Whistleblower Insider

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

June 21, 2018

False Claims Act Developments: Sixth Circuit Rules that Timing Matters When It Comes to Certifying Plans of Care

By Leah Judge

Reaffirming the importance of patient plans of care, the Sixth Circuit recently held that the timing of a physician’s certification of such plans is material to the government’s decision to pay for home health services. The case marks another circuit court’s application of the materiality standard announced in Universal Health Servs., Inc. v. United States ex rel. Escobar, and serves as a rebuke to recent decisions that have minimized compliance with federal health care regulations as “just too much paperwork.”  click here for more »

June 18, 2018

Constantine Cannon Partner Mary Inman on Whether UK Whistleblowers Should Get Paid

By the C|C Whistleblower Lawyer Team

Mary Inman, a partner in Constantine Cannon’s London office, will be presenting at a seminar by the UK Bar Association for Commerce, Finance & Industry on Tuesday, July 10th about whether UK Whistleblowers should get paid when coming forward. Ms. Inman and other panel members will discuss if the UK should follow the example set by other jurisdictions, such as the US and Canada. Click here to read more and register for the event!

June 15, 2018

What the Panama and Paradise Papers Tell Us

By the C|C Whistleblower Lawyer Team

At this spring’s OffshoreAlert Conference in Miami, journalists involved in two of the biggest document leaks in history, the Panama and Paradise Papers, spoke on panels about secrecy jurisdictions and discussed the tax avoidance, corruption, and money-laundering they permit. Their fascinating presentations provided a chance to reflect on the magnitude of the information released to the public and on how far the world still has to go to encourage positive whistleblowing, so that some of the crimes revealed in those leaks are harder to perpetrate in the future. click here for more »

June 15, 2018

Catch of the Week — Signature HealthCARE

By the C|C Whistleblower Lawyer Team

In a major victory for patients and taxpayers alike, DOJ announced an over $30 million settlement with Signature HealthCARE, LLC, a Kentucky-based company accused of overbilling federal healthcare programs for rehabilitation and skilled-nursing services. As a prime example of how valuing profits over patients can lead to fraudulent behavior, Signature HealthCARE wins the title of Catch of the Week. click here for more »

June 13, 2018

Question of the Week — Do You Agree With The Ruling That AT&T’s Takeover of Time Warner Can Proceed Without Limitations?

By the C|C Whistleblower Lawyer Team

The New York Times reported that AT&T took one step closer to becoming a telecom-media giant after Richard J. Leon, a United States District Court judge, ruled that its $85.4 billion takeover of Time Warner can proceed without limitations.

The takeover was announced in October 2016, and is the latest effort by a big telecom or cable company to acquire media assets. The cable company Comcast owns NBCUniversal, and Verizon owns websites including Yahoo and HuffPost. click here for more »

June 8, 2018

How Copayment Waivers can Give Rise to a Whistleblower Claim

By the C|C Whistleblower Lawyer Team

What’s not to like about a doctor waiving a patient’s copayment, or a pharmaceutical company offering a prescription drug assistance program? Turns out there are plenty of reasons to be concerned about such activities. And, as a recently announced $24 million settlement with Pfizer illustrates, unlawful patient cost waivers can result in big liability for defendants.

Patient cost-sharing is a core principle of all health insurance programs, and is required by federal healthcare programs including Medicare. Payment for even a small portion of healthcare costs makes patients aware of those costs. Cost-awareness makes patients better healthcare consumers and incentivizes them to select medical services and drugs because they are medically necessary, rather than simply because they are free. Routine coinsurance and copayment waivers and other patient discounts undermine cost-sharing principles and increase healthcare costs. While patients avoid their small share of the cost, insurers and the government are left to pick up the rest. click here for more »

June 8, 2018

The Catch of the Week — Société Générale S.A.

By the C|C Whistleblower Lawyer Team

In a joint effort by the DOJ, CFTC, and French authorities, Société Générale agreed on June 4th to pay penalties and disgorgement in excess of $1 billion arising out of two separate wrongful schemes, making them our Catch of the Week.

First, in connection with alleged violations arising from manipulation of the London InterBank Offered Rate (LIBOR), Société Générale agreed to pay $275 million in a settlement with DOJ and approximately $475 million in regulatory penalties and disgorgement to settle charges filed by the CFTC, making Société Générale the latest financial institution to be face government action in the long-running LIBOR manipulation investigations. Second, Société Générale also agreed to pay $585 million to resolve claims relating to an alleged scheme to pay bribes to officials in Libya.  click here for more »

June 6, 2018

Question of the Week — Will New Tariffs Result in More Fraudulent Tariff Dodging?

By the C|C Whistleblower Lawyer Team

On May 31, the White House announced new tariffs on steel and aluminum entering the United States from Canada, Mexico, and the European Union. Steel from those countries and the European Union will be subject to a 25% tariff, and aluminum will be subject to a 10% tariff.

While the steel and aluminum tariffs were originally proposed to apply to imports from a larger number of countries, the White House announcement states that agreements were reached regarding steel imports with Australia, Argentina, Brazil, and South Korea, and regarding aluminum with Australia and Argentina. Imports from those nations will not be subject to the new tariffs. click here for more »

June 5, 2018

Constantine Cannon Partner Eric Havian Will Be a Guest Speaker for the American Bar Association’s National Institute on the Civil False Claims Act and Qui Tam Enforcement

By the C|C Whistleblower Lawyer Team

On Thursday, June 14, at 10:45am Eastern, Partner Eric Havian will be speaking as a special panel at the American Bar Association’s 12th National Institute on the Civil False Claims Act and Qui Tam Enforcement in Washington, DC. Mr. Havian will discuss relator and government prerogatives, the development of damages and the negotiation of settlement agreements. Click here for more and to register for the conference!

May 31, 2018

US Obtains $114M FCA Judgement in Kickbacks Case

By the C|C Whistleblower Lawyer Team

On May 23, the US District Court in South Carolina issued judgment for the US for roughly $114M against three individuals, LaTonya Mallory, Floyd Dent III, and Robert Johnson, for violating the FCA by paying kickbacks to doctors in exchange for patient referrals. The defendants also caused two labs to bill Medicare, TRICARE, and Medicaid for medically unnecessary tests. The judgment follows a January jury verdict that determined liability.

Broadly speaking, the Anti-Kickback statute prohibits hospitals, physicians, pharmacies, nursing homes, durable medical equipment (DME) companies, pharmaceutical (drug) companies, medical device manufacturers, and other medical providers from paying or receiving kickbacks, remuneration, or anything of value in exchange for referrals of patients who will receive treatment paid for by government healthcare programs such as Medicare and Medicaid. The law seeks to prevent physicians proscribing medically unnecessary medications, or recommending unneeded tests. The Anti-Kickback Statute is also intended to ensure that a physician’s medical judgment is not compromised by financial incentives and is solely based on the best interests of the patient. click here for more »