With the development of big data and predictive analytics, it is easier today than ever before to detect and prevent healthcare fraud. Gone are the days of lengthy, old-fashioned investigation, and here to stay are new technologies that can identify fraudulent activities automatically and instantly. By parsing through big data…
With about one-third of the cost of the healthcare industry in the U.S. lost to fraud, waste, and abuse, it is vitally important to society that we report healthcare fraud when we see it. While it is certainly helpful to familiarize yourself with the most common healthcare fraud schemes and…
The majority of U.S. states have their own version of the federal False Claims Act (FCA), and California is no exception. Anyone who engages in fraudulent activity in California may be subject to punishment under the California False Claims Act (CFCA). While the FCA and CFCA have many similarities, they…
The government only chooses to intervene in whistleblower cases that it finds to be strong and in which it has an interest. By presenting your qui tam case in a strategic way, you can catch the eye of the government and encourage them to intervene. Below are several practical tips…
While most individuals have the opportunity to bring a qui tam whistleblower suit for any violation of the False Claims Act, there are certain exceptions to who may bring a qui tam whistleblower suit and the conditions of the suit. The following are five instances that, if applicable to you,…
You blew the whistle on your employer’s illegal actions, and now your employer is retaliating against you. This is not an unusual situation, but it is an illegal one. Both federal law and California law protect whistleblower employees from employer retaliation and impose large fines on employers who choose to…
Medi-Cal fraud occurs more frequently than you think and often goes unnoticed. Unfortunately, this only harms recipients and future recipients of Medi-Cal who desperately need this healthcare assistance program in order to obtain the medical treatments they require. As a whistleblower, you have the opportunity to help put an end…
One of the biggest fears many employees have when deciding whether to blow the whistle on their employer’s illegal conduct is employer retaliation. No one wants to rat out an employer when it means he or she will be fired from a job. Luckily, California has whistleblower protection laws in…
No one likes a snitch in petty situations, but in the face of corporate fraud, employee whistleblowers are some of the most invaluable individuals to society. While employees may try to seek recourse for improper employer actions internally, they will often find this path closed off to them. A company’s…
With the high number of TRICARE fraud cases in the United States, it is no wonder that healthcare fraud is the second highest priority of focus for the U.S. Department of Justice. The $2.7 trillion healthcare industry is an enticing target for those wanting to commit healthcare fraud, which is…