Author name: Barrett Johnston Martin & Garrison, PLLC

What Do Healthcare Whistleblower Cases Really Pay? 100 Cases Analyzed

Healthcare whistleblower settlements can make headlines for hundreds of millions of dollars. But what does the data actually show about the cases in between? If you have witnessed potential healthcare fraud, one of the questions you may eventually ask is: What happens when a whistleblower case succeeds? The answer is more complicated than the biggest

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Several men standing side by side in a row, at waist height, all handcuffed. Healthcare fraud concept.

Four Members of Bronx “War Room” Charged in $12 Million Medicaid Fraud and Racketeering Scheme

Four members of a Bronx-based racketeering organization known as the “War Room” have been charged in a nine-count indictment for their roles in a wide-ranging conspiracy involving the fabrication of transportation data used to support at least $12 million in fraudulent Medicaid claims. Louis Trejo, Kenneth Garner, Harold Stevenson, and Erihk Belis are accused of

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A retired couple, a man and woman, sitting on a couch in front of a laptop on the screen of which a doctor is talking them through an issue they're having. Healthcare fraud concept.

Former Owner of Telemedicine Companies Sentenced to Two Years in Prison for $110 Million Medicare Fraud Scheme

The former owner of a network of telemedicine companies has been sentenced to two years in federal prison for orchestrating a scheme that billed Medicare more than $110 million for medically unnecessary durable medical equipment and genetic testing. The defendant, who operated the companies from Massachusetts, was also ordered to pay restitution and forfeit assets

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A prisoner in a light gray shirt holding the bars of a jail cell with both hands. Healthcare fraud concept.

Former Brooklyn Bank Manager Sentenced to Prison for Laundering Proceeds of Medicare Fraud Scheme

A former branch manager at a Brooklyn-based bank has been sentenced to federal prison for his role in laundering the proceeds of a healthcare fraud scheme that targeted Medicare. The defendant, whose name and sentence are detailed in the Justice Department’s announcement, was convicted of conspiring to launder money obtained through fraudulent Medicare billing. According

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A chair with a doctor's white coat draped over the back. The office has all the appearances of a clinic, but the doctor is absent. Healthcare fraud concept.

Federal Government Intervenes in False Claims Act Whistleblower Suit Against Colorado Medical Companies

The United States has formally intervened in a qui tam whistleblower lawsuit accusing three Colorado healthcare companies and two individuals of systematically inflating reimbursements from Medicare and TRICARE. The defendants named in the government’s complaint are Front Range Urgent Care, Comfort Care Family Practice, QwikCareMD, Anita Weiscamp, and Dr. Steven L. Wenrich. According to the

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A pharmacist standing in the aisle of a pharmacy, taking inventory of a drug inside a pill bottle and reading something off an iPad. Healthcare fraud concept.

Veloxis Pharmaceuticals Agrees to Pay Over $46 Million to Resolve Criminal and Civil Kickback Allegations

Veloxis Pharmaceuticals Inc., a North Carolina-based drug manufacturer, has agreed to pay more than $46 million to resolve criminal and civil allegations that it paid illegal kickbacks to induce prescriptions of Envarsus XR, a kidney transplant immunosuppression drug. The resolution includes a deferred prosecution agreement filed in the District of Massachusetts charging the company with

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A legal professional is examining a dashboard on the computer, full of laws, regulations, and guidelines to ensure she is in compliance with the law. Healthcare fraud concept.

DOJ-OIG Guidelines

The DOJ-OIG Guidelines establish frameworks for detecting and deterring fraud, waste, and abuse in federal healthcare programs. They provide voluntary compliance guidance to help healthcare entities design effective programs that prevent violations of the False Claims Act, Anti-Kickback Statute, and other federal laws. The General Compliance Program Guidance (GCPG) covers seven core elements of an

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A judge's gavel sits on a legal bench in front of an American flag. Healthcare fraud concept.

State Level False Claims Acts

More than 30 states have enacted False Claims Acts, but their strength varies dramatically. California offers the nation’s largest whistleblower reward—up to 50% of total recovery, far exceeding the federal 15-30% range—and covers fraud against private insurers. New York has recovered over $4 billion since 2011 and applies its FCA broadly to “almost any situation

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A nurse is talking to a resident of an adult day-care facility. Healthcare fraud concept.

Michigan Adult Day Care Owner Pleads Guilty to $539,000 Medicare Fraud Scheme

A Michigan woman has pleaded guilty to billing Medicare for psychotherapy services that were never provided to residents of her adult day care center. Yolanda Matthews, 58, of Farmington Hills, admitted in court to submitting over $539,000 in false and fraudulent claims to Medicare as part of a scheme that exploited vulnerable beneficiaries. According to

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Prescription pills are tumbling out of an orange pill bottle onto a reflective tabletop. Healthcare fraud concept.

Three Individuals Sentenced to Prison for Fraudulently Billing Medicare and Medicaid Through Opioid Addiction Treatment Clinics

A Texas businessman, a Kentucky doctor, and a Kentucky woman have been sentenced to federal prison for their roles in a scheme that fraudulently billed Medicare and Kentucky Medicaid more than $4.8 million through a series of addiction treatment facilities. Michael Bregenzer, 53, of Houston, Texas, the CEO of Kentucky Addiction Centers, was sentenced to

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