False Claims / Qui Tam

False Claims Act legislation to cover tax frauds is under consideration in D.C., Michigan, and California, according to Bloomberg Tax.

The inspiration for these new proposed laws comes in part to the success of New York’s false claims law, which has racked up a whopping $467.4 million in settlements in the past ten years.
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Whistleblowers helped the government collect $3 billion in fines and recoveries in fiscal year 2019, up from $2.8 billion in 2018.

Medicare and Medicaid were big targets for fraudsters this year, as they have been in years past, according to the annual report from the Department of Justice. The list also includes military contractors, universities and a fish oil producer. Read the full list here.
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The AARP calls Medicare’s coverage of medical devices “a boon to beneficiaries but also a big draw for fraudsters, who exploit older Americans’ health care concerns to enrich themselves.” This week’s Modern Healthcare offers a piece that argues a recent False Claims Act case involving medical device kickbacks to doctors “illustrates an increasingly tenuous arrangement that may spur more whistleblower cases.” The piece also appeared Crain’s Chicago Business. 

The story refers to a July case where  the FBI, the Department of Health and Services and the Department of Justice joined in the whistleblower suit against spinal implant company called Life Spine. The feds charge that the company paid doctors to use their devices. The kickbacks included “millions of dollars of consulting fees, royalties, and intellectual property.”

In a release on the case, Manhattan U.S. Attorney Geoffrey S. Berman said: “Kickbacks to doctors can alter or compromise their judgment about the medical care and services to provide to patients,and can increase healthcare costs. This office will continue to hold companies and the people who run them accountable when they make improper payments to doctors.”

Life Spine tells Modern Healthcare in a statement “that both parties are engaged in discussions and look forward to resolving the matter.”


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