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Category Archives: Qui Tam/Whistleblower

What is Risk Adjustment Fraud?

By McCabe Rabin, P.A. |

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 »

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What Should You Not Do as a Whistleblower? Tell the Defendant

By McCabe Rabin, P.A. |

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 »

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Billing for Medically Unnecessary Services

By McCabe Rabin, P.A. |

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 »

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Feds Recover $4.7 Billion from False Claims Act Cases in 2016

By McCabe Rabin, P.A. |

The Department of Justice recently announced its tally of total recoveries for 2016 under the False Claims Act. The government recovered an astonishing $4.7 billion during this time. The DOJ press release shows the following trends. First, qui tam whistleblower cases continue to be on the rise. Whistleblowers filed 702 qui tam lawsuits in… Read More »

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Why are Qui Tam Cases Filed Under Seal?

By McCabe Rabin, P.A. |

Anyone reading this blog probably knows that we represent whistleblowers who file so-called “qui tam” cases under the False Claims Act. The term “qui tam” is a Latin term derived from the longer and ancient legal expression “qui tam pro domino rege quam pro se ipso in hac parte sequitur,” meaning one “who pursues… Read More »

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How do I become a whistleblower?

By McCabe Rabin, P.A. |

A whistleblower is a person who reports fraud, corruption or other wrongdoing, usually, but not always, at their place of work. Most states have laws that protect whistleblowers and prohibit employers from firing, demoting or retaliating against whistleblowers. When a whistleblower sees fraud committed against the government, he or she has the opportunity to… Read More »

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The False Claims Act – One Defense Against Military Contractor Fraud

By McCabe Rabin, P.A. |

A study done by the National Contract Management Association revealed that in 2014, at close to three billion dollars, the Department of Defense accounted for two-thirds of the nation’s corporate contract spending. This vast amount of money, however, provides ample incentive for dishonest contractors to bilk the government and taxpayers, and potentially put the… Read More »

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More Medicare Part D Fraud in Miami

By McCabe Rabin, P.A. |

On November 8, 2016, the United States Attorney’s Office for the Southern District Florida announced the conviction and sentencing of two defendants in a Medicare Part D fraud case. What is Medicare Part D? As most people know, Medicare is a federally funded program that provides free or below-cost healthcare benefits to certain individuals,… Read More »

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Medicare Open Enrollment is Open Season for Scammers

By McCabe Rabin, P.A. |

Each year, Medicare beneficiaries can make changes to their Medicare health plans and prescription drug coverage between October 15 and December 7, during the Medicare Open Enrollment Period. Unfortunately for consumers, this period is also open season for Medicare scammers. Here are some common ploys that Medicare scammers use to try and take advantage… Read More »

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Grisham’s “The Whistler” May Open the Door to More Whistleblowers

By McCabe Rabin, P.A. |

Book Review: Grisham’s “The Whistler” by Florida Business Attorney Adam Rabin The hype is upon us with the release of John Grisham’s new legal thriller, “The Whistler.” While it feels like yesterday when I was a law student and could not stop turning the pages of “The Firm,” I am particularly excited for Grisham’s… Read More »

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