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Whistleblower Insider Blog

Whistleblower Insider is written by the Constantine Cannon law firm team of experienced qui tam and whistleblower lawyers. It is updated regularly to provide the latest whistleblower and fraud news and developments.

Overpayment Rule Decision Doesn't Imperil Risk Adjustment Cases: Mary Inman and Max Voldman in RAC Monitor

Posted  10/19/18
On September 7, a federal district court in Washington, D.C. vacated a single Centers for Medicare & Medicaid Services regulation – the 2014 “overpayment rule.”  As Constantine Cannon whistleblower attorneys Mary Inman and Max Voldman write in RAC Monitor, many Medicare Advantage Organizations have since made bold statements about the significance of this decision and its impact on the series of False Claims Act cases currently being pursued against them...

Tagged in: CC Lawyers, FCA Federal, Managed Care, Medicare, Risk Adjustment Fraud,

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Catch of the Week — Universal American Mortgage Company

Posted  10/19/18
Universal American Mortgage Company (UAMC), a Miami-based mortgage company, agreed on October 19 to a $13.2 million settlement to resolve allegations that it violated the False Claims Act (FCA) by falsely certifying that it complied with Federal Housing Administration (FHA) mortgage-insurance requirements in connection with certain loans. UAMC is part of Lennar, one of America’s leading homebuilders. The settlement resolves allegations brought by Kat Nguyen-Seligman, a former employee of a...
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Question of the Week — Should Whistleblowers Receive Rewards for Exposing Data Breaches?

Posted  10/17/18
Hardly a week goes by without more news of an actual or attempted data breach threatening consumer privacy or government security. In just this past month, Uber, Anthem and Facebook all made headlines for massive data breaches affecting millions of users and customers. In late September, Facebook notified its users of a data breach that exposed over 50 million people to hackers who could have taken over the users’ Facebook...

Tagged in: Question of the Week,

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Healthcare Fraud: it’s not just Medicare and Medicaid

Posted  10/17/18
Last year, the U.S. Department of Justice recovered $2.4 billion in settlements and judgments involving fraud in the healthcare industry perpetrated against government payors. But government programs like Medicare and Medicaid aren’t the only targets of massive healthcare fraud schemes. A recent Department of Justice press release announced the unsealing of a 32-count indictment containing charges against four individuals and seven companies in a $1 billion healthcare fraud that impacted...

Tagged in: Compounding Pharmacy Fraud, Healthcare Fraud, Private Insurance Whistleblower Reward Programs,

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Catch of the Week – AmerisourceBergen Corporation

Posted  10/12/18
Last Monday, one of the largest drug wholesalers in the country agreed to pay $625 million to settle allegations that it put cancer patients at risk by illegally repackaging and distributing millions of vials of oncology drugs. The federal government and forty-four states claimed that AmerisourceBergen Corp. (“ABC”) and one of its subsidiaries, Medical Initiatives, Inc. (“MII”) engaged in a thirteen-year-long scheme to open sterile vials of oncology drugs, pool...

Tagged in: FCA Federal, Healthcare Fraud, Pharma Fraud, Whistleblower Case,

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Constantine Cannon Partner Gordon Schnell Quoted in Law360 on the Rise of "Outside" Whistleblowers

Posted  10/12/18
Following the blockbuster False Claims Act settlement by AmerisourceBergen Corp., Law360 reported that 3 of the 4 whistleblowers who brought the case forward were not employees of the company. Rather, two were pharmacy workers at a Michigan hospital and one was a Florida physician group, and all of them were exposed to the alleged misconduct in the regular course of their work. As Law360 explains, these "outsiders" represent a new...

Tagged in: CC Lawyers, Whistleblower Eligibility,

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Havian opens trial in damages phase of FCA case against top PVC water-pipe maker, J-M Eagle

Posted  10/11/18
Constantine Cannon partner Eric Havian launched the damages-phase of a trial against J-M Eagle with opening statements on October 10, 2018. As reported by Daniel Siegal in Law360, a Los Angeles federal jury will hear evidence in a long-running case by public entities in several states who bought large transmission water-pipe from the nation’s number one PVC pipe company. A November 2013 jury unanimously found in Phase I of the...

Tagged in: CC Lawyers, Contract Non-Compliance, FCA Federal, FCA State, Government Procurement Fraud, Whistleblower Case,

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Question of the Week — Is it Time for an Anti-Money Laundering Whistleblower Program?

Posted  10/11/18
Current US law includes a variety of whistleblower programs that reward private persons for bringing information to the government. The programs range widely, and include everything from the False Claims Act (which rewards whistleblowers for revealing fraud against the government) to the SEC whistleblower program (rewards for reporting violations of US securities laws) to the Act to Prevent Pollution from Ships (rewards for reporting unlawful dumping of waste into the...
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Federal Judge — CFTC Can Regulate “Cryptocurrency” Fraud

Posted  10/10/18
Cryptocurrency
In good news for investors, a Massachusetts federal judge recently ruled that the Commodity Futures Trading Commission (CFTC) has the authority to fight fraud in the booming virtual currency market. The decision follows on the heels of a ruling in New York where a different federal judge reached the same conclusion. Through the Commodity Exchange Act, Congress authorized the CFTC to fight fraud involving “commodities.” As the virtual currency sector...

Tagged in: CFTC Whistleblower Reward Program, Court Decision, Cryptocurrency, Fraud in CFTC-Regulated Markets,

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Catch of the Week — Health Management Associates

Posted  09/27/18
Health Management Associates, LLC (“HMA”), a former hospital chain now part of Community Health Systems, agreed on September 25th to a $260 million settlement to resolve allegations of false billing and kickbacks alleged in eight qui tam cases under the False Claims Act (“FCA”). HMA was a hospital chain headquartered in Tampa, Florida that was acquired by Community Health Systems Inc., a major U.S. hospital chain, in 2014. One whistleblower...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Hospital Fraud, Upcoding, Whistleblower Case, Whistleblower Rewards,

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