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You Can Go Your Own Way

Go your own way, if you must, but in whistleblower cases, it’s better to have a partner, especially when that partner is the Department of Justice. Under the whistleblower, or qui tam, provisions of the False Claims Act, citizens may sue on behalf of the government, and if they do, they stand to collect anywhere from 15-30% of the recovery. That can Read More

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An Active Forecast for Healthcare Enforcement

Here is a good summary of the state of affairs when it comes to healthcare fraud and compliance. The bottom line is it continues to be a high priority for government. The highlights? Follow the money. For fiscal year 2015, Congress more than doubled the funding of the government’s Health Care Fraud and Abuse Control program to $672 million. The HCFAC, as it were, was created Read More

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Government Intervenes in “Reverse” False-Claims Case of Overpayments

For the first time, the United States has intervened in a whistleblower case under the False Claims Act that alleges not false claims per se but a failure to refund overpayments by the government within 60 days of identifying them. To be clear, the government doesn’t allege that the defendant-hospitals were responsible for the overpayments. Instead, it alleges that, sometime in Read More

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What Is A Kickback, Anyway?

When is it a bribe, when is it business, and when is it speech? We know it’s a bribe if you toss some cash in someone’s lap, but what if you just give them some good business advice? Well, that may have value, too, so it could be a kickback, but then what if you charge them for it? Okay, well, that Read More

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Another Banner Year for Healthcare Fraud Enforcement and the False Claims Act

Do you like a good return on your investments? So does the federal government, and when it comes to healthcare-fraud enforcement, it’s doing pretty darn well. How well? Try $8.10 for every $1 spent, and yes, you’re reading correctly. That’s more than $8 in recoveries for every $1 that was spent investigating and prosecuting healthcare fraud over the last three Read More

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