As the Department of Justice’s annual False Claims Act report shows, Medicaid fraud comprises a significant portion of all the frauds against the federal government each year. In fiscal year 2023, the DOJ reported $2.68 billion in FCA settlements and judgments. Almost half that, $1.2 billion, was recovered from Medicaid provider fraud and patient abuse or neglect. And because California’s Medicaid program, Medi-Cal, is exponentially larger than in most other states, it’s a big target for … [Read more...]
Largest Cyberattack on U.S. Healthcare System Underscores Need for Whistleblowers
Weeks after a cyberattack on UnitedHeath Group’s Change Healthcare unit crippled the processing of medical claims and prescriptions nationwide — and potentially exposed patient data — some lessons have emerged. First, the federal government and industry executives have known for years that the U.S. healthcare system was vulnerable to hacking, according to The Washington Post, but failed to make improvements that could stop attacks. Ransomware gangs like “Blackcat” (also known as ALPHV) that … [Read more...]
California Supreme Court Gives Broad Definition of ‘On the Clock’. What workers should know
Are you still on the clock in California if your workday is over but you are still waiting to pass an employer-mandated security inspection before heading home? Yes, under certain conditions, the California Supreme Court said last month in its ruling in Huerta v. CSI Electrical Contractors. The opinion follows similar worker-friendly rulings by the court. In 2020 the court said Apple needed to pay employees for bag searches after the end of their shifts and in 2018 it ruled Starbucks hourly … [Read more...]
Justice Department Will Establish Whistleblower Program for Corporate Crime Tips
In another example of how the government turns to whistleblowers to help discover and shut down fraud it isn’t able to ferret out on its own, the Justice Department is launching a program this year that will grant monetary awards to whistleblowers who deliver tips on significant corporate or financial misconduct. U.S. Deputy Attorney General Lisa Monaco announced the program during a legal conference this month. She said the goal is to address the “full range of corporate and financial … [Read more...]
Once Again, Recovered Money from Declined FCA Cases Exceeds Recoveries in Cases Initiated by DOJ
The U.S. Department of Justice reported record False Claims Act numbers last month: $2.68 billion in recoveries from 543 settlements and judgments in the fiscal year ending September 30, 2023. And for the second straight year, these record numbers show the importance of non-intervened whistleblower cases. Those are lawsuits filed by whistleblowers under the False Claims Act that federal prosecutors declined to intervene in, leaving the whistleblowers and their attorneys, like those at Keller … [Read more...]
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