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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.

CFTC Whistleblower Program has a Banner Year, but Challenges Remain

Posted  11/6/18
Seventy-five million dollars. That’s how much the United States Commodity Futures Trading Commission’s (CFTC’s) Whistleblower Program paid five whistleblowers - including $30 million to one, the CFTC’s largest award to date-according to the agency’s annual report to Congress for 2018. Also, for the first time, the CFTC awarded a whistleblower living in a foreign country. Without a doubt, 2018 was a banner year for the program. The CFTC’s Whistleblower Program...

Watch: “Taking Advantage” Highlights Medicare Risk Adjustment Fraud

Posted  11/2/18
Constantine Cannon partner Mary Inman and two Constantine Cannon whistleblower clients are featured in Episode 3 of the PBS series “Playing by the Rules: Ethics at Work.” The episode investigates ”risk adjustment” in the Medicare Advantage program and practices by some of America’s largest insurance companies to make patients look sicker than they really are-which boosts payments to the insurance companies from the Medicare program. Watch the 30-minute episode, Taking...

Question of the Week — Pricing information in prescription ads on television?

Posted  11/2/18
The Centers for Medicare & Medicaid Services has proposed a rule that requires the list price (or, “wholesale acquisition cost”) to appear clearly in television ads for prescription drugs and biologics. The CMS reasons that by ensuring that Medicare and Medicaid patients receive cost information, patients can make more informed decisions that will save them money. For example, co-insurance for some high cost drugs requires the patient to pay a...

Two Constantine Cannon Clients Featured on 60-Minutes Australia

Posted  11/1/18
Two Constantine Cannon clients who blew the whistle on Takata’s exploding airbags, the largest corporate cover-up in the auto industry, were featured on 60-Minutes Australia. The show revealed how Takata made these low-cost airbags to get a jump on competitors, ultimately putting millions of lives at risk and resulting in hundreds of deaths and injuries. Valuing profits over public safety, Takata ignored the whistleblowers’ warnings and sold airbags that were...

“Widespread and Persistent” Problems in Medicare Managed Care Burden Patients and Are Potential Violations of the False Claims Act

Posted  10/30/18
The federal government’s internal watchdog for the Medicare and Medicaid healthcare programs, the U.S. Department of Health and Human Services Office of the Inspector General (OIG), has issued a report finding that Medicare Advantage Organizations (MAOs) have engaged in a “widespread and persistent” practice of inappropriately denying coverage for medical services to Medicare patients. In addition, OIG has found that the MAOs failed to adequately inform Medicare patients and providers about...

Constantine Cannon Welcomes Former AUSA Edward Baker, Expands Its Healthcare Fraud Expertise

Posted  10/29/18
Constantine Cannon LLP announced today that the firm has expanded its whistleblower practice to better serve prospective whistleblowers reporting healthcare fraud, with the addition of former Assistant U.S. Attorney Edward A. Baker, Of Counsel, in the Washington, D.C., office. Ed joins the firm from the U.S. Attorney’s Office in the Eastern District of California, where he has worked since 2014, most recently as the Coordinator for Civil Healthcare Fraud. In...

Catch of the Week — VA Official Pleads Guilty to Bribery, Fraud, and Obstruction in $2 Million Scheme

Posted  10/26/18
A former U.S. Department of Veterans Affairs official, James King, 63, of Baltimore, Maryland, pleaded guilty to demanding and receiving bribes from three for-profit schools in exchange for enrolling disabled military veterans in those schools. King facilitated over $2 million in improper payments from the VA using the veterans’ federal benefits. He pleaded guilty to one count of honest services and money/property wire fraud, one count of bribery, and one...

Question of the Week — Should a Non-Disclosure Agreement Hush Up the Danske Bank Whistleblower?

Posted  10/24/18
Over the last month, a major financial scandal has roiled Europe. In September, Danske Bank, the largest bank in Denmark, announced that hundreds of billions of dollars in suspicious money had moved through its Estonia branch. Moreover, the company knew about the money, which originated in Russia and other former Soviet states, for years before taking action. In the wake of this tectonic money-laundering scandal, Danske Bank’s stock has plummeted...

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...

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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