HHS-OIG Continues to Uncover Unfounded Malnutrition Claims in Medicare Data
Posted 01/25/17
By the C|C Whistleblower Lawyer Team
Inaccurate medical coding of malnutrition in seniors is a multi-billion dollar problem for Medicare, the federal health insurance program that primarily provides coverage to people aged 65 and older. As obscure as it sounds, it’s also an issue for the average American taxpayer, whose tax dollars are wrongly paid out to hospitals clever—or careless—enough to falsely claim...
By the C|C Whistleblower Lawyer Team
We’ve covered Medical Loss Ratio (MLR) minimum requirements before. The MLR is, generally, the percentage of premium revenues an insurer spends on clinical services and quality improvements as opposed to on things like executive salaries, overhead, or marketing. Requiring a minimum MLR standard, something that the Federal Medicare Program does and several State Medicaid...
By the C|C Whistleblower Lawyer Team
On Monday, a federal judge in the Eastern District of Michigan sentenced Dr. Aria Sabat to nearly 20 years in prison for defrauding Medicare and Medicaid and harming his patients. Dr. Sabat pleaded guilty in May 2015 to various counts of fraud, one count of conspiracy to commit fraud leading to serious bodily injury, and one count of illegally distributing a controlled...
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to Ireland-based Shire Pharmaceuticals LLC. On Wednesday, the company and certain subsidiaries agreed to pay $350 million to settle charges that Shire and the company it acquired in 2011, Advanced BioHealing (ABH), violated the 
By the C|C Whistleblower Lawyer Team
Texas-based MB2 Dental Solutions and 21 of the company's affiliated pediatric dental practices agreed to pay $8.45 million to resolve allegations they violated the 
By the C|C Whistleblower Lawyer Team
Here is our look-back at the top-10 Department of Justice 
By the C|C Whistleblower Lawyer Team
Here is our look-back at the top-10 Department of Justice False Claims Act recoveries for 2016.
10. Vibra Healthcare -- The Pennsylvania-based hospital chain agreed to pay $32.7 million to resolve claims it violated the False Claims Act by billing Medicare for medically unnecessary services by admitting patients to its long term care hospitals and rehab facilities who did not...
By the C|C Whistleblower Lawyer Team
Here is our look-back at the top-10 whistleblower award recoveries for 2016.
10. Harry Markopolos -- Famed Bernie Madoff whistleblower Harry Markopolos made a filing under the whistleblower provisions of the Financial Institutions Reform, Recovery and Enforcement Act (FIRREA) which led to the agreement by Massachusetts-based State Street Bank and Trust Company to pay a total...
By the C|C Whistleblower Lawyer Team
The U.S. Health and Human Services Office of the Inspector General (HHS-OIG) 
By the C|C Whistleblower Lawyer Team
Last month the Department of Health and Human Services’ Office of the Inspector General (OIG) published a