Sutter Health settles closely watched whistleblower lawsuit alleging it violated the False Claims Act by submitting inaccurate and unsupported medical information on tens of thousands of patients enrolled in Medicare Advantage. SAN FRANCISCO, Aug. 31, 2021 /PRNewswire/ -- Keller Grover, Constantine Cannon, and Kleiman Rajaram announce the landmark $90 million False Claims Act settlement against Sutter Health on behalf of their whistleblower client, Kathy Ormsby, over allegations … [Read more...]
Five Ways Hospice Providers Use Terminally Ill Patients to Rip Off Taxpayers
Hospice care is the provision of specialized palliative treatment for terminally ill patients, focused not on curing them but making their last days as comfortable as possible. Hospice has gone from a grassroots movement on the outskirts of the U.S. medical establishment to a massive, multibillion-dollar industry. And as it has come of age, it has increasingly attracted the same type of fraud, waste, and abuse that plagues U.S. healthcare at large. Hospice treatment has been covered by … [Read more...]
Whistleblowers Stop Nursing Home Fraud and Patient Harm – With help from the False Claims Act
Healthcare fraud puts patients’ lives at risk and costs billions of dollars every year. Nursing homes, which house vulnerable patients away from loved ones and the outside world, are especially fertile breeding grounds for healthcare fraud schemes. While government agencies have stepped up their enforcement efforts, nursing home workers who witness fraud are in the best position to put it to a stop—and thanks to federal and state whistleblower laws like the False Claims Act, a single principled … [Read more...]
Court embraces use of statistics to hold massive healthcare providers accountable
Healthcare fraud costs Americans as much as $300 billion a year. But uncovering fraud in a healthcare system as sprawling and complex as ours—Medicare alone processes over 1 billion claims annually from over 1 million providers—is like digging for needles in a breathtakingly huge haystack. That's why the federal government relies heavily on the False Claims Act’s qui tam provisions to encourage ordinary people to blow the whistle on fraud by filing private civil lawsuits. False Claims Act … [Read more...]
Supreme Court Strikes Blow in Favor of Whistleblowers
In May, we wrote about how U.S. Supreme Court Justice Antonin Scalia’s death might impact a key whistleblower case brought under the False Claims Act. It turns out that Justice Scalia’s presence might not have made much of a difference: The eight remaining Justices came through with a significant—and unanimous—victory for whistleblower plaintiffs, and delivered a strong rebuke to government contractors that would defraud taxpayers through misleading omissions and then evade responsibility by … [Read more...]
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