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Whistle-Blower Claims Archives

DOJ settles medical device whistleblower case for $33.2M

Fraudulent billing practices to directly increase products often seem to be the focus of healthcare fraud lawsuits. However, as a recent settlement under the False Claims Act (FCA) highlights, healthcare fraud issues may be somewhat more indirect. A former quality control analyst for a medical device manufacturer noted defects in a device that ultimately cost taxpayers money, according to the Department of Justice.

Defective bulletproof vest whistleblower lawsuit settles for $66M

Members of law enforcement and the United States armed forces rely on bulletproof vests to preserve their lives. The Department of Justice recently announced that a fiber manufacturing company has agreed to settle a whistleblower lawsuit that alleged the company was aware that the fiber known as "Zylon" was not suited for use in bulletproof vests, yet the manufacturer continued to market and sell the fiber for use in protective vests.

Whistleblower ignores death threat, reports fraud and prevails

We don't know where being burned alive ranks on the list of worst possible ways to go, but it must be near or at the top. Far from Milwaukee, a mortuary worker was threatened with being cremated alive if he revealed ongoing fraud committed by his employer.

DOJ announces new task force to fight the opioid epidemic

The opioid crisis continues to make headlines - and government officials continue to take note. In late February, Attorney General Jeff Sessions announced that the federal government is stepping up its efforts to attack the opioid epidemic through the Department of Justice Prescription Interdiction and Litigation Task Force.  The unit will use both civil and criminal legal mechanisms to gain better control over opioid prescription abuse.

Whistleblower lawsuit involving unnecessary dental treatment for children settles

Several former employees of a chain of dental clinics brought forward evidence that the clinics were performing unnecessary dental procedures on children and billing Medicaid for the services. The whistleblowers filed five lawsuits under the False Claims Act to recover taxpayer money that was fraudulently obtained through an allegedly unlawful incentive plan, according to a statement from the Department of Justice (DOJ).

Sales reps for medical lab find evidence of unlawful kickbacks

The Department of Justice (DOJ) recently announced a settlement in a pharmacogenomics whistleblower lawsuit. Pharmacogenomic testing analyzes a patient's genetic makeup to help identify the proper drugs and doses of the drugs that may provide the best benefit for the individual patient's condition.

Whistleblower awarded roughly $2.9 million in MRI scan lawsuit

We have discussed a variety of ways that healthcare providers may try to bend the rules to obtain more money from programs such as Medicare and Medicaid. Upcoding is a common issue in healthcare fraud. This occurs when the provider uses the billing code assigned to a more expensive procedure or service than was actually provided. Charging the government for services that were never provided is also common. An interesting twist that seems to fall somewhere between these two common kings of healthcare fraud schemes arose in a recent whistleblower lawsuit on the East Coast.

Whistleblower uncovers 'Pill Mill' scheme in chiropractic clinics

A chiropractic management company operating four pain clinics in Tennessee has agreed to settle a whistleblower lawsuit involving opioid prescriptions. A former office manager for the chiropractic and pain management company noticed medical and billing discrepancies. The worker brought the information forward in a whistleblower lawsuit filed under the federal False Claims Act (FCA).

Whistleblower lawsuit is a warning to wholesalers and retailers

Even if you are not directly responsible for breaking federal law in a scheme to avoid import duties, you might find yourself under the microscope of prosecutors. That is one of the takeaways from the recently announced settlement of a whistleblower lawsuit against a clothing wholesaler.

Pharmacist awarded more than $9 million in whistleblower lawsuit

Kmart Corp. has agreed to settle a health care fraud lawsuit that alleged the big-box retailer overcharged state and federal health care programs for prescription medications. The case came to light after a pharmacist noted discrepancies in what the pharmacy chain charged Medicare, Medicaid, and Tricare for generic drugs. For his involvement in coming forward with the lawsuit, the pharmacist will receive $9.3 million of the settlement. That is 29 percent of the $32.3 million overall, according to NBC News.

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