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.
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:
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The Justice Department has quietly rescinded a Trump administration policy that was needlessly undermining the role of government agency guidance.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 Healthwill 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...
Whistleblowers are Essential to Protect Infrastructure Funds
America’s roads, bridges, power grids, and airports are a mess. Recently a group of civil and structural engineers graded the nation’s infrastructure a below-average C-. The Bipartisan Infrastructure Bill currently before Congress aims to solve some of those issues, with what the White House described as “a once-in-a-generation investment in our infrastructure.” The Bipartisan Infrastructure Bill promises...
Catch of the Week: Florida Man Charged with Stealing Over $12 Million in Funds Slated for PPE
DOJ continues to make good on its promise to root out fraud in pandemic relief. This week, a Florida resident Brian Sperber was indicted for defrauding hospitals and medical institutions out of more than $12 million dollars by falsely promising to deliver personal protective equipment to those purchasers. Sperber and his co-conspirators, who ran medical supply and logistics companies, took orders for N95 masks and...
Unnecessary procedures have long plagued the U.S. healthcare system, costing taxpayers billions and subjecting thousands of patients to invasive procedures that sometimes do more harm than good. For decades, various government actors have acknowledged the problem.
Why then is it so difficult to prevent unnecessary procedures in the U.S.?
Reporter Chris Outcalt recently pondered in a piece for The Atlantic. The...
Catch of the Week: Telemedicine Company Owner Charged in $784 Million Kickback Scheme
Underscoring the fraud risks associated with the government’s continued expansion and loosening of restrictions on telehealth, the U.S. Department of Justice recently announced that a grand jury in New Jersey has returned a superseding indictment against the Florida owner of multiple telemedicine companies, referred to by DOJ prosecutors as the Video Doctor Network, for allegedly participating in a massive Medicare...
Court says that fraudsters who violate rules they later claim are unclear may not violate the False Claims Act
Last week, the Seventh Circuit Court of Appeals, the federal appellate court for Illinois, Indiana, and Wisconsin decided U.S. ex rel. Yarberry v. Supervalu, an important decision that may lead more unscrupulous government contractors to help themselves to public funds to which they are not entitled. Unless the Supreme Court or Congress steps in to correct the Seventh Circuit’s errors, the government may have...
The Federal Financial Supervisory Authority, otherwise known as BaFin, is Germany’s version of the U.S. Securities and Exchange Commission (SEC), a supervisory body working to ensure the functioning, stability and integrity of the German financial system. BaFin was created following a 2002 merger between Germany’s Federal Banking Supervisory Office (BAKred), the Federal Securities Supervisory Office (BAWe), and...