On November 15, 2024, the Department of Justice announced that Inova Health System, a major healthcare system in Northern Virginia, agreed to pay $2.37 million to resolve allegations of fraudulent healthcare billing. The settlement underscores the critical role whistleblowers play in exposing fraudulent practices in the healthcare industry. The Allegations…
read moreThis week, nine people were charged with healthcare fraud involving a company that provided home care to residents of Western Virginia. A recently unsealed November 2023 indictment revealed the extent of the scheme. All nine individuals that were charged were owners or employees of Adult N Pediatric Healthcare Service, a…
read moreI recently read an article in the June/July edition of the AARP Magazine on healthcare fraud. The article was titled, “The $80 Million Healthcare Fraud,” and described the criminal activity of a family of chiropractors who operated the Dolson Avenue Medical Clinic in New York. It appears the two brothers,…
read moreOne of the most common areas for whistleblowers is the opioid crisis. As chronicled in countless books, podcasts, and TV shows, the opioid industry is rife with fraud. In 2020 and 2021 alone, the Justice Department secured settlements in excess of $3 billion arising from whistleblower and False Claims Act…
read moreMedically 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…
read moreA 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…
read moreOur 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…
read moreHealthcare 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…
read moreFraud occurs with surprising frequency in facilities with especially vulnerable patients. For this reason, nursing homes can be easy targets for Medicare and Medicaid fraud. These facilities are not under as much official scrutiny as hospitals. Nursing home residents are often unable to advocate for themselves. It is up…
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