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Health Insurance Whistleblowers

ArentFox Schiff

Investigations Newsletter: DOJ Launches Corporate Whistleblower Awards Pilot Program

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DOJ Launches Corporate Whistleblower Awards Pilot Program - On August 1, the US Department of Justice (DOJ) announced the details of its new Corporate Whistleblower Awards Pilot Program. According to the DOJ, the...more

Dinsmore & Shohl LLP

DOJ’s New Self-Disclosure Policy and Corporate Whistleblower Awards Pilot Program

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?? In this Spotlight on White Collar Defense and Government Investigations, Cincinnati's Lindsay Gerdes explains how the U.S. Department of Justice’s (DOJ) self-disclosure policy encourages companies to voluntarily disclose...more

Dentons

DOJ Reports Record False Claims Act Settlements & Judgments in FY 2023

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Fiscal year 2023 saw record recoveries and the highest number of settlements and judgments ever under the Federal False Claims Act. According to a new report released by the United States Department of Justice (“DOJ”), the...more

Robinson+Cole Health Law Diagnosis

Home Health Company and Two Corporate Officers Settle False Claims Act Allegations for Over $30 Million

On October 18, 2022, the Department of Justice (DOJ) announced two settlements with CHC Holdings, LLC, an Oklahoma limited liability company doing business as Carter Healthcare (Carter), and two former senior corporate...more

Dechert LLP

Key Developments for Employers in the UK - Issue 4

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Welcome to the fourth edition of The Employment Edit – a summary of the most important recent cases and news affecting employers in the UK. We hope you find this newsletter helpful and informative. In this edition we look at:...more

Miles & Stockbridge P.C.

Weighing Employers’ Strategies for Employee Benefits in a Post Roe World

As is now well known both in and outside of the legal community, the Supreme Court of the United States recently decided Dobbs v. Jackson Women’s Health Organization, where the Court analyzed a Mississippi law that restricted...more

Benesch

Dialysis & Nephrology Digest - November 2020 #2

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DaVita shareholders ask federal judge to approve $50M from executives to settle insurance scheme action - DaVita shareholders brought the derivative action forward over a scheme by the company to steer dialysis patients...more

Spilman Thomas & Battle, PLLC

The Dome Report - 2020 West Virginia Legislature Update: Issue 5

The 2020 Regular Session of the West Virginia Legislature is now entering the final stretch with only a little less than two weeks left. No new bills may be introduced in either chamber (though a committee may still originate...more

Patrick Malone & Associates P.C. | DC Injury...

Waste, fraud, and abuse? For health insurers, fat profits matter more

What happens when a whistle blower provides detailed information about a burly Texan — with convictions for felony theft and felony injury of a child — and a burgeoning scam to rip off health insurers for $25 million? Pretty...more

Carlton Fields

Court Finds No Coverage for $42 Million False Claims Act Suit Due To Late Reporting

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A federal court has found no coverage for a $42 million whistleblower settlement due to the insured’s failure to timely report the claim to its carrier. PAMC, Ltd. v. National Union Fire Insurance Company of Pittsburgh, Pa.,...more

Holland & Knight LLP

EMTALA as a Basis for a Qui Tam Case?

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The Emergency Medical Treatment & Labor Act (EMTALA) requires a hospital with an emergency department (ED) to provide "an appropriate medical screening examination" when an individual comes to the ED and a request is made on...more

Orrick, Herrington & Sutcliffe LLP

Orrick's Financial Industry Week In Review

U.S. Financial Industry Developments - CFTC and SEC Announce Approval of New MOU - On June 28, 2018, the Commodity Futures Trading Commission ("CFTC") and the Securities and Exchange Commission ("SEC") announced that...more

Seyfarth Shaw LLP

California Court Of Appeal Holds That Disclosure Of Confidential Information Protected By Anti-SLAPP Statute

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A recent California Court of Appeal decision held that the receipt, retention and dissemination of confidential information by a whistleblower’s attorney is protected by the state’s anti-SLAPP statute. MMM Holdings, Inc. v....more

Farrell Fritz, P.C.

Medicaid Fraud Whistleblower Loses Bid To Keep His Name Out Of The Public Eye

Farrell Fritz, P.C. on

False Claims Act whistleblowers expose themselves to significant risks by coming forward and asserting claims of fraud against the government. Often, the whistleblowers, called relators under the False Claims Act, would...more

Troutman Pepper

Federal Court Strikes DOJ's Risk Adjustment False Claims Act Case - For Now

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On October 5, a federal district court in California dealt a significant setback to the government’s efforts to extend False Claims Act (FCA) liability to Medicare risk adjustment submissions....more

Bass, Berry & Sims PLC

Dismissal of Medicare Advantage FCA Suit Marks Significant Defeat for Government

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The U.S. District Court for the Central District of California recently dismissed a complaint-in-intervention filed by the U.S. Department of Justice (DOJ) in U.S. ex rel. Swoben v. Secure Horizons. As previously reported,...more

Sheppard Mullin Richter & Hampton LLP

Alert: In a Surprise Decision Issued on October 5, 2017, Honorable John Walter, United States District Judge, Dismissed a Medicare...

On October 5, 2017, the Honorable Judge John Walter of the United States District Court, Central District of California, granted the Defendants’ Motion to Dismiss the Medicare Advantage (“MA”) Federal False Claims Act (“FCA”)...more

Skadden, Arps, Slate, Meagher & Flom LLP

Employment Flash - June 2017

This edition examines recent labor and employment developments at the U.S. federal, state and local levels, including the House of Representatives' American Health Care Act and the Senate's Better Care Reconciliation Act, the...more

Manatt, Phelps & Phillips, LLP

Health Update - February 2017

Securing the Safety Net for America's Vulnerable Populations - Editor's Note: America's population is aging rapidly. By 2029, 75 million baby boomers will have reached age 65 and older, and older adults will represent...more

McDermott Will & Emery

Affordable Care Act Whistleblower Complaint Procedures

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On October 11, 2016, the Occupational Safety and Health Administration published a final rule that establishes procedures and time frames for handling whistleblower complaints under the Affordable Care Act (ACA); for hearings...more

Polsinelli

SEC Takes Aim at Anti-Whistleblower Employment Agreements

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On August 15, 2016, the U.S. Securities and Exchange Commission (SEC) issued its second fine in six days to a health insurer for allegedly creating severance agreements that illegally restrict former employees from collecting...more

Polsinelli

Millennium Health to Pay $256 million in False Claims Act Settlement

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Millennium Health, one of the nation’s largest urine drug testing laboratories, has agreed to pay the government $256 million to resolve claims that it violated the Federal False Claims Act (“FCA”). The Settlement...more

Manatt, Phelps & Phillips, LLP

Health Update - September 2015

Latest Healthcare False Claims Act Roundup and Top 3 Best Practices to Reduce Exposure - As the legal landscape in healthcare becomes increasingly complex, healthcare companies that receive federal program funds face...more

Carlton Fields

Kane v. Healthfirst and the 60-day Repayment Rule

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Case: Kane v.Healthfirst, Inc. et al. and U.S. v. Continuum Health Partners Inc. et al., case number1:11-cv-02325, in the U.S. District Court for the Southern District of New York. As part of the Affordable Care Act...more

PilieroMazza PLLC

Weekly Update Newsletter - January 2015 #2

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GOVERNMENT CONTRACTS - HHS IG Issues Report Regarding Federal Marketplace: Inadequacies in Contract Planning and Procurement - The Department of Health and Human Services (HHS) inspector...more

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