At Barrett Johnston, we often hear from healthcare professionals who are confused about what exactly counts as an illegal kickback. The Anti-Kickback Statute (AKS) is the federal law that makes it a crime to exchange anything of value in order to generate referrals for healthcare services paid for by federal programs like Medicare or Medicaid. […]
Anti-Kickback Statute (AKS) Read More »
One of the most important laws in the fight against healthcare fraud is the False Claims Act (FCA). The FCA was originally passed in 1863 to combat fraud against the Union Army during the Civil War, when unscrupulous contractors were selling defective goods to the government. Today, the FCA is the primary legal tool used
False Claims Act (FCA) Read More »
We often find that people have heard of whistleblower cases but aren’t familiar with the legal term that makes many of these cases possible: qui tam. The phrase comes from the Latin expression qui tam pro domino rege quam pro se ipso in hac parte sequitur, which translates roughly to “he who sues in this
The healthcare industry has long been the primary target for False Claims Act (FCA) enforcement, with no other sector in close second place.Over the past year, the federal government has unveiled several new or revamped whistleblower programs, most notably the Department of Justice’s antitrust program, which we have previously written about. However, despite the expanded
The Healthcare Industry Remains the Largest Target for False Claims Act Enforcement Read More »
From the earliest days of the False Claims Act (FCA), the federal government has understood that providing financial incentives to whistleblowers is one of the best ways to encourage private citizens to come forward and file qui tam actions. That is why the FCA expressly provides that in the event of a successful case, the
Factors Determining the Relator’s Share of an FCA Recovery Read More »
Preparing a successful qui tam case comes down to evidence. It is all well and good to tell the government where and how to find supporting documents and records, but there is no substitute for providing that evidence to the government on the front end. Recorded conversations can be some of the most effective and
A recent GAO report has cast a spotlight on persistent fraud vulnerabilities within the Federal Employees Health Benefits (FEHB) program, revealing that the Office of Personnel Management (OPM) has yet to take decisive action to protect that program. This stands in stark contrast to the comparatively robust fraud prevention mechanisms in place for other federal
Whistleblowers Needed: FEHB Fraud Oversight Lags Behind Medicare and Medicaid Read More »
As a simple matter of dollars and cents, it is hard to overstate just how big a problem healthcare fraud is. A good reminder of this came earlier this summer, when the Department of Justice (DOJ) announced numerous criminal indictments in “Operation Gold Rush,” targeting a multinational, multi-billion-dollar health care fraud scheme. The Department of
Operation Gold Rush – A Reminder of Just How Much Money Is Lost from Healthcare Fraud Read More »
The Department of Justice’s Antitrust Division has launched its first-ever Whistleblower Rewards Program, working in tandem with the U.S. Postal Service (USPS) and Postal Inspection Service. Under this new program, individuals who provide credible information leading to successful antitrust prosecutions are eligible for awards between 15% and 30% of any criminal fines the government recovers,
Department of Justice Announces First-of-Its-Kind Antitrust Whistleblower Program Read More »
This is the sixth and final entry in a six-part series on the process and practical realities of being a whistleblower and exposing fraud against the government.
So You Want to Blow the Whistle (Part 6): My Case Is On File. Now What? Read More »
