During his days as a data encounter manager at SCAN, Jim suspected the company had been double-billing Medicare and Medicaid for years. He expressed his concerns within SCAN. When he refused a job reassignment, he was fired....more
Who knew? When you park for free at your doctor’s office, you may be a pawn in a scheme to violate the Anti-Kickback Statute, the Stark Law, and the False Claims Act. It’s enough to make you sick....more
Finding that Community Hospital Systems had been “too clever by half” in negotiating a global settlement agreement for seven whistleblower suits, a federal judge ordered the chain to pay the attorneys’ fees of all the...more
New York’s Mt. Sinai Hospitals can’t seem to catch a break in its long-running battle with whistleblower Bob Kane. First, the government joined the case and wanted not just the $1,000,000 in Medicaid overpayments, but an...more
Alisia and David blew the whistle on their former employer, Nurses’ Registry & Home Health, for sending gift baskets and ticket events to doctors who referred patients to the home health operation. Their qui tam suit alleged...more
7/22/2015
/ Anti-Kickback Statute ,
Client Referrals ,
False Claims Act (FCA) ,
Gifts ,
Home Health Care ,
Nurses ,
Physician Compensation Arrangements ,
Physicians ,
Qui Tam ,
Stark Law ,
Summary Judgment ,
Whistleblowers
The False Claims Act makes it illegal to obtain government money through false claims. Under the Act a private party, known as a relator, may bring a civil suit on the government’s behalf against an entity that has allegedly...more
On May 26, 2015, the United States Supreme Court issued a decision favoring whistleblowers in False Claims Act cases, basing its decision in part on the status of the trial of Socrates.
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Yesterday’s U.S. Supreme Court decision is good news and bad news for both whistleblowers and government contractors, including health care providers–a win for whistleblowers on one important issue, for contractors on...more
On Wednesday of this week, the federal court for the Southern District of New York rejected Fox’s plea to spare it from the $169,000 bill submitted by the white shoe law firm that successfully defended Managed Health Care...more
William Verrinder filed a False Claims Act against three of America’s biggest companies—Wal-Mart, Sears and Rite-Aid—claiming they charged Medicare for expired drugs. Since he’s a lawyer himself, he filed pro se. That way he...more
As of March 3, Solvay Pharmaceuticals is ready to second P.T. Barnum’s famous dictum that there’s no such thing as bad publicity. That’s the day a federal court in Texas dismissed a qui tam action against Solvay....more
Hospitals have long seethed over employees who exploit their inside information to become whistleblowers. There’s generally not much they can do besides seethe unless the employee has some special duty of confidentiality...more
On Monday the United States Supreme Court declined to hear Danny Smart’s appeal of the Fifth Circuit’s rejection of his attempt to share in the proceeds of a $5 million settlement of a False Claims Act suit brought by another...more
Last Wednesday the Seventh Circuit affirmed the dismissal of a whistleblower suit brought by a pharmacist against his former employer, the Shopko pharmacy chain, for what he alleged was fraudulent billing of Medicaid by...more
We’re only one-third of the way through the month of November, but we already have a winner of November’s Generality-in-Pleading Award. The hands-down winner is Dr. Warren Troxler, whose False Claims Act whistleblower suit...more
Want to be a whistleblower but worried your own wrongdoing will prevent it? If so, Tuesday’s decision by a federal court in Texas should come as welcome news. In that long-running False Claims Act case, the court rejected a...more
Back in 2003 Karl Schumann filed a whistleblower suit alleging that as an executive with benefits company Medco, he learned that Bristol-Myers Squibb and AstraZeneca paid kickbacks to Medco to buy and recommend brand name...more
On Tuesday a federal court in Illinois awarded fees of $200,000 to attorneys for a whistleblower in a False Claims Act action. Not impressed? Well, consider this: the whistleblower got a little less than $30,000. Figured...more
Antonio Saidiani filed a whistleblower suit alleging that NextCare urgent centers and CEO Dr. Shufeldt had collected tens of millions of dollars in false Medicare claims. Antonio was in a position to know because he was that...more
The last time we heard about Susan Thayer’s whistleblower suit against Planned Parenthood, a federal district court in Iowa had thrown it out because she hadn’t provided any specific examples of fraud and therefore had failed...more
Last Friday’s Eighth Circuit decision in Thayer v. Planned Parenthood of the Heartland favored the whistleblower in the ongoing controversy over specificity requirements in False Claims Act actions. The split had been even...more
Two nurses filed a whistleblower suit against the Illinois nursing home where they worked. Their theory was that the care provided at the home was so poor that it was worthless. So any bills to Medicare and Medicaid were...more
In U.S. ex rel. Corporate Compliance Assocs. v. N.Y. Society for the Relief of the Ruptured & Crippled the court ruled that the whistleblower failed to meet the False Claims Act’s requirement that allegations be described...more
Medicare and Medicaid providers lie awake at night worrying about disgruntled—or worse yet, fired—finance officers filing whistleblower suits. After all, Medicare and Medicaid regulations are notoriously complicated, and...more
It’s been a long time since Orlando’s Halifax Hospital got any good news from the federal court hearing the whistleblower case brought by employee Elin Baklid-Kunz. Earlier this year the hospital had to agree to an $85...more