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Private-Equity Red Flags Signal Potential False Claims Act Liability

Posted 05/21/21

Private equity (PE) firms that manage healthcare entities have further reason to take note of the growing record of exposure for False Claims Act (FCA) liability.

Martino-Fleming Case

In the latest shot across the bow, the PE firm, a majority shareholder of a for-profit mental-health provider, knew about the false claims and played a sufficiently active role in operations potentially to have caused them. Evidence...

Tagged in: COVID-19, Defendants, FCA Federal, Financial and Investment Fraud, Healthcare Fraud, Importance of Whistleblowers, Provider Fraud, SNF,

Catch of the Week: University of Miami to Pay $22 Million to Resolve Allegations of Lab Test Fraud

Posted 05/14/21

The University of Miami will pay $22 million to resolve three False Claims Act lawsuits, the first of which was filed in 2013. The government alleged that UM, which operates a medical school out of Jackson Memorial Hospital and an extensive health system spanning four south Florida counties, fraudulently billed government health care programs to boost declining revenues. Jackson Memorial will separately pay $1.1...

Tagged in: Bundling and Unbundling, Catch of the Week, FCA Federal, Healthcare Fraud, Hospital Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

Listen to James Glenn, Cybersecurity Whistleblower and Constantine Cannon Client, on Tech & Main Podcast

Posted 05/10/21

Cybersecurity whistleblower James Glenn and Constantine Cannon whistleblower attorney Mike Ronickher spoke to the Tech & Main cybersecurity podcast about the experience Glenn had discovering and reporting a security flaw in Cisco’s Video Surveillance Manager software. Glenn, who was represented by Constantine Cannon, brought a whistleblower lawsuit that resulted in the first government recovery under the False...

Tagged in: CC Lawyers, Cybersecurity and Data Breaches, FCA Federal, Government Procurement Fraud, Whistleblower Spotlight and Interviews,

Catch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation

Posted 05/7/21

The Department of Justice announced this week that Incyte Corporation, a Delaware pharmaceutical company, has agreed to pay $12.6 million to resolve allegations that it violated the False Claims Act by paying kickbacks to a charitable foundation to increase prescriptions for the drug Jakafi, which is used to treat myelofibrosis, a form of leukemia that causes extensive scarring in bone marrow and leads to severe...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Medicare, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

Whistleblower Reward Programs Work, Harvard Business School Study Says

Posted 05/7/21

A team of researchers from Harvard Business School published study results showing whistleblower incentive programs work to expose corporate misconduct. Financial rewards also help to compensate whistleblowers for costs flowing from their decision to come forward, the paper said. The study contradicts various claims by critics of programs that offer cash incentives for blowing the whistle, according to its authors....

Tagged in: FCA Federal, Importance of Whistleblowers, Whistleblower Eligibility, Whistleblower Rewards,

Partner Mary Inman joins Shaifali Joshi-Clark of the Ontario Securities Commission’s Whistleblower Office to discuss the OSC’s whistleblower reward program at Whistleblowing Canada Research Society event “The Expansion of Whistleblower Reward Programs in the U.S., Canada and Globally.”

Posted 04/30/21

On March 17, 2021, Constantine Cannon whistleblower partner Mary Inman joined Shaifali Joshi-Clark, a senior forensic accountant in the Whistleblower Office of the Ontario Securities Commission (“OSC”), as a co-panellist for a webinar entitled “The Expansion of Whistleblower Reward Programs in the U.S., Canada and Globally,” organised by Whistleblowing Canada Research Society (“WCRS”) and moderated by...

Tagged in: CFTC Whistleblower Reward Program, FCA Federal, International Whistleblowers, SEC Whistleblower Reward Program, Securities Fraud, Whistleblower Rewards,

Catch of the Week: Dozens of Fraudsters Sentenced in Multimillion Dollar Compounding Pharmacy Fraud

Posted 04/30/21

On Thursday, an Alabama District Court Judge sentenced dozens of defendants to prison for participating in a massive conspiracy to swindle insurers for medically unnecessary compound drugs. The defendants included company executives and managers, a prescriber, billers, and sales representatives associated with Northside Pharmacy, which was doing business as Global Compounding Pharmacy (Global). According to the DOJ...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Compounding Pharmacy Fraud, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Pharma Fraud, Whistleblower Case,

P-Stim Fraud: A New DOJ Enforcement Priority?

Posted 04/23/21

The Department of Justice regularly publicizes its fraud prevention and False Claims Act enforcement priorities. These announced priorities typically focus on broad issues that affect the lives of millions of Americans – COVID-19 fraud, the opioid crisis, and the rapid expansion of telehealth. In addition, we keep an eye on DOJ enforcement actions, and these can reveal emerging trends, often in narrow areas. One...

Tagged in: Chiropractic, FCA Federal, Healthcare Fraud, Medical Billing Fraud, Medical Devices and DME, Provider Fraud,

Catch of the Week: Telemarketer Gets 10 Years in $3.3 Million Telemedicine and Genetic Testing Fraud Scheme

Posted 04/16/21

Ivan Andre Scott, a 36-year-old Florida man, just landed a 10-year prison sentence for organizing a $3.3 million Medicare fraud scheme involving two of the hottest healthcare trends – telemedicine and genetic testing to assess the likelihood of future cancer. The conspiracy targeted vulnerable Medicare beneficiaries for pricey cancer screening genetic tests, prosecutors said. Claims for these tests were falsely...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicare,

As COVID-19 Stimulus Funds Flow, DOJ Puts Fraudsters on Notice and Calls Whistleblowers “Essential”

Posted 04/2/21

On March 11th, President Biden signed The American Rescue Plan Act of 2021 (ARPA), a sweeping economic stimulus plan that will pump $1.9 trillion into the US economy. In addition to direct relief to Americans, ARPA includes record-setting government spending in numerous areas to speed recovery from the economic and health effects of the COVID-19 pandemic and the ongoing recession. As we have previously written,...

Tagged in: COVID-19, FCA Federal, FIRREA, Government Loan Programs, Government Procurement Fraud, Government Programs Fraud, Importance of Whistleblowers,

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Private-Equity Red Flags Signal Potential False Claims Act Liability

Martino-Fleming Case

Catch of the Week: University of Miami to Pay $22 Million to Resolve Allegations of Lab Test Fraud

Listen to James Glenn, Cybersecurity Whistleblower and Constantine Cannon Client, on Tech & Main Podcast

Catch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation

Whistleblower Reward Programs Work, Harvard Business School Study Says

Partner Mary Inman joins Shaifali Joshi-Clark of the Ontario Securities Commission’s Whistleblower Office to discuss the OSC’s whistleblower reward program at Whistleblowing Canada Research Society event “The Expansion of Whistleblower Reward Programs in the U.S., Canada and Globally.”

Catch of the Week: Dozens of Fraudsters Sentenced in Multimillion Dollar Compounding Pharmacy Fraud

P-Stim Fraud: A New DOJ Enforcement Priority?

Catch of the Week: Telemarketer Gets 10 Years in $3.3 Million Telemedicine and Genetic Testing Fraud Scheme

As COVID-19 Stimulus Funds Flow, DOJ Puts Fraudsters on Notice and Calls Whistleblowers “Essential”

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