Author: tracyfeldman@gmail.com

The healthcare industry continues to see enforcement of strict regulations designed to prevent fraud, especially when it comes to the misuse of government healthcare programs like Medicare, Medicaid, and TRICARE. In one significant case, Acadia Healthcare Company Inc., a Delaware corporation with its principal place of business in Franklin, Tennessee, agreed to pay $19.85 million...

In a significant case highlighting the risks of medical billing fraud, Precision Toxicology, a California-based clinical laboratory, has agreed to pay $27 million to resolve allegations of fraudulent billing practices. The allegations, as detailed by the Department of Justice (DOJ), center around the submission of false claims to Medicare, resulting from unnecessary drug testing and...

The U.S. Securities and Exchange Commission (SEC) recently announced an extraordinary milestone in its efforts to encourage whistleblowers and uphold market integrity. In a groundbreaking decision, the SEC awarded over $98 million to two whistleblowers whose tips and subsequent cooperation were instrumental in leading to significant enforcement actions against violators of federal securities laws. This...

The $3.85 Million Settlement: A Case of Healthcare Fraud In one of the most significant settlements in recent years, a nationwide home healthcare and hospice provider found itself at the center of a major legal battle over alleged violations of the False Claims Act. The Department of Justice (DOJ) announced that the company had agreed...

The Paycheck Protection Program (PPP) was designed to provide relief to small businesses during the COVID-19 pandemic. However, the program has been marred by instances of fraud, leading to significant financial losses. Whistleblowers play a crucial role in exposing such fraudulent activities. Their courage and integrity are instrumental in preserving the integrity of government relief...

In recent years, the importance of whistleblower programs has gained significant attention, particularly in the realm of corporate governance. The U.S. Department of Justice has recognized the need to bolster efforts in reporting corporate criminal conduct, leading to the launch of the Corporate Whistleblower Awards Pilot Program. This initiative aims to incentivize individuals to come...

On July 26, 2024, the Securities and Exchange Commission announced a substantial award exceeding $37 million to a whistleblower whose information and cooperation contributed to a successful enforcement action. The SEC whistleblower’s dedication to reporting misconduct internally prompted the employer to launch a comprehensive investigation, which was then shared with the Commission. This self-reporting spurred...

Whistleblowing technology refers to the act of disclosing illegal, unethical, or harmful practices within an organization by someone with insider knowledge. Protecting whistleblowers is vital, as it shields them from retaliation and fosters accountability and transparency in organizations. The rise of whistleblowing technology, fueled by online communication platforms in today’s digital age, has profoundly influenced...

CVS PBM Settlement Details CVS Health and its pharmacy benefit manager (PBM) recently reached a $45 million settlement with the state of Illinois over allegations that they failed to pass on drug rebates to the state’s Medicaid program. This agreement resolves claims that CVS improperly retained rebates that were meant to reduce drug costs for...