Articles Tagged with Medicare fraud

A task force to help combat health care fraud involving programs intended to help Veterans was announced in October 2019.  The U.S. Department of Justice and the Office of Inspector General of the U.S. Department of Veterans Affairs are undertaking a joint effort to focus attention on the increasing harm to the financial viability of its Veterans’ health care programs.

Veterans are entitled to health care services under a program called the Community Care program, which offers fee-for-service care.  It allows non-VA health care providers in the Veteran’s community to provide health care services to the Veteran and, in turn, submit claims for payment to the VA.  Under this program, Veterans who do not have access to care at a VA facility, may be entitled to care through a nearby community provider (a doctor’s office).  To be eligible, the Veteran must meet special eligibility requirements.  In addition to this unique program, the VA also provides other health care options for the families of Veterans through programs like the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA).

The authors of this blog are former prosecutors who now represent whistleblowers: Renée Brooker (former Assistant Director for Civil Frauds) reneebrooker@finchmccranie.com (202) 288-1295 and Eva Gunasekera (former Senior Counsel for Health Care Fraud) eva@finchmccranie.com

The Department of Justice needs whistleblowers to report fraud involving any federal or state government programs or contracts, including Medicare and Medicaid, as well as government spend on non-health care dollars.

Guidance is available for how to blow the whistle on your employer.  Reaching out to a former prosecutor who represents whistleblowers is a helpful first step.  An attorney can guide you through the process, assist you with documenting your concerns, answer your questions and instruct you on the nature and strength of evidence you do have.  A good whistleblower attorney will provide you a free consultation.  You should seek out an accomplished attorney as soon as you have concerns, and while you are still employed by the company where you believe there is wrong-doing.  Bottom line:  don’t wait and don’t do it alone.  Get an expert opinion from a prosecutor who’s tried False Claims Act cases and has significant experience under their belt.

The authors of this blog are former prosecutors who now represent whistleblowers / Renée Brooker (former Assistant Director for Civil Frauds) reneebrooker@finchmccranie.com (202) 288-1295 / Eva Gunasekera (former Senior Counsel for Health Care Fraud) eva@finchmccranie.com.

The Department of Justice needs whistleblowers to report fraud involving kickbacks or off-label drug marketing, which can lead to patient harm.  As one example, Abbott Laboratories and AbbieVie Inc. paid $25 million for allegations that it paid kickbacks to prescribers of the drug TriCor and unlawfully marketed the drug for off-label uses.  The whistleblower, a former Abbott sale representative, received $6.5 million as her share of the recovery in the case.  The United States Attorney described how the case was not possible without a whistleblower putting the Government onto the fraud:  “We thank [the whistleblower] for coming forward and providing essential assistance to the government.  Preserving government program funds would be far more difficult without [whistleblowers] who are willing to shine a spotlight on alleged illegal practices like the ones involved in this case.  [The whistleblower’s] efforts, and those of her attorneys, were critical to our favorable resolution of this case.”

Guidance is available for how to blow the whistle on your employer.  Reaching out to a former prosecutor who represents whistleblowers is a helpful first step.  An attorney can guide you through the process, assist you with documenting your concerns, answer your questions and instruct you on the nature and strength of evidence you do have.  A good whistleblower attorney will provide you a free consultation.  You should seek out an accomplished attorney as soon as you have concerns, and while you are still employed by the company where you believe there is wrong-doing.  Bottom line:  don’t do it alone.  Get an expert opinion from a prosecutor who’s tried False Claims Act cases and has significant experience under their belt.

The authors are former prosecutors who now represent whistleblowers / Renée Brooker (former Assistant Director for Civil Frauds) reneebrooker@finchmccranie.com (202) 288-1295 / Eva Gunasekera (former Senior Counsel for Health Care Fraud) eva@finchmccranie.com.

The Department of Justice needs whistleblowers to report fraud involving drug pricing overbilling in the Medicare, Medicaid, TRICARE and FEHB programs.  There are potential rewards and protections for whistleblowers who have evidence of false claims against the Government.

In declining to dismiss a whistleblower’s lawsuit against Rite Aid for alleged drug overbilling, the court laid out the basis for its decision that the whistleblower’s lawsuit alleged sufficient evidence for the case to proceed.  The allegation was that Rite Aid charged Medicare, Medicaid, and TRICARE prices that exceeded prices paid by other customers.  A pharmacist who had worked for Rite Aid stepped forward with information that allowed the case to proceed, in April 2019.

Guidance is available for how to blow the whistle on your employer.  Reaching out to a former prosecutor who represents whistleblowers is a helpful first step.  An attorney can guide you through the process, assist you with documenting your concerns, answer your questions and instruct you on the nature and strength of evidence you do have.  A good whistleblower attorney will provide you a free consultation.  You should seek out an accomplished attorney as soon as you have concerns, and while you are still employed by the company where you believe there is wrong-doing.  Bottom line:  don’t do it alone.  Get an expert opinion from a prosecutor who’s tried False Claims Act cases and has significant experience under their belt.