Archive

Catch of the Week — Wound Care Device Manufacturer ACell Inc.

Posted 06/14/19

Our Catch of the Week goes to ACell Inc., a Maryland-based medical device manufacturer that pleaded guilty to violating the Federal Food, Drug, and Cosmetic Act (FDCA) by failing to report that it had partially removed its wound-care product, MicroMatrix, from the market because it was contaminated with endotoxins, placing treated patients in danger of serious infection, even death, without informing the FDA that it...

Tagged in: Catch of the Week, FCA Federal, FDA Fraud, Medical Devices and DME, Whistleblower Case,

Blowing the Whistle on Data Breaches and Cybersecurity Flaws

Posted 06/14/19

Computer Security Profession Sitting at Her Computer Desk

With increasing dependence on technology, cybersecurity has emerged as a critical issue for customers, investors, and government regulators. Data breaches and other cybersecurity incidents can have devastating effects. In 2018, the Council of Economic Advisers estimated that malicious cyber activity cost the U.S. economy up to $109 billion dollars in 2016 alone. Typically, the public only learns of such flaws and...

Tagged in: Cybersecurity and Data Breaches, FCA Federal, Government Procurement Fraud, Importance of Whistleblowers, SEC Whistleblower Reward Program, Whistleblower Answers, Whistleblower Rewards,

Qui Tam Lawsuits: How to Report Fraud Under the False Claims Act

Posted 06/14/19

What potential whistleblowers need to know about working with a qui tam lawyer to report fraud under the False Claims Act

Using the False Claims Act (FCA), a whistleblower can bring a lawsuit on behalf of the United States to recover damages from parties who are cheating the government out of taxpayer funds. Also called qui tam actions, these lawsuits allow eligible whistleblowers, referred to as “relators,”...

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

Whistleblowers Needed to Stop Secret Kickbacks, Bribes, Overcharging, and False Costs in E-Rate, Lifeline, Connect America, and Rural Healthcare programs

Posted 06/7/19

Large broadband cable bales awaiting installation on rural road.

The FCC disburses billions of dollars every year for its massive Universal Service Fund (USF) and its laudable mission to promote telephone and internet access to all U.S. persons regardless of income and location. This massive pot of government money attracts a commensurate measure of opportunists seeking to defraud these well-meaning programs.

What is the Universal Service Fund?

The Universal Service Fund...

Tagged in: Bribery and Bid-Rigging, Contract Non-Compliance, Cybersecurity and Data Breaches, Education Fraud, Falsifying Invoices, FCA Federal, FCA State, Government Procurement Fraud, Government Programs Fraud, Pricing Fraud,

Question of the Week — Should the Medicare Fraud Hotline or HHS OIG Reward Informants?

Posted 06/7/19

Opioid manufacturer Insys Therapeutics agreed to a $225 million settlement related to allegations that it unlawfully marketed its drug Subsys and paid kickbacks to providers through “speaker programs” that rewarded providers who prescribed Subsys. We previously asked whether our readers thought CEOs should be more liable for corporate wrongdoing after the Insys CEO was convicted for participating in a criminal...

Tagged in: FCA Federal, Healthcare Fraud, Importance of Whistleblowers, Medicare, Question of the Week, Reporting to Government, Whistleblower Rewards,

Default by Nursing Home Chain on HUD-Guaranteed Mortgage Highlights Potential for Fraud in Section 232 Program

Posted 06/3/19

Last week, the New York Times reported on the collapse of Rosewood Care Centers, a chain of nursing homes with facilities in Illinois and Missouri. According to the report, the chain had faced years of operational and financial difficulties, including fines by state regulators, personal injury claims by residents, and lawsuits by investors and vendors. When it went under, Rosewood defaulted on $146 million in...

Tagged in: FCA Federal, Government Loan Programs, Housing and Mortgage Fraud, SNF,

DOJ Catch of the Week — Dr. Joseph Galichia

Posted 05/31/19

Paper Ripped Uncovering Medical Necessity Wording

This week's DOJ Catch of the Week goes to Kansas cardiologist Joseph Galichia. Yesterday, he agreed to pay $5.8 million to resolve allegations that he and his company, Galichia Medical Group, violated the False Claims Act by billing federal health care programs for medically unnecessary cardiac stent procedures. This is the government's third False Claims Act settlement with Dr. Galichia. Which may explain why he also...

Tagged in: Catch of the Week, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

WATCH THIS SPACE: Proposed $700M Fix for Installed Foreign-Telecom Could Compound Fraud Related to Universal-Service-Fund Projects

Posted 05/31/19

Hand touching lock icon on modern digital screen interface stating “hacking detected” and “security breach”

Congress, the President, and the FCC are moving to restrict and phase out foreign-made telecommunications components seen as national security risks. While the president’s executive order of May 15, 2019 prohibits U.S. companies from buying foreign telecom, we have a huge problem: our systems already have large quantities of this equipment installed – antennas, radios, electronics, routers, services, etc. The...

Tagged in: Bribery and Bid-Rigging, Contract Non-Compliance, Education Fraud, Falsifying Invoices, FCA Federal, FCA State, Government Procurement Fraud, Government Programs Fraud, Pricing Fraud,

United States Intervenes in Home Health Care Fraud Case

Posted 05/30/19

Doctor Hand Taking Money from Patient's Hand

Last week, the United States intervened in a lawsuit brought against Florida-based Doctor’s Choice Home Care and its two owners. The Department of Justice alleged that the company bribed doctors to refer patients in violation of the federal Anti-Kickback Statute and Stark Law. Both laws prohibit medical providers from paying or receiving kickbacks in connection with government-funded health care...

Tagged in: Anti-Kickback and Stark, FCA Federal, Government Decision, Home Health and Hospice, Whistleblower Case, Whistleblower Eligibility,

Intermountain Settles Dispute Pending Before Supreme Court, Leaving 9(b) Ambiguity Unresolved

Posted 05/24/19

Earlier this month, a Utah-based hospital chain announced it would settle whistleblower Dr. Gerald Polukoff’s case alleging the hospital performed unnecessary heart surgeries on Medicare patients, thereby overcharging the federal government in violation of the False Claims Act (FCA). Defendant Intermountain Health, the largest healthcare provider in the Intermountain West, had petitioned the U.S. Supreme Court to...

Tagged in: Court Decision, FCA Federal, FCA Pleading, Healthcare Fraud, Hospital Fraud, Lack of Medical Necessity,

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Catch of the Week — Wound Care Device Manufacturer ACell Inc.

Blowing the Whistle on Data Breaches and Cybersecurity Flaws

Qui Tam Lawsuits: How to Report Fraud Under the False Claims Act

Whistleblowers Needed to Stop Secret Kickbacks, Bribes, Overcharging, and False Costs in E-Rate, Lifeline, Connect America, and Rural Healthcare programs

What is the Universal Service Fund?

Question of the Week — Should the Medicare Fraud Hotline or HHS OIG Reward Informants?

Default by Nursing Home Chain on HUD-Guaranteed Mortgage Highlights Potential for Fraud in Section 232 Program

DOJ Catch of the Week — Dr. Joseph Galichia

WATCH THIS SPACE: Proposed $700M Fix for Installed Foreign-Telecom Could Compound Fraud Related to Universal-Service-Fund Projects

United States Intervenes in Home Health Care Fraud Case

Intermountain Settles Dispute Pending Before Supreme Court, Leaving 9(b) Ambiguity Unresolved

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