Whistleblowing is good for our health. Not necessarily the whistleblower’s health. But, while we’ve been watching the battle over whistleblower protection in Washington, insiders have been busy flagging health fraud.

As a result, there are patients out there who may have been spared unnecessary spine surgery or viscosupplementation injections. As a bonus, the rest of us won’t have to pay for them through Medicare.

In its October announcement of a $7.1 million settlement with the now defunct Osteo Relief Institutes, the Department of Justice (DOJ) describes viscosupplementation as a treatment for osteoarthritis “in which a doctor injects a gel-like fluid into a patient’s knee joint to act as a lubricant and to supplement the natural properties of joint fluid.”

But the clinic didn’t quite get it right, according to the DOJ.


Continue Reading Healthcare whistleblowers have your back, and your knees

The False Claims Act (FCA) has long served as a powerful weapon against fraud and waste in government programs, from rancid Civil War rations to Medicare scams. The Department of Justice (DOJ) recovered $2.88 billion under the law last year, with whistleblowers involved in the majority of cases.

March 2 marks the anniversary of the law, which was signed in 1863 by President Abraham Lincoln. After the Civil War, the FCA continued to identify military contractors guilty of mismanagement and fraud. With rising health costs, much of it covered by Medicare, most cases now involve medical providers and suppliers. The DOJ’s December report noted that $2.5 of the $2.8 billion in recovery involved the health care industry. The first line of a story in the trade publication Modern Healthcare reports “Healthcare industry groups have always hated False Claims Act whistleblower lawsuits.”


Continue Reading For more than 150 years, the False Claims Act has been key to ferreting out fraud in US military and health care spending.