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DOJ FY2022 Annual Fraud Report Shows $2.2 Billion in Total Recoveries, with $1.9 Billion Thanks to Whistleblowers - But There are Reasons for Concern

The Department of Justice released its annual report of civil recoveries for fraud and false claims against the U.S., showing $2.2 billion in settlements and judgments for the fiscal year ending September 2022. The data released by DOJ show the critical role that whistleblowers play in securing these recoveries for the government:  of the $2.2 billion recovered, $1.96 billion – 89% – was recovered in cases...

Top Ten Whistleblower Awards of 2022

2022 was a big year for whistleblowers, who once again recouped billions of government dollars and in turn received hundreds of millions in whistleblower rewards.  This year’s top rewards came from various government whistleblower programs, including the qui tam provisions of the federal False Claims Act, various state False Claims Act programs, and the Dodd-Frank SEC Whistleblower Program. Below is a...

Top Ten Non-Healthcare False Claims Act Recoveries of 2022

This year’s Top Ten Non-Healthcare False Claims Act Recoveries exhibit the False Claim Act’s (FCA) enduring ability to combat corporate misconduct across distinct industries.  In 2022, the United States recovered hundreds of millions in taxpayer funds falsely obtained by defendants through bribery and bid-rigging schemes, mortgage underwriting fraud, fraudulent loan applications, fraud in the energy sector, and...

Top Ten Healthcare Fraud Recoveries of 2022

Consistent with the trend in prior years, 2022 saw government enforcement agencies taking aim at fraud and false claims in healthcare.  As the cost of healthcare rises along with its share of the U.S. economy, the enforcement focus on healthcare fraud is likely to accelerate. And, as always, the role of whistleblowers will be critical, as demonstrated by the dominance of cases originated by whistleblowers under the...

New York Times Covers “Cash Monster” of Risk Adjustment Fraud, Featuring Cases Initiated by Constantine Cannon Clients

Kaiser whistleblower Dr. James Taylor got the headline on the front page of Sunday’s New York Times: “The cash monster was insatiable.” The article, subtitled How Insurers Exploited Medicare for Billions, highlights that nearly half of the Medicare beneficiaries in the U.S. are now enrolled in Medicare Advantage programs. Federal payments to Medicare Advantage insurers make up a correspondingly increasing share...

Jury Finds Eli Lilly Cheated Medicaid in Case Highlighting Legal Battle Over False Claims Act Intent Standard

Constantine Cannon whistleblower lawyers Marlene Koury and Leah Judge were published in Law360 on the verdict in favor of a whistleblower against Eli Lilly, and what that case says about legal developments in the interpretation of the False Claims Act since the Seventh Circuit’s SuperValu decision. This post is an adaptation of that article.

In August, a Chicago jury in the U.S. District Court for the Northern...

Telehealth Boomed During the Pandemic - and so Did Telehealth Fraud

Prior to the pandemic, telehealth was basically nonexistent, with one study clocking the percentage of “virtual” doctors’ visits before Covid-19 at zero percent. At the time, America’s largest insurer, Medicare, only covered telemedicine in limited circumstances that usually still involved a visit to a healthcare facility. Medicare’s coverage limitations demonstrated the Department of Health and Human...

Constantine Cannon Attorneys Explain How the Recent Conviction of Theranos COO Sunny Balwani Underlines the Need to Expand Whistleblower Rewards Programs

As Gordon Schnell and Max Voldman explain in Fortune, the Balwani conviction closed a chapter that began several years ago when whistleblowers at the company reported to the press and authorities what they saw as something very wrong in Elizabeth Holmes’ biotech startup.  They followed a path many whistleblowers have taken, risking their own careers and livelihoods, to stop what they saw as serious fraud and...

A recent case could undermine the rules that have been protecting taxpayer money from fraud since the time of Lincoln

Constantine Cannon whistleblower lawyers Eric Havian, Mike Ronickher, and Ari Yampolsky were published in Fortune.com on the Supreme Court's consideration of the SuperValu decision.

We’re whistleblower lawyers who spend our careers speaking in legalese. But every once in a while, a case comes along that is so alarming, yet so couched in jargon, that an issue of great importance can easily escape notice. When that...

American hospitals have been resistant to whistleblowers. Here’s how they can save money and lives by embracing them.

Last month, the American Hospital Association wrote a pointed letter to the Justice Department, asking them to investigate, and potentially sue, Medicare Advantage plans for improperly denying coverage of patients’ hospital services. Medicare Advantage is a popular government program that pays private insurers premiums to cover seniors, and the insurers are required by law to provide at least the same benefits as...