Alarming patterns keep cropping up in the Medicare Advantage program, and whistleblowers could be key to protecting both patients and taxpayers. More than half of the roughly 100 million Medicare beneficiaries choose this program, which is supposed to offer patients a health plan comparable to traditional Medicare administered by private insurance companies at less cost to the government. The problem: As more and more beneficiaries have elected Medicare Advantage it is proving to be more … [Read more...]
Tariffs, Customs Fraud, and How Whistleblowers Can Help
You’ve probably heard plenty about tariffs lately, including a heavy dose of speculation. What you may not have heard about are the fraudulent measures some companies take in an effort to evade them and essentially get an unfair pricing advantage by defrauding the federal government. If existing tariffs increase or new ones are imposed, we’ll likely see more attempts to evade them, including fraudulent labeling or transshipment, which involves shipping to an intermediate destination that … [Read more...]
Historic Bank Secrecy Act Settlement: Was a Whistleblower Involved?
TD Bank last month became the largest bank in U.S. history to plead guilty to Bank Secrecy Act program failures and to conspiracy to commit money laundering. The dubious distinction came with agreements to pay more than $3 billion in penalties — the largest penalty ever imposed under the act. Internal bank communications showed that employees knew lax internal policies made TD Bank, the nation’s 10th-largest bank, an easy solution for criminal networks. What’s not known: How the … [Read more...]
Crypto-related fraud losses hit $5.6B; whistleblowers can help
Online scams are soaring, drawing the eye of federal enforcers, who want the help of whistleblowers to prosecute and stop fraudsters. Cryptocurrency-related complaints, an up-and-coming area of fraud, hit $5.6 billion in losses last year, up 45 percent from 2022, according to an FBI report. Investment fraud accounted for the bulk of the crimes with a cryptocurrency nexus, followed by tech support scams, personal data breaches, extortion, confidence/romance, and government … [Read more...]
$60M settlement underscores need for Medicare whistleblowers
A CVS subsidiary recently struck a $60 million settlement to resolve kickback allegations, the latest settlement highlighting financial threats to Medicare programs. Oak Street Health allegedly paid third-party insurance agents to recruit to its primary care clinics seniors who were either eligible for or enrolled in Medicare Advantage, regardless of the best interests of the seniors, in violation of the False Claims Act and Anti-Kickback Statute, according to a release. Some Medicare … [Read more...]
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