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Tag: False Claims

Feb 24, 2015 - False Claims by |

Whistleblowers Filing Qui Tam Suits Over Medicare Advantage Fraud

ATTORNEY NEWSLETTER More than a half-dozen whistleblowers nationwide have recently filed qui tam/false claim lawsuits alleging systematic over-billing by Medicare Advantage plans, according to San Francisco based qui tam/fraudulent claim lawyers. Medicare Advantage allows the government to pay different amounts for senior care based on each patient’s risk score. It […]

Jan 27, 2015 - Class Action by |

Whistleblowing Continues To Be A Success

ATTORNEY NEWSLETTER Whistleblowers are individuals or groups that report about possible wrongdoings of a particular organization or company. Often times, whistleblowing involves an employee reporting employer misconduct that is illegal, unethical, or against public policy. Approximately 1400 whistleblowers have filed qui tam lawsuits in the last two years, and have […]

Nov 18, 2013 - Blog by |

Insurance Fraud and False Claims in California

ATTORNEY NEWSLETTER Insurance Code section 1871.7 provides a private right of action to sue perpetrators of insurance fraud on behalf of the State of California.  Although modeled on federal False Claims Act, 31 U.S.C. §§ 3729-3733, section 1871.7 is an attractive tool that offers significant advantages.  Section 1871.7, like other […]

Aug 5, 2013 - Blog by |

Hospitals Defraud Medicaid

ATTORNEY NEWSLETTER As chief financial officer for a large hospital operator, Ralph Williams was tasked with monitoring contracts and bill pay between his employer, Healthy Management Associates (HMA) and its partners. After discovering inconsistences in the contracts and payments, Williams began an investigation of the contracts. Williams discovered HMA; a […]

Jul 29, 2013 - Blog by |

Whistleblowers are under pressure from employers

ATTORNEY NEWSLETTER Whistleblowing employees face unique challenges in building qui tam cases against their employers for violations of the False Claims Act. Challenges such as shielding oneself from workplace retaliation, the perils of internally reporting the violations, making the choice to undertake an internal investigation and risks faced while negotiating […]

Jul 22, 2013 - Blog by |

Pharmaceutical Manufacturer Agrees to Settle Whistleblower Lawsuit for $500 Million

ATTORNEY NEWSLETTER A large Indian pharmaceutical manufacturer has agreed to settle with the United States and states’ attorneys general in a whistleblower lawsuit.  The pharmaceutical manufacturer was alleged to have falsified data, violated Current Good Manufacturing and Laboratory Practices, and sold substandard and unapproved drugs.  This settlement happened due of […]

Jul 19, 2013 - Blog by |

Whistleblower Protection Enhancement Act is Valid for Pending Cases

ATTORNEY NEWSLETTER In November of 2012 congress unanimously approved the passage of the whistleblowers could not protect themselves against associated retaliation by employers because of loopholes by the Federal Circuit Court of Appeals.  By passing the Whistleblower Protection Enhancement Act, congress acknowledged that bad administrative and court rulings had undermined […]

Jul 12, 2013 - Blog by |

How to Avoid Delays Once You Have Submitted an IRS Whistleblower Claim

ATTORNEY NEWSLETTER Exposing an organization’s misconduct or illegal activities requires courage. Employees who risk their professional careers by coming forward to report and help remedy illegal conduct are referred to as “whistleblowers.” After reporting the misconduct to the Internal Revenue Service (IRS), whistleblowers often finds themselves patiently waiting for a […]

Jul 8, 2013 - Blog by |

Whistleblowers are helping to clean up pharmaceutical manufacturing facilities

ATTORNEY NEWSLETTER In the past, the Food and Drug Administration (FDA) took the lead role in investigating pharmaceutical manufacturing facilities for violations of good manufacturing practices (cGMP’s).  Recently, the Department of Justice (DOJ) became a more actively involved in enforcement actions against pharmaceutical manufacturing facilities due to whistleblowers.  The DOJ […]

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