishing healthcare fraud involving Medicare and Medicaid. While these cases often involve fraud by physicians’ offices or pharmaceutical companies, the FCA covers any situation involving reimbursement of a claim through a federal healthcare agency. If any person or entity submits […]
January 23, 2014
General
Novartis Pharmaceuticals Facing Healthcare Fraud Claims
As we have discussed in previous posts, the U.S. government has taken a hardline approach against unlawful kickback schemes within the healthcare industry. The government continues to prosecute companies found to be engaging in these schemes and continually reiterates its position that “[i]nvestigations such as these are a high priority […]
January 22, 2014
General
Highest-Grossing False Claims Act Cases of 2013
In Fiscal Year 2013, the False Claims Act recovered $3.8 billion in judgments and settlements – the highest amount ever in a single year. Many of these cases involved healthcare fraud; however, some interesting cases revealed that fraud can abound in virtually any area or industry. The following lists the […]
January 21, 2014
General
Whistleblower Wins $3.26 Million After Pursuing Kickback Fraud Case
At the heart of medical ethics lies the presumption that patients should be able to choose their doctor, course of treatment, and medical care without outside influence by self-interested parties. This ethic guides an important policy prohibiting unlawful kickbacks between doctors and pharmaceutical companies, which is enforced under the False […]
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