In the wake of the determined, undercover, and brave efforts of whistleblowers across the managed care industry over a long period of time, the inescapable conclusion is managed care has been replete with fraud. Cigna is now paying $172 million to resolve claims for false coding and misuse of risk adjustment,
Upholding Accountability and Safeguarding Public Interest Whistleblowers have long been unsung heroes in the fight against corruption, injustice, and wrongdoing. A recent Delray Beach case related to contaminated water systems in Florida illustrates the essential role whistleblowers play in upholding the public’s right to safety and transparency, and the courage required to stand up against
Gold Coast (aka Ventura County Medi-Cal Managed Care Commission) to pay $17.2 million to U.S. and California; providers that received allegedly illegal payments – Ventura County Medical Center, Dignity Health, and Clinicas del Camino Real Inc. – will pay an additional $53.5 million August 19, 2022, San Francisco–(BUSINESSWIRE)–The law firm of Lieff Cabraser Heimann &
Complaint in the case alleged The Door falsely inflated the number of visits to its facility on cost reports in order to fraudulently receive additional undeserved reimbursement money from the Indigent Care Pool In a press release issued today, the U.S. Attorney’s office has announced that the United States filed and settled a civil fraud
The National Highway Traffic Safety Administration (NHTSA) has announced it will be paying out a whistleblower award to a former Hyundai safety engineer who reported an engine defect in 2016, which Hyundai failed to address, that was causing vehicles to seize up and even catch fire. NHTSA found that Korean car manufacturer Hyundai and its
New York Governor Kathy Hochul has enacted legislation that protects employees in the state from retaliatory actions for reporting illegal or dangerous business activities. In meaningfully amending the prior law, there are multiple important and noteworthy aspects of the new law that together give crucial support to whistleblowers.
After eight years of delays, the federal and state governments have intervened in the concealed overpayments lawsuit against two Nashville-based hospice care providers and their parent company. The suit alleges that Nashville-based Avalon Hospice, Brentwood-based Regency Health Care Group and Curo Health Services, along with its parent, pressured staff to “conceal overpayments to maximize census
Lawsuit alleged AbbVie pharmaceutical company committed fraud in promotion of blockbuster prescription drug Humira The California Department of Insurance has announced a settlement agreement with AbbVie Inc. to resolve a lawsuit alleging the pharmaceutical giant violated the California Insurance Frauds Prevention Act (Act) by providing kickbacks to healthcare providers throughout California relating to the sale of its
As reported by Law.com (subscription), the U.S. Securities and Exchange Commission has given a $450,000 whistleblower award to a worker who had compliance-related job functions at an undisclosed company. This is the third time in eight years that an award has gone to an individual with compliance or internal audit duties at a company found
As reported by USA Today, there is a growing concern across the U.S. over the apparent surge in dangerous and highly expensive medications being pushed on the public by drug manufactures whose main concern is not turning a new corner in patient health but rather turning over millions in profits.