Category: News

The recent move by Pennsylvania pharmacies to consolidate antitrust claims against GoodRx in the District of Rhode Island shines a light on the often murky and generally contentious relationships between pharmacies, pharmacy benefit managers (PBMs), and prescription discount platforms. For whistleblowers who know anything about the often-complex practices of PBMs, this case brings forth the...

The U.S. Securities and Exchange Commission recently released its Annual Report to Congress for Fiscal Year 2024, highlighting the significant achievements of its Whistleblower Program. The program is—and has been—a significant component in the protection of investors and maintaining market integrity through incentivizing reporting of possible violations of the securities laws by individuals. Top 5...

2024 witnessed some of the most notable class action lawsuits in the United States, ranging from accusations of antitrust violations to data breaches. The suits were brought not only in pursuit of monetary redress but also to ensure corporate accountability and consumer protection. 1. Blue Cross Blue Shield’s Antitrust Settlement A US judge has granted...

UCHealth, a major health care provider in Colorado, has agreed to pay $23 million to resolve allegations of fraudulent billing in its emergency departments. The settlement addresses claims that UCHealth falsely billed Medicare and Medicaid for more costly levels of care than were necessary, a practice known as “upcoding.” The allegations, brought to light through...

Paragon Systems, Inc., a security contractor for federal agencies, has agreed to pay $52 million to settle allegations of violating the False Claims Act (FCA). According to the U.S. Department of Justice (DOJ), Paragon allegedly submitted fraudulent claims to the U.S. government for security services that were not provided as promised. This case underscores the...

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...