Whistleblower Insider Blog

Catch of the Week: Bayada Home Health Care Settles Kickback Allegations for $17 Million in Case Demonstrating that Kickbacks Come in Many Forms

Last week, Bayada Home Health Care, Inc., a national home health company with more than $1.5 billion in reported revenues and offices in twenty-two states, agreed to pay the United States $17 million to settle allegations that it violated the federal Anti-Kickback Statute (AKS).  The AKS prohibits paying illegal remuneration in any form to induce business or referrals paid for with federal health care dollars, and...

U.S. Pursuit of Risk Adjustment Fraud Continues with Complaint in Intervention in Case Filed by Constantine Cannon Client against Independent Health and its Coding Subsidiary DxID

In July, we wrote that managed care enforcement had reached a “tipping point,” as the Department of Justice intervened in whistleblower cases against Kaiser Permanente alleging risk adjustment fraud, including a case brought by Constantine Cannon client Dr. James Taylor.  Just last month, we announced a $90 million settlement in a different Medicare Advantage risk adjustment fraud case brought by Constantine...

SEC Awards $114 Million to Two Whistleblowers, Including an Apparent Outsider, Passing the $1 Billion Mark with a Bang

The SEC announced $114 million in whistleblower awards to two unnamed individuals whose information substantially contributed to an SEC enforcement action and two related actions by other enforcement agencies.  With this award, the SEC can say it has issued more than $1 billion in awards to whistleblowers – truly, a milestone worth celebrating. As is typical with SEC press releases about whistleblower awards,...

Eric Havian Discusses Beginning of Theranos Trial on Talking Feds Podcast: Listen Here

Our very own Harry Litman, host of the Talking Feds podcast which brings together former government officials, recently welcomed Constantine Cannon Whistleblower partner Eric Havian to discuss the trial of Theranos founder and former CEO Elizabeth Holmes. While this Talking Feds podcast would ordinarily be available only through Patreon, we have made it available to you below. Ms. Holmes is charged with 12 counts...

Constantine Cannon Attorneys Present on Whistleblower Cases Involving MA Risk Adjustment Fraud at RISE West Conference

Building on Constantine Cannon’s reputation as the preeminent law firm representing whistleblowers in FCA cases involving Medicare Advantage (MA) risk adjustment fraud, three Constantine Cannon attorneys, Mary Inman, Ed Baker, and Max Voldman, recently presented on case developments in this fast-developing area of the law at RISE West, a national conference for healthcare professionals working in the managed care...

Catch of the Week: San Francisco Garbage Companies Cop to Bribing Corrupt City Regulator in $36 Million Deal with Feds

Three San Francisco trash and recycling companies, all Recology, Inc. subsidiaries, have agreed to pay $36 million in a corruption scheme involving substantial bribes to former San Francisco Public Works Director Mohammad Nuru. The SF Recology Group, which includes Recology San Francisco, Sunset Scavenger Company, and Golden Gate Disposal & Recycling Company agreed to a deferred prosecution deal on charges they...

SEC Whistleblower Program Summer Roundup - Nearing the Billion Dollar Mark

For the SEC Whistleblower Program, it was business as usual this summer.  With total awards of more than $50 million to 25 whistleblowers, the agency moved ever closer to the billion dollar mark.  Here is how it played out for the SEC program over the not so lazy days of summer:

• June 2 – $23 million (2 whistleblowers)
• June 14 – $3 million (2 whistleblowers)
• June 21 – $5.3 million (4...

DOJ Reasserts the Proper Role for Agency Guidance in Fraud Cases

The Justice Department has quietly rescinded a Trump administration policy that was needlessly undermining the role of government agency guidance.  On July 1, 2021, Attorney General Merrick Garland issued a memorandum revoking what is known as the Brand Memo.  In her memo, Former Associate Attorney General Rachel Brand had set out a position that defense attorneys scrambled to use to argue for leniency or...

Catch of the Week: Florida Lab Owner Pleads Guilty to $73 Million Telemedicine Fraud Scheme

Editor’s Note: For this week’s biggest story, the record $90 million settlement secured by a Constantine Cannon client against Sutter Health, read more here.

Healthcare fraudsters have a track record of exploiting health crises for personal gain. The COVID-19 pandemic created new telemedicine opportunities for patients to receive care without having to see doctors in person. As expected, fraudsters seized on...

Managed Care Risk Adjustment Enforcement Continues with Sutter Health Settlement: Constantine Cannon Client Secures Largest Ever Medicare Advantage Settlement by a Hospital

Sutter Health will pay the Government $90 million under the False Claims Act for allegedly submitting inaccurate and unsupported medical information on tens of thousands of patients.  The settlement in a case brought by a whistleblower represented by Constantine Cannon, together with co-counsel Keller Grover and Kleiman Rajaram, is the largest Medicare Advantage FCA settlement against a hospital system, and the...