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Top Ten Whistleblower Awards of 2018

Posted 01/25/19

Book text showing definition of Whistleblower

2018 was another banner year for whistleblowers. As the DOJ recently reported in its annual summary of False Claims Act recoveries, $2.1 billion of the $2.8 billion in settlements and judgments reported last year arose from lawsuits filed under the qui tam provisions of the False Claims Act. During the same period, the government paid out $301 million in whistleblower awards to the individuals who exposed the fraud by...

Tagged in: CFTC Whistleblower Reward Program, FCA Federal, FCA State, SEC Whistleblower Reward Program, Top 10, Whistleblower Rewards,

Top Ten Healthcare Recoveries of 2018

Posted 01/15/19

Consistent with the trend in prior years, the bulk of the Justice Department’s fraud and false claims recoveries in 2018 stemmed from healthcare fraud matters. And again, most of the funds recovered arose from cases originated by whistleblowers under the qui tam provisions of the False Claims Act. Here are the top ten healthcare recoveries of 2018 by the numbers:

1. Amerisource Bergen Corporation - In...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Hospital Fraud, Managed Care, Medical Billing Fraud, Medical Devices and DME, Medicare, Pharma Fraud, Risk Adjustment Fraud, Top 10,

What the Government Shutdown Means for Whistleblowers

Posted 01/3/19

Lincoln Memorial behind fence with sign saying closed for shutdown

As of January 3, 2019, the federal courts are still open, and say they can stay open at least through January 11 by using available funds from court fee payments and other sources not dependent on new appropriations. However, most Department of Justice civil attorneys have been furloughed. Without attorneys from DOJ, cases involving the United States are not be able to proceed as they normally would. ...

Tagged in: CFTC Whistleblower Reward Program, FCA Federal, IRS Whistleblower Reward Program, SEC Whistleblower Reward Program,

Healthcare Whistleblowers Continue as Backbone of DOJ Recoveries: A Look at DOJ’s 2018 Fraud and FCA Statistics

Posted 01/2/19

The Department of Justice released its annual report of DOJ recoveries for fraud and false claims against the U.S., showing recoveries of $2.8 billion in settlements and judgments for the fiscal year ending September 2018. Once again, recoveries for healthcare fraud accounted for the majority of funds recovered: of the $2.8 billion recovered, $2.5 billion was attributed to healthcare fraud. And, once again,

Tagged in: FCA Federal, Healthcare Fraud, Importance of Whistleblowers, Statistics,

WATCH THIS SPACE: New U.S. Development Agency for High-Risk Investment in Developing Countries a Magnet for Fraud

Posted 12/21/18

Steel wheel pavers driving over fresh asphalt

Combine 60 billion U.S. dollars, newly authorized private investment, vulnerable foreign countries, and competition with Russia and China - What could go wrong? Amid the daily D.C. drama plaguing the fall of 2018, Congress quietly passed the Better Utilization of Investments Leading to Development (BUILD) Act to create a new U.S. development agency: the U.S. International Development Finance Corporation (IDFC). The...

Tagged in: FCA Federal, Financial and Investment Fraud, International Whistleblowers, Securities Fraud,

Catch of the Week — Hospice Provider to Pay $6 Million to Settle False Claims Act Suit

Posted 12/21/18

Younger person resting hand on hand of seated elderly woman with cane

SouthernCare, Inc., a hospice provider owned by Curo Health Services, has agreed to pay the federal government nearly $6 million dollars to settle a lawsuit alleging that the company defrauded Medicare by billing medically unnecessary hospice care. The fraud was unearthed by two whistleblowers formerly employed by the company, who filed suit under the qui tam provisions of the False Claims Act, where they will share...

Tagged in: Catch of the Week, FCA Federal, Home Health and Hospice, Lack of Medical Necessity, Whistleblower Case,

Catch of the Week — PA Hospital and Health System Pays $12.5 Million to Settle FCA Allegations

Posted 12/14/18

Doctor discussing knee injury with patient seated on exam table

Coordinated Health Holding Company, LLC, a for-profit hospital and health system, and its founder, owner, and CEO, Emil DiIorio, M.D., have agreed to pay a combined $12.5 million to settle allegations of violating the False Claims Act for submitting false claims to Medicare and other federal health care programs for orthopedic surgeries. Coordinated Health is a for-profit hospital and health system based in the Lehigh...

Tagged in: Bundling and Unbundling, Catch of the Week, FCA Federal, Healthcare Fraud, Hospital Fraud, Medical Billing Fraud, Medicare, Other Government Health Programs, Provider Fraud,

When a Gift is Not a Gift: Pharma Companies Use Charities to Increase Drug Profits

Posted 12/13/18

Pile of blister packs with medications of different colors and sizes

Imagine if at the end of Charles Dickens’ “A Christmas Carol,” Ebenezer Scrooge announced that he was giving the prize turkey to the Cratchit family for Christmas dinner, but that this “gift” was conditional upon Bob Cratchit agreeing to work even longer hours in the new year, the turkey being cooked in a certain way, and only certain family members eating it. Would we consider Scrooge to have been truly...

Tagged in: Anti-Kickback and Stark, FCA Federal, Pharma Fraud,

DOJ Affirms its Materiality Provision but Threatens to Dismiss Gilead FCA Case

Posted 12/7/18

On November 30, 2018, the United States filed its amicus curiae brief before the Supreme Court in Gilead Sciences, Inc. v. United States ex rel. Campie (“Gilead”). The brief highlights two key topics in False Claims Act (“FCA”) litigation: (1) the interpretation of materiality under Universal Health Services, Inc. v. United States ex rel. Escobar, 136 S. Ct. 19889 (2016) (“Escobar”) and (2) the impact of...

Tagged in: FCA Federal, FCA Materiality, Whistleblower Case,

Catch of the Week — DOJ Nets 3 South Korean Companies in Bid Rigging Scheme

Posted 11/16/18

Our Catch of the Week celebrates DOJ’s massive $236 million settlement with three South Korean-based companies accused of rigging bids to inflate the cost of fuel supplied to U.S. Army, Navy, Marine Corps, and Air Force bases in South Korea, the investigation of which was initiated by a whistleblower represented by Constantine Cannon. The three companies, SK Energy Co. Ltd., GS Caltex Corporation, and Hanjin...

Tagged in: Bribery and Bid-Rigging, Catch of the Week, Defense Contract Fraud, FCA Federal, Government Procurement Fraud, International Whistleblowers,

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Top Ten Whistleblower Awards of 2018

Top Ten Healthcare Recoveries of 2018

What the Government Shutdown Means for Whistleblowers

Healthcare Whistleblowers Continue as Backbone of DOJ Recoveries: A Look at DOJ’s 2018 Fraud and FCA Statistics

WATCH THIS SPACE: New U.S. Development Agency for High-Risk Investment in Developing Countries a Magnet for Fraud

Catch of the Week — Hospice Provider to Pay $6 Million to Settle False Claims Act Suit

Catch of the Week — PA Hospital and Health System Pays $12.5 Million to Settle FCA Allegations

When a Gift is Not a Gift: Pharma Companies Use Charities to Increase Drug Profits

DOJ Affirms its Materiality Provision but Threatens to Dismiss Gilead FCA Case

Catch of the Week — DOJ Nets 3 South Korean Companies in Bid Rigging Scheme

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