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‘Qui Tam Whistleblower’ Category

Medicare fraud by chiropractors costs taxpayers, insurers millions

Chiropractic Medicare Fraud

Medicare fraud by chiropractors costs taxpayers, insurers millions

Fraud in chiropractic care is on the rise as cases of unscrupulous billing practices and abusive care increasingly come to light, according to a Dallas-based analytics company that identifies fraud, waste and abuse by investigating self-funded employers’ healthcare claims.

A shocking 82 percent of the chiropractic services billed to Medicare is unallowable, according to a recent audit...

2022 Healthcare Fraud, False Claims Act Settlements Exceeded $2B

Healthcare Fraud 2022

2022 Healthcare Fraud, False Claims Act Settlements Exceeded $2B

Citizen whistleblowers helped the U.S. Department of Justice (DOJ) resolve a near-record number of False Claims Act investigations in 2022, resulting in more than $2.2 billion in taxpayer funds recovered, according to a recent DOJ report.

“The government and whistleblowers were party to 351 settlements and judgments, the second-highest number of settlements and judgments in a single...

Medical Imaging Company and CEO to Pay Record $85.4M Whistleblower Settlement

Whistleblower Settlement

Medical Imaging Company and CEO to Pay Record $85.4M Whistleblower Settlement

Illinois-based medical imaging company Cardiac Imaging, Inc. and its CEO have agreed to pay an $85.4 million settlement to resolve whistleblower claims that the company paid illegal kickbacks to physicians in a scheme to defraud government programs in violation of the False Claims Act (FCA).

The agreement is the largest single district civil settlement in the history of the U.S....

Damaging Impact of Private Equity in Healthcare

Private Equity Impact on Healthcare

Damaging Impact of Private Equity in Healthcare

Private equity firms continue to invest in healthcare as they look to generate quick and substantial profits through acquisitions and sales. But increasingly, these investments appear to come at a cost in lower quality of care and an increase in the bills footed by the American taxpayer.

Private Equity Increase Healthcare Investment

According to a report from PwC, 2022 private...

Private Equity Firms Increasingly Held Responsible for Healthcare Fraud

Private Equity Firms Increasingly Held Responsible for Healthcare Fraud

As private equity firms increasingly pour investment money into home health, nursing homes, mental health centers, and hospices, federal regulators are taking notice. As a result, these profit-driven organizations are increasingly being held responsible for violating statutes like the False Claims Act, as well as SEC regulations.

About 30% to 50% of home health and hospice transactions...

Whistleblowers and Rewards: Why It Matters

Importance of Whistleblowers

Whistleblowers and Rewards: Why It Matters

In 2021, the U.S. Department of Justice recuperated $5.6 billion from False Claims Act (FCA) cases. Whistleblowers played an important role in this recovery.

Who Are Whistleblowers?

Private citizens, called “relators,” are allowed to file suit for FCA violations on behalf of the government. These are known as qui tam actions. Anyone can become a whistleblower to report...

Dallas Doctors Sentenced to 23 Years For Medicare Fraud

Dallas Doctors' Medicare Fraud Sentence

Dallas Doctors Sentenced to 23 Years For Medicare Fraud

Two North Dallas doctors, along with other healthcare employees, were sentenced to federal prison for Medicare fraud in December 2021.

Dr. Mark Gibbs and Dr. Laila Hirjee, medical directors at Novus Health Services, a hospice agency in Frisco, Texas, were found guilty of conspiracy to commit healthcare fraud. The doctors will serve a combined 23 years in prison and were ordered to pay...

Nearly 150 Groups Call Better Whistleblower Protections

Better Whistleblower Protections

Nearly 150 Groups Call Better Whistleblower Protections

Prior to 2009, there were no government protections for whistleblowers who exposed wrongdoing or abuse of power with regard to government contractors and grantees. This changed when President Barack Obama signed the Fraud Enforcement and Recovery Act of 2009, which protects whistleblowers who expose fraud in federal contracting. The new law provided whistleblower protections to those who work...

How Does the False Claims Act Work?

False Claims Act

How Does the False Claims Act Work?

Last year, whistleblowers led the way to over $1.6 billion in False Claims Act recoveries, continuing a long legacy of ordinary citizens fighting for what’s right since the United States’ first qui tam whistleblower law was passed in 1778. But how do whistleblower laws work, and why do they matter? Fraud on the government takes many forms, but its result is the same—high cost to...

New Legislation Proposed to “Beef Up” the False Claims Act

False Claims Act Enhancement

New Legislation Proposed to “Beef Up” the False Claims Act

The world’s first whistleblower law was enacted by the Continental Congress on July 30, 1778, after two jailed men alleged the commander-in-chief of the Navy was corrupt. When government contract fraud became widespread during the Civil War, Congress passed the False Claims Act (FCA) on March 2, 1863, to encourage people to come forward with information on corrupt contractors. Congress then...

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