Skilled Nursing Facilities Are in the Government’s Crosshairs

We came across some interesting facts recently regarding Skilled Nursing Facilities (SNFs) on Lexology: “Since 2016, the Department of Justice has settled several multimillion-dollar False Claims Act cases with SNFs, including at least six worth more than $10 million and two separate settlements worth more than $120 million each.” This is clearly an industry rife […]

It Pays To File First

A federal judge has approved the DOJ’s request to divide the payouts from a $350 million qui tam settlement among six whistleblowers who filed claims.  Under the False Claims Act, the award for bringing a claim on behalf of the government ranges between 15 and 30 percent of the amount recovered.  Here, the whistleblowers may […]

DOJ’s Largest Recovery from Hospice Provider for Medicare Fraud

The Department of Justice recently announced the resolution of a false claims act case against two hospice service providers for $75 million. The case arose out of three separate whistleblower actions and represents the largest recovery from a provider of hospice services.  The awards to the whistleblowers have not yet been determined.  Under the False […]

Foreign Corrupt Practices Act Enforcement

There has been a lot of speculation this past year about whether the DOJ and SEC would continue their robust enforcement of the FCPA under the Trump administration given his previous public comments.  In the past, Trump has said that “this country is absolutely crazy” to prosecute alleged FCPA violations because, according to Trump, the […]

Motor Vehicle Safety Whistleblower Program

Over the past decade major car safety scandals dealing with issues such as faulty ignitions, unintended acceleration and defective airbags have caused hundreds of unnecessary deaths and many more injuries. In response to the public’s outrage, Congress passed the Motor Vehicle Safety Whistleblower Program. The Senate report for the program can be viewed here.  This […]

This Will Have A Ripple Effect

Today, the Supreme Court announced they will decide a case that determines whether a whistleblower who reports securities laws violations internally and is fired is entitled to anti-retaliation protections under Dodd-Frank.  The case is Digital Realty Trust, Inc. v. Paul Somers. The company in this case argues that a whistleblower needs to report wrongdoing to […]

Upcoming Pharmacy Conference

We’re excited to announce that BT Pharmacy Consulting is hosting a virtual online conference for independent pharmacists. The virtual conference, which will go live on September 15-19th, will provide advice and tips for independent pharmacy owners and consultants on issues important to them, such as marking, quality control, billing challenges and more. I participated in […]

How Are Whistleblowers Paid?

[This article originally appeared on CafePharma in June 2017, written by Joseph Gentile.] Given the career risk many people take when they decide to blow the whistle, a natural question is how much money you can potentially receive if your information and efforts lead to a successful prosecution? The answer is, a lot. For example, […]

Should You Blow The Whistle?

[This article originally appeared on CafePharma in July 2016, written by Joseph Gentile.] The pharmaceutical industry is one of the world’s most innovative and socially beneficial industries. Every day, pharmaceutical companies and their employees literally save lives. This puts the industry in a tremendous position of trust and power. Unfortunately, this trust is sometimes abused. […]

Risk Adjustment Fraud, Coding Creep, etc.

Risk Adjustment fraud is a major problem estimated to cost Medicare billions of dollars per year. Here is how it works. Medicare pays Medicare Advantage plans a “capitated” rate per insured. That is, they pay a flat rate per covered person per month. However, to compensate plans for the fact that some insureds are at […]