The Stark Law, formally known as the Physician Self-Referral Law, is one of the most important — and most complex — regulations in healthcare fraud enforcement. At its core, Stark Law prohibits physicians from referring Medicare or Medicaid patients to entities in which they (or an immediate family member) have a financial interest. For example, […]
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The False Claims Act (FCA) has been on the books since the Civil War, but by the mid-20th century, its impact had faded. That changed in 1986, when Congress passed a major amendment that revitalized the law and transformed it into the powerful whistleblower tool we know today. At Barrett Johnston, we often trace modern
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From 1863 contractors to today’s hospitals and drug companies, it has always taken brave insiders to expose fraud. The False Claims Act (FCA) is one of the most important laws in the fight against fraud against the United States government, and its story begins during the American Civil War. In 1863, President Abraham Lincoln signed
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In 2012, GlaxoSmithKline (GSK) agreed to pay $3 billion in what was then the largest healthcare fraud settlement in U.S. history. At Barrett Johnston, we highlight this case because it shows the incredible scale of misconduct that whistleblowers and federal investigators can uncover when they work together. The case centered on allegations that GSK engaged
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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.
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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
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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
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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
