Whistleblower Litigation

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

  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

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

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

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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Nursing Home Whistleblowers and Qui Tam Cases

The False Claims Act is the government’s primary tool in addressing the misuse of taxpayer funds. Since 2017, the U.S. Department of Justice recovered approximately $11.4 billion under the False Claims Act.[1] Of the $11.4 billion recovered over the past four years, approximately 90 percent or $9 billion was recovered in health care fraud matters.[2]

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Healthcare Fraud at Universities

Earlier this month, the University of Miami agreed to pay $22 million to resolve a lawsuit brought under the False Claims Act for fraudulent healthcare billing.[1] Four former healthcare executives at the University of Miami filed the suit. The Department of Justice will award the whistleblowing executives a share of 15% to 25% of the

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Investment Fraud

Earlier this month, a federal jury in Virginia convicted a Florida banker and Virginia attorney of running a fraud scheme that swindled more than 300 victims, most of them seniors, out of more than $25 million.[1] Following a month-long trial, the jury found Daryl Bank of Florida and Billy Seabolt of Lynchburg, Virginia guilty of

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Medical Malpractice and Whistleblower Claims

Our law firm has a fairly unique practice…we represent patients in medical malpractice cases against health care providers and whistleblower cases on behalf of honest folks who report cases of financial and billing fraud.  I recently learned of a case which deals with both issues: a whistleblower on illegal kickbacks for unnecessary back surgeries. South

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Healthcare Fraud: Inflated Medicaid Billing

Healthcare providers violate the False Claims Act by knowingly submitting false claims for payment to government insurers. One of the most frequent sources for whistleblower lawsuits is inflated Medicaid billing. In September of 2020, a Virginia mental health agency agreed to pay over $250,000 to settle a false claims act lawsuit.[1] Victoria Transcultural Clinical Center

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