Health Care Fraud is commonly known by other names such as health insurance fraud, medical billing fraud, health insurance fraud and Medi-Cal Fraud. The complicated and confusing bureaucracy associated with the payment process has lead to authorities accusing innocent providers and beneficiaries of health care fraud. In many instances these…
As concerned citizens and as a health care fraud law firm, our team continues to be pleased with the terrific successes whistleblowers are having using the False Claims Act, Anti-Kickback Statute and related federal and state statutes to fight fraud in the medical field. A major settlement announced this month…
You’ve witnessed something amiss in your workplace. Whether it is a medical practice routinely upcoding Medicare claims to charge for more expensive procedures than were actually performed, a government contractor cheating the government by providing goods that are inferior to those promised, or another form of overcharging the government, you…
Last week, we wrote about the upcoming Supreme Court case that will decide if the implied certification theory is a valid interpretation of the Federal False Claims Act (“FCA”). It is a decision that could substantially empower government fraud whistleblowers. However, it is worth remembering that the federal false claims…
Last year, our health care fraud whistleblowers’ law firm reported on an important issue in the False Claims Act arena: implied certification. The implied certification theory has the potential to be a powerful tool in the fight against fraud and, when we last discussed the topic, the Fourth Circuit Court…
By its nature, fraud is a crime of secrets. The depth and breadth of these secrets are part of the reasons why whistleblowers are such an essential part of the fight against health care fraud. The law recognizes this and both rewards and protects health care fraud whistleblowers for their…
It is a simple concept — health care should be dictated by the patient’s needs rather than the provider’s fiscal interest. While most providers adhere to this core principle, far too many do not, especially in the long-term and nursing home care arenas. Nursing home billing fraud, including rehabilitative therapy fraud,…
The False Claims Act (“FCA” or “the Act”) is one of the most important tools we have in the fight against health care fraud and other frauds on the federal government. When an organization or individual knowingly takes more money from the government than the law allows or otherwise submits…
In Fiscal Year 2015, the government, often with the assistance of private whistleblowers, recovered more than $3.5 billion using the False Claims Act to target companies and individuals who attempted to commit fraud and steal money from federal government programs. We took a broad look at these recoveries a couple…
Last week, we looked at the recoveries made on behalf of the federal government using the False Claims Act (“FCA”) in 2015. While informative, those numbers don’t tell the whole story. Many states have their own versions of the FCA. These statutes are particularly important in the Medicaid fraud arena…