Whistleblower Insider Blog

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

Posted 12/14/18

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 Valley region of Pennsylvania. It...

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

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,

Question of the Week — Should the government pay for automatically refilled prescriptions?

Posted 12/13/18

This week, Target agreed to pay $3 million to resolve a former pharmacist’s whistleblower suit alleging Target submitted false claims by violating Massachusetts Medicaid rules barring claims for automatic prescription refills. Under the state’s rule, pharmacies are prohibited from billing Medicaid for refills dispensed without a patient request. As pharmacy costs continue to rise, more state Medicaid programs are refusing to pay for automatically refilled drugs. In addition to Massachusetts,...

Constantine Cannon Attorneys Eric Havian and Michael Ronickher Published in Law360 on the Need for Anti-Money Laundering Whistleblower Rewards

Posted 12/12/18

In the wake of anti-money laundering enforcement activity spurred by the Panama Papers, Constantine Cannon attorneys Eric Havian and Michael Ronickher published an article in Law360 on why we need an anti-money laundering whistleblower program. Havian and Ronickher argue for a new, DOJ-led whistleblower program to close the “large enforcement gap” left open by the existing IRS and SEC programs: “Domestic law enforcement agencies have great difficulty detecting and prosecuting...

Tagged in: Abusive Tax Shelters, CC Lawyers, Financial and Investment Fraud, Financial Institution Fraud, Importance of Whistleblowers, International Whistleblowers,

Listen: Expected Dismissal of Providence Health Upcoding Suit

Posted 12/7/18

Constantine Cannon partner Mary Inman joins the RAC Monitor “Monitor Monday” podcast to comment on the government’s decision to decline to intervene in a $188.1 million whistleblower lawsuit Med Analytics, LLC filed against Providence Health (now known as Providence St. Joseph) alleging Providence upcoded diagnoses it submitted to government health programs for reimbursement. Several reports have indicated the allegations are likely to be dropped on Jan. 14, 2019. Listen to...

Tagged in: CC Lawyers, Managed Care, Upcoding, Whistleblower Case,

Listen: Taxcast’s November 2018 Podcast on How Governments Can Better Protect and Encourage Whistleblowers

Posted 12/7/18

Constantine Cannon partner Mary Inman is featured in the Tax Justice Network’s November podcast on, among other things, whistleblowing on tax fraud. Inman discusses the impact of U.S. whistleblower laws on corporate wrongdoing and white collar enforcement and speaks to improvements governments can make to better protect whistleblowers, encourage whistleblowers to bring evidence to their governments, and financially incentivize or reward whistleblowers. Listen to the full episode below:

Tagged in: CC Lawyers, International Whistleblowers, IRS Whistleblower Reward Program, Tax 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 the January 2018 Granston...

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

Catch of the Week — Actelion Pharmaceticals

Posted 12/7/18

This week's Department of Justice "Catch of the Week" goes to Actelion Pharmaceuticals US, Inc., a California pharmaceutical company that sells various pulmonary arterial hypertension drugs, including Tracleer, Ventavis, Veletri, and Opsumit. Yesterday, Actelion agreed to pay $360 million to resolve allegations that it violated the Anti-Kickback Statute by indirectly paying drug copays for thousands of Medicare patients. It did so by donating to a 501(c)(3) nonprofit organization, which in...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Healthcare Fraud, Pharma Fraud,

Question of the Week — Should Trump’s businesses have to answer subpoenas in a case that alleges foreign powers are lining the President’s pockets?

Posted 12/5/18

On Tuesday, the attorneys general of Washington, D.C. and Maryland issued several subpoenas in a lawsuit alleging President Donald Trump violated the U.S. Constitution’s emoluments clauses. The “foreign” emoluments clause generally prohibits federal officeholders from receiving any gift, payment, or other thing of value from a foreign state or its rulers, officers, or representatives. The “domestic” emoluments clause prohibits the president from receiving any “Emolument” from the federal government or...

Tagged in: Question of the Week,

Catch of the Week — Bottini Fuel Busted for Illegal “Family and Friends” Scheme

Posted 11/30/18

Bottini Fuel, a fuel and heating company based in New York, has agreed to a $3.3M settlement to resolve allegations that it defrauded customers by keeping rather than returning overpayments. For over a decade, the company used the ill-gotten gains to pay the fuel expenses of company employees, family members, and friends. The whistleblower who brought the fraud to light in a case filed under the New York State False...

Tagged in: Catch of the Week, FCA State, Government Procurement Fraud, Whistleblower Case, Whistleblower Rewards,

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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

Question of the Week — Should the government pay for automatically refilled prescriptions?

Constantine Cannon Attorneys Eric Havian and Michael Ronickher Published in Law360 on the Need for Anti-Money Laundering Whistleblower Rewards

Listen: Expected Dismissal of Providence Health Upcoding Suit

Listen: Taxcast’s November 2018 Podcast on How Governments Can Better Protect and Encourage Whistleblowers

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

Catch of the Week — Actelion Pharmaceticals

Question of the Week — Should Trump’s businesses have to answer subpoenas in a case that alleges foreign powers are lining the President’s pockets?

Catch of the Week — Bottini Fuel Busted for Illegal “Family and Friends” Scheme

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Whistleblower Insider Blog

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

Question of the Week — Should the government pay for automatically refilled prescriptions?

Constantine Cannon Attorneys Eric Havian and Michael Ronickher Published in Law360 on the Need for Anti-Money Laundering Whistleblower Rewards

Listen: Expected Dismissal of Providence Health Upcoding Suit

Listen: Taxcast’s November 2018 Podcast on How Governments Can Better Protect and Encourage Whistleblowers

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

Catch of the Week — Actelion Pharmaceticals

Question of the Week — Should Trump’s businesses have to answer subpoenas in a case that alleges foreign powers are lining the President’s pockets?

Catch of the Week — Bottini Fuel Busted for Illegal “Family and Friends” Scheme

Learn about Whistleblower Rewards Programs

Newsletter

Subscribe to receive email updates from the Constantine Cannon blogs

Sign up for: