False Claims-Qui Tam

Whistleblowers helped the government collect $3 billion in fines and recoveries in fiscal year 2019, up from $2.8 billion in 2018. Medicare and Medicaid were big targets for fraudsters this year, as they have been in years past, according to...

Whistleblowing is good for our health. Not necessarily the whistleblower’s health. But, while we’ve been watching the battle over whistleblower protection in Washington, insiders have been busy flagging health fraud. As a result, there are patients out there who may...

Harvard Law School professor Terri Gerstein writes that the case of the IC whistleblower is strangely familiar to her. A worker learns of brazen violations of law and feels compelled to speak up. The boss and his buddies go bananas,...

Sen. Chuck Grassley believes the Department of Justice has moved to dismiss false claims cases without considering the merits or conducting cost-benefit analyses. In a September 4 letter to Attorney General William Barr, Grassley writes that he is concerned about...

The AARP calls Medicare’s coverage of medical devices “a boon to beneficiaries but also a big draw for fraudsters, who exploit older Americans’ health care concerns to enrich themselves.” This week’s Modern Healthcare offers a piece that argues a recent...

Whistleblowers are playing a key role in revealing Medicare kickback schemes disguised as so-called patient assistance programs. In April, five separate pharmaceutical companies paid a total of $247 million for running such programs. This week, a new qui tam suit was...

Medicare and Medicaid are the deep pockets of the federal budget, paying out nearly $1 trillion in 2018. So, it’s no wonder the programs are targets for fraudsters. Some steal from the sick. Some steal money meant to soothe the...

The Department of Justice announced last week that Encompass Health Corporation, formerly known as HealthSouth Corporation, has agreed to pay $48 million to resolve allegations that it was enrolling patients in its program and charging Medicare whether they would benefit...

Citizens and activists can help stop environmental crime, but they need to know which laws apply, how to collect evidence and when to get a lawyer. Different approaches to the role of citizens in collecting and reporting evidence of environmental...

Medicine is a profession with high ethical standards. At the same time, there is much money to be made. Bad players find ways to siphon some of the nearly $600 billion we spend on Medicare each year. So, both the...