Private Insurance Whistleblower Reward Programs
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Healthcare Fraud: it’s not just Medicare and Medicaid
Posted 10/17/18
January 4, 2018
Kmart Corporation agreed to a $1 million settlement with the California Department of Insurance to resolve a whistleblower claim brought under the California Insurance Fraud Prevention Act. KMart contracted with insurance companies to be reimbursed at a rate based on the company's charges to cash-paying customers, but was alleged to have submitted claims to private insurers in amounts that exceeded the agreed-upon rates. CASeptember 5, 2017
Novo Nordisk, Inc. has agreed to $1.1 million to resolve claims that its diabetes drug Victoza was unlawfully promoted for off-label use in violation of the California Insurance Frauds Prevention Act. The claims were brought in a whistleblower action under that act filed by former Novo Nordisk researcher Peter Dastous, who will receive a share of the settlement. CAFraudster of the Week -- Monarch Medical Group
Posted 04/28/17
Last week, California state prosecutors charged 26 individuals, including 21 physicians and 2 pharmacists, in connection with a kickback scheme orchestrated by Tanya and Christopher King, the owners of a practice management company called Monarch Medical Group and other related companies. If convicted, the involved physicians could face up to 25 years in prison and the pharmacists could face up to 28 years. ...
DOJ intervenes in $50 Million Healthcare Fraud Case
Posted 03/2/17
By the C|C Whistleblower Lawyer Team
Preet Bharara, US Attorney for the Southern District of New York, announced a civil suit and criminal actions against several doctors and health care entities alleging over $50M in fraud through schemes that lasted over 12 years. Five of the six doctors charged in their personal capacity were arrested in the New York area on Wednesday.
The allegations center around Asim...
January 30, 2017
Florida announced a $1.5 million life claim settlement agreement reached with subsidiaries of the Ameriprise Group, RiverSource Life Insurance Company and RiverSource Life Insurance Company of New York. The settlement agreement focuses on the one-sided use of the Social Security Administration’s Death Master File to stop paying a deceased person’s annuity, but not using the same information to find and begin paying the deceased’s family or other beneficiaries for life insurance policies. Florida, California, New Hampshire, North Dakota and Pennsylvania conducted the examination into the companies that led to this agreement. Florida’s allocation of the multi-state settlement payment by Ameriprise is more than $111,000, which covers the costs of the investigations and future compliance monitoring. To date, state insurance regulators have either reached settlements or concluded the investigation of 28 of the top 40 companies constituting 80 percent of the total market. Efforts continue to be focused on the examination of the remaining 12 insurers. FLNovember 21, 2016
Pennsylvania announced the filing of criminal charges against 50 individuals following investigations by the Office of Attorney General’s Insurance Fraud Section. The charges are part of a November sweep conducted by the Insurance Fraud Section, which is the largest law enforcement entity in Pennsylvania with specific authority to investigate and prosecute cases of insurance fraud. The total potential fraud involved in these cases is more than $1.1 million. The charges announced involve some of the most common types of insurance fraud. PAJuly 18, 2016
Bristol-Myers Squibb agreed to a $30 million settlement to resolve allegations of unlawful kickbacks to physicians in the marketing of Pravachol and other drugs. The claims were made in a whistleblower suit filed under the California Insurance Frauds Prevention Act by three former Bristol-Myers sales representatives, who will receive a share of the settlement. CAA Big Friday for Whistleblowers
Posted 12/21/15
By the C|C Whistleblower Lawyer Team
In what might be a first of its kind for whistleblowers and the government, this past Friday there were four significant government fraud recoveries all initiated by whistleblowers. In the midst of what is certainly an ever-expanding parade of whistleblower-prompted fraud settlements by the government, this may be the only time four major settlements were announced in a single...