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COVID-19 Fraud Cases are Coming: What To Expect

Healthcare fraud costs American taxpayers billions of dollars every year. With the widespread coronavirus pandemic, it is expected that much of the fraud in 2020 will be related to the COVID-19 crisis. But what will COVID-19 fraud look like? What we’re already seeing This spring, the United States Department of Justice put out a press Read More

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Florida Healthcare Organization Faces Federal Whistleblower Lawsuit for Medicare Fraud Allegations

A former auditor for Lee Health alleges in a federal whistleblower lawsuit that the Florida hospital system routinely defrauded Medicaid and Medicare by inflating doctor’s bills to drive more referrals to its clinics and hospitals. The case specifically points to fraudulent incidents involving certain neurosurgeons, cardiologists, pulmonologists and a cancer doctor who received six- and Read More

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Epic Systems Accused of Healthcare Fraud in Whistleblower Lawsuit

A lawsuit filed against Epic Systems, a digital health care records company based in Verona, Wisconsin, alleges the company systematically overbilled the government for Medicare and Medicaid. The lawsuit was initially filed under the False Claims Act (FCA) in 2015 by Geraldine Petrowski, a former employee for a health care company in North Carolina. Under Read More

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Medicare Advantage Insurers Reach $32 Million Settlement in Whistleblower Case

A pair of Medicare Advantage insurers based in Florida agreed to pay nearly $32 million to settle a whistleblower claim. In the claim, a whistleblower alleged the insurance providers routinely exaggerated the severity of patients’ conditions and took various other steps to overbill Medicare. The suit was initially filed in 2009 by Dr. Darren Sewell, Read More

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Kmart Pays $1.4 Million Settlement in Medicare Fraud Case

The Kmart Corporation has agreed to pay $1.4 million to settle allegations by the federal government that it violated the False Claims Act. The U.S. Department of Justice said Kmart was accused of inducing beneficiaries under Medicare to fill prescriptions at Kmart pharmacies. According to reports, Kmart let Medicare beneficiaries use coupons from drug manufacturers Read More

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First ACA Whistleblower Claim Resolved with $6.88 Million Settlement

In the first-ever healthcare fraud lawsuit resulting from whistleblower actions under the Patient Protection and Affordable Care Act, a provider of home medical care services to medically vulnerable children has agreed to pay a settlement worth $6.8 million. As a part of the settlement, the two whistleblowers who alerted authorities to the company’s wrongdoing split Read More

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