At Barrett Johnston, we’ve seen firsthand how the federal government’s approach to Medicare and Medicaid fraud has evolved from modest oversight to one of the most sophisticated enforcement systems in the world—albeit a system that is still limited in its ability to stop fraud, waste, and abuse. Understanding that history helps explain why today’s whistleblowers […]
The Johnson & Johnson (J&J) $2.2 billion settlement in 2013 stands as another major milestone in healthcare fraud enforcement—particularly in curbing deceptive pharmaceutical marketing. The case centered on allegations that J&J and its subsidiaries promoted several prescription drugs, including Risperdal and Invega, for off-label uses not approved by the FDA. The company was also accused
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One of the most unusual features of qui tam actions under the False Claims Act (FCA) is how cases begin—with the filing of a sealed complaint. When a whistleblower files a qui tam lawsuit under the FCA, that complaint is filed under seal. This means it’s kept confidential from the public, and even from the
The Affordable Care Act (ACA) is often discussed in terms of its expansion of healthcare coverage. A lesser-known aspect of this law is that it contained various provisions that significantly improved healthcare fraud enforcement and punishment. Passed in 2010, the ACA introduced new tools to fight healthcare fraud, waste, and abuse. It strengthened enforcement under
Few cases better illustrate the scale of healthcare fraud than the qui tam action against HCA Healthcare. That case ultimately settled in 2000 and marked a major achievement in federal FCA enforcement. The case stemmed from widespread allegations that HCA, one of the largest hospital chains in the U.S., engaged in fraudulent billing practices. The
One of the first questions we hear from potential whistleblowers concerned about retaliation is: “What exactly counts as protected activity?” Understanding this term is crucial for anyone considering pursuing a whistleblower action. Protected activity refers to actions taken by an employee to expose, oppose, or report illegal or unethical conduct—particularly fraud against the government. Under
We often explain that some of the most damaging healthcare fraud doesn’t come from fake bills—it comes from improper relationships between providers and suppliers. The Anti-Kickback Statute (AKS) directly targets this kind of corruption. The AKS is a federal law that prohibits offering, paying, soliciting, or receiving anything of value to induce or reward referrals
The False Claims Act (FCA) is the single most powerful tool for combating fraud against the U.S. government. It’s also the foundation for nearly every major healthcare fraud case we see today. Originally passed during the Civil War in 1863, the FCA was designed to stop suppliers from defrauding the Union Army. It has since
When the Sarbanes-Oxley Act (SOX) was enacted in 2002, corporate America was still reeling from major scandals like Enron and WorldCom. At Barrett Johnston, we see this law as a key turning point in how whistleblowers were viewed—not as troublemakers, but as vital defenders of financial integrity and public trust. The Sarbanes-Oxley Act introduced sweeping
Strong whistleblower protections are the backbone of meaningful fraud enforcement. The Whistleblower Protection Act of 1989 (WPA) stands as one of the most important milestones in this evolution—especially for federal employees who witness wrongdoing from within. Before the WPA, government workers who reported fraud, abuse, or waste were often left exposed to retaliation. The 1989
