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Whistleblowers for PPP Fraud 150 150 Bo Frith
  • Bo Frith

Whistleblowers for PPP Fraud

In response to widespread economic uncertainty due to COVID-19, the federal government enacted the Paycheck Protection Program (PPP). Because that program is especially vulnerable to fraud, whistleblowers are key players in addressing illegal conduct. Just last week, a Roanoke city jury convicted Roanoke City Councilman Robert Jeffrey of fraudulently obtaining pandemic relief funds.[1] Mr. Jeffrey…

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How Can I Pay For Nursing Home Care? 150 150 Bo Frith
  • Bo Frith

How Can I Pay For Nursing Home Care?

Paying for nursing home care is a complicated and rather grim topic. Nevertheless, it is an important issue for families. Seven out of every ten seniors will need long-term care at some point during their lifetime.[1] Without a standalone long-term care policy, out-of-pocket costs could range from $20,000 to $100,000 a year, depending on the…

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Top 5 Medical Myths in American Healthcare 2022 (part I) 150 150 Lauren Ellerman

Top 5 Medical Myths in American Healthcare 2022 (part I)

It is my daily privilege to speak with families who call our office looking for help when they aren’t sure where else to turn. And in the thousands of conversations we have had with Virginians over the last 20 years, we hear recurring themes, and myths about modern healthcare. Beliefs that patients hold to be…

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What are medically unnecessary procedures? 150 150 Bo Frith
  • Bo Frith

What are medically unnecessary procedures?

Medically unnecessary procedures are health care items and services that are not “reasonable and necessary for the diagnosis or treatment of illness or injury.”[1] The False Claims Act provides a mechanism for individuals to “blow the whistle” on instances of waste, fraud, or abuse for systemic unnecessary procedures in healthcare settings. Individuals who bring a…

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Why People Become Whistleblowers 150 150 Bo Frith
  • Bo Frith

Why People Become Whistleblowers

There are many reasons why an individual “blows the whistle.” The debate often centers on whether these individuals are frivolous, disgruntled employees seeking financial gain or people with legitimate concerns who suffered personal loss. A wealth of academic research clearly shows it is the latter. The False Claims Act is the primary vehicle empowering whistleblowers…

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What is Medical Malpractice? 150 150 Dan Frith
  • Dan Frith

What is Medical Malpractice?

Medical malpractice happens when a doctor, hospital, pharmacist, nurse, or other health professional injures a patient by acting negligently. This negligence can occur in a variety of different ways, including improper treatment, misdiagnosis, lack of follow-up, or surgical mistake.  Medical malpractice causes more than 250,000 deaths per year and is the third largest cause of death…

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What is a Whistleblower? 150 150 Dan Frith
  • Dan Frith

What is a Whistleblower?

A whistleblower is someone who reports waste, fraud, abuse, or dangers to public health and safety to someone who is in the position to rectify the wrongdoing. A whistleblower typically works inside of the organization where the wrongdoing is taking place; however, being a company “insider” is not essential. What matters is that the individual discloses information about wrongdoing that otherwise…

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Outside Whistleblowers Exposing Healthcare Fraud 150 150 Bo Frith
  • Bo Frith

Outside Whistleblowers Exposing Healthcare Fraud

  The typical whistleblower is often an aggrieved employee who brings to light his employer’s fraudulent conduct. These individuals, often called internal whistleblowers, are important in combatting healthcare fraud. There remains, however, a different kind of whistleblower. Some whistleblowers are individuals or entities that are not employed by the company who committed the wrongdoing. These…

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Doctor Alleged to have Billed for Multiple Surgeries at the same time 150 150 Dan Frith
  • Dan Frith

Doctor Alleged to have Billed for Multiple Surgeries at the same time

Can a doctor bill Medicare and Medicaid for multiple surgeries performed at the same time?  First, I don’t want my surgeon operating on me and other patients at the same time.  I prefer he/she concentrate on performing my surgery safely and correctly.  But, my concerns aside, can surgeons get away with this practice?  The answer…

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Illegal Kickbacks and Referrals in Healthcare Fraud 150 150 Bo Frith
  • Bo Frith

Illegal Kickbacks and Referrals in Healthcare Fraud

A whistleblower may bring a variety of different allegations of healthcare fraud. One such allegation concerns improper referral fees. Whistleblowers can bring a lawsuit for this type of fraud through the Anti-Kickback Statute and the Stark Law. The Anti-Kickback Statute and Stark Law prohibit medical providers from paying or receiving financial compensation, or anything of…

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Doctors and Fraudulent Billing 150 150 Dan Frith
  • Dan Frith

Doctors and Fraudulent Billing

There are three main funding sources for health care in the United States: the government, private health insurers and individuals.  However, in 2018, 34 percent of Americans received their health care via government insurance or direct public provision…we are primarily talking about Medicare and Medicaid.  Both Medicare and Medicaid are funded by your tax dollars. Doctors…

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You may not want a Pizza, Pasta, Taco, Sushi Lawyer 150 150 Lauren Ellerman

You may not want a Pizza, Pasta, Taco, Sushi Lawyer

Do you know those restaurants that claim to be “known” for everything? The ones that say Pizza, Pasta, Tacos and Sushi on the sign? Or, Worlds Best Donuts and Hot Dogs? Unless you are 7 years old, the combination of vastly different cuisines, methods of preparation, and ingredients leaves most adults worried that a place…

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