A $1.2B+ Health Care Graft Grift! Arizona Couple Pleads Guilty to Fraud
Posted 02/4/25
On January 31, 2025, the government announced an update in a case involving a Phoenix, Arizona couple pleading guilty to causing the submission of over $1.2 billion of fraudulent claims to Medicare and other health insurance programs. The couple submitted claims for costly, medically unnecessary wound grafts applied to elderly and terminally ill patients.
Alexandra Gehrke, 39, and her husband, Jeffrey King, 46,...
California Woman Sentenced in $369M Fraud Scheme Involving Billing for Medically Unnecessary Respiratory Tests
Posted 02/3/25
On January 28, the government announced that California resident Lourdes Navarro, 66, was sentenced to nine years in prison for her involvement in submitting fraudulent claims to both government and private insurance companies during the COVID-19 pandemic. Navarro and her co-conspirator, Imran Shams, illegally bundled COVID-19 screening tests with expensive and medically unnecessary respiratory pathogen panel (RPP)...
The Foreign Corrupt Practices Act (FCPA) bars paying foreign officials for any kind of business advantage, such as securing government contracts or other kinds of favorable business treatment. The statute covers any form of consideration including gifts, meals, travel, and entertainment. It also imposes strict record-keeping and internal control requirements to prevent falsifying company books and records to...
Alleged AML failures at Visa and Mastercard: Card Companies Accused of Processing Payments for Child Sexual Abuse Content
Posted 01/31/25
On January 24, Reuters reported that a whistleblower filed a complaint with the U.S. Treasury Department's Financial Crimes Enforcement Unit, or FinCEN, alleging Visa and Mastercard had failed to stop payment networks from laundering money from child sexual abuse material and sex trafficking on the porn-centric creator platform, OnlyFans.
According to Reuters and CBS, the whistleblower filed the complaint in...
From our recent survey of top SEC fraud recoveries this past year, we found it was not an especially standout year for the securities regulator in terms of big-dollar hauls. It was not necessarily a banner year for the Commodity Futures Trading Commission (CFTC) either in terms of its fraud recoveries. Only five of them brought in 9-digit amounts or higher.
But the Number 1 hit -- the eye-popping $12.7 billion...
Top 10 Most Notable Whistleblower Stories and Government Enforcement Actions of 2024
Posted 01/28/25
We don’t often like to pick favorites, but when the moment strikes, we glance back at the previous year’s news to reflect. This January, as we unveiled our series of Top-10 lists, we reviewed 2024’s robust archive of Whistleblower Insider Blog posts to revisit a wide range of compelling topics, government enforcements, settlements, and extraordinary whistleblower stories.
On this list, we covered some...
Pfizer to Pay $60M to Settle DOJ and Whistleblower Kickback Charges
Posted 01/27/25
Last Friday (January 24), the Department of Justice announced that Pfizer Inc. subsidiary Biohaven Pharmaceutical Holding Company agreed to pay roughly $60 million to settle DOJ and whistleblower charges of violating the False Claims Act and Anti-Kickback Statute by paying kickbacks to induce prescriptions of Biohaven’s migraine medication Nurtec ODT. The alleged misconduct occurred prior to Pfizer’s acquisition...
CFTC Promotes Whistleblower Chief Brian Young to Acting Head of Enforcement
Posted 01/27/25
Last week (January 22), Commodity Futures Trading Commission (CFTC) Acting Chair Caroline Pham announced a slew of leadership changes at the commodities regulator. Key among them was elevating current head of the CFTC Whistleblower Office Brian Young to Acting Director of the CFTC's Division of Enforcement.
It is a big move for Young who has been with the agency for less than a year. He joined last February...
Top 10 Most Fascinating Whistleblower Stories and Recoveries of 2024
Posted 01/24/25
We’re rolling out our slew of Top-10 lists covering whistleblower cases, government enforcement actions, and recoveries from 2024. Over the past year, we engaged with a vast number of interesting topics, government updates, and fraud settlements originated by whistleblowers, several represented by Constantine Cannon.
As we look back at 2024, we’ve gathered some of the most fascinating whistleblower news and...
It was not necessarily the biggest year for Securities and Exchange Commission (SEC) securities fraud recoveries, with only a handful in the hundred-million-dollar range and only one in the billions. But it was a very active year nonetheless, with the SEC under Gary Gensler pursuing a very aggressive approach to enforcing the securities laws.
With Gensler's recent departure, and Paul Atkins taking the reins, all...