Author Archives: Site Administrator
Whistleblower Beware: You May Need to Act Quickly
You work for a company that is committing a major fraud against the Government. Maybe it’s Medicare fraud, government contracting fraud, or education fraud. Most of the people in your workplace know the fraud is happening, but nobody is doing anything about it because the company is making so much money. You know it’s… Read More »
Seventh Circuit Offers Additional Guidance on the Pre-2010 Public Disclosure Bar
In an opinion by Judge Richard Posner, the Seventh Circuit recently had an opportunity to revisit the pre-2010 version of the public disclosure bar found in 31 U.S.C. § 3730(e)(4). In United States ex rel. Bogina v. Medline Industries, Inc., No. 15-1867 (7th Cir. Jan. 4, 2016), the court considered the dismissal of a… Read More »
Ambulance Fraud in Florida
Ambulance fraud is on the rise in Florida, and taxpayers are paying the bill. In September 2015, the Department of Health and Human Services, Office of Inspector General (“OIG”) issued a report titled Inappropriate Payments and Questionable Billing for Medicare Part B Ambulance Transports. In May 2015, the United States Attorney for the Middle… Read More »
Senior Medicare Patrols – Empowering Medicare Beneficiaries
Senior Medicare Patrols (“SMP”) provide free assistance to Medicare beneficiaries, their families, and caregivers to prevent, detect, and report Medicare fraud. SMP’s are funded with grants from the U.S. Department of Health and Human Services, U.S. Administration for Community Living. There is an SMP office in each of the 50 states, Washington, D.C., Puerto… Read More »
Supreme Court to Consider Triple Canopy Case at Certiorari Conference This Week
The U.S. Supreme Court will consider Triple Canopy, Inc.’s petition for a writ of certiorari this week for review of the Fourth Circuit’s decision in U.S. ex rel. Badr v. Triple Canopy, Inc. The case that wades into the thorny issue of “implied certifications.” In Triple Canopy, the federal government awarded a fixed price… Read More »
DOJ Takes a Bite Out of the Gators’ Hospital System
The University of Florida in Gainesville (the “University”) has settled with the U.S. Department of Justice (DOJ) for claims that the University improperly charged the U.S. Department of Health and Human Services (HHS) for unapproved salaries and administrative costs on hundreds of federal grants the University run hospital system received from HHS. HHS considers… Read More »
Making Copays for Patients
We have blogged in the past about a common Medicare fraud scheme that involves waiving patient copayments and deductibles. The basic scheme works like this. Medicare normally requires that healthcare providers collect a copayment equal to 20% of the covered item or service. Crooked healthcare providers will waive or forgive this 20% copay as… Read More »
Medicare Paid $54 Million for Medically Unnecessary and “Mystery” Ambulance Rides
The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently released a detailed study of ambulance transports billed to Medicare Part B in the first half of 2012 that identified millions of dollars of dubious and potentially fraudulent payments. Of the $2.86 billion paid by Medicare for ambulance services in… Read More »
Can Whistleblowers Bring Group Qui Tam Claims?
Yes, whistleblowers can bring group claims in qui tam cases. Indeed, this is a somewhat frequent occurrence and often is a successful strategy once the pros and cons are considered. What are the pros of bringing a group qui tam claim? A number of pros exist for bringing a group qui tam claim with… Read More »
Urine Drug Testing Laboratory Fraud
On October 19, 2015, the United States Department of Justice announced that Millennium Health, formerly Millennium Laboratories, had agreed to pay $256 million to resolve allegations of Medicare fraud in connection with urine drug testing and genetic testing. Millennium is a nationwide company engaged in the lucrative and highly competitive business of urine drug… Read More »