Qui Tam Blog
False Claims Act: Top Health Care Recoveries for Fiscal Year 2017
There’s no denying that health care fraud accounts for a large percentage of the claims that qualify under the Federal False Claims Act (FCA). According to the Justice Department, of the more than $3.7 billion in settlements and judgments recovered in fiscal year 2017, $2.4 billion of them involved the health care industry. Claims… Read More »
Whistleblowers and Wildlife Crime
When we talk about qui tam litigation, whistleblowers, and the Federal False Claims Act, some people think it’s primarily related to the healthcare industry. While the healthcare industry certainly makes up a chunk of the active lawsuits, especially those under the Federal False Claims Act, there are other areas where whistleblowers could play an… Read More »
Potential Whistleblowers Take Note of Employer Monitoring
If you’re working in an environment where you’ve suddenly become aware of illegal or unethical behavior, especially that which might qualify under a whistleblower case, you need to stop and think for a minute. It’s critical to consider all your future actions once you’ve uncovered something worth reporting, before you report anything. In many… Read More »
Stark Law and Qui Tam Cases
Stark Law violations are a source of referrals for whistleblower claims, or qui tam lawsuits under the False Claims Act (FCA). Stark law refers to Section 1877 of the Social Security Act, 42 U.S.C. 1395nn, which deals with physician self-referrals. Stark Law Defined Under the Social Security Act provisions, Stark Law: Prohibits a physician… Read More »
Justice Department Recovers over $3.7 Billion in False Claims Act Cases in the 2017 Fiscal Year
The United States Department of Justice recently released statistics from the 2017 fiscal year, which includes more than $3.7 billion in settlements and judgments from civil cases involving fraud and false claims. Total recoveries since the False Claims Act (FCA) was strengthened in 1986 now top more than $56 billion. Types of Recoveries Of… Read More »
Qui Tam Litigation: What is the False Claims Act?
We talk about qui tam, or whistleblower litigation, but what is the False Claims Act (FCA) that brings rise to this type of litigation. Qui Tam Defined The word qui tam is Latin and translates to “who as well”, and references lawsuits that are brought on behalf of the plaintiff and the government. These… Read More »
What is Risk Adjustment Fraud?
In 1997, Congress decided that traditional Medicare was way too expensive. At the time, Medicare operated under a traditional fee-for-service model. Under this model, if a doctor delivered services to Mrs. Jones, the government paid the doctor a fee for his or her services, i.e, fee-for-services. Congress thought it found a better way. Rather… Read More »
What Should You Not Do as a Whistleblower? Tell the Defendant
One thing we cannot stress enough as attorneys for relators in False Claims Act cases is to respect the seal. As you may know from reading this blog, the False Claims Act requires that any case filed by a qui tam whistleblower has to remain under seal for at least 60 days to give… Read More »
How do I blow the whistle on tax fraud?
Every year, people and companies in the United States cheat on their taxes. The IRS has a special term for the amount of taxes that go unpaid each year. It’s called the “Tax Gap,” which means the amount of true tax liability faced by taxpayers that is not paid on time. The IRS estimates… Read More »
Billing for Medically Unnecessary Services
In the world of False Claims Act qui tam cases, the concept of medical necessity is a very big issue. This is because Medicare requires, as a condition of coverage, that services delivered to a patient be “reasonable and necessary for the diagnosis or treatment of illness or injury.” See 42 U.S.C. § 1395y(A)(1)(a)…. Read More »
