Lawyers and doctors are both in the professional service industry. Setting lawyer pay is pretty easy, particularly at the partner level. Just estimate the amount of business (i.e., revenue) they’ll bring in and determine how to split it up. There’s
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Fraud is … upselling medical services.
Whenever I get work done on my car, it’s pretty common for the mechanic to try to upsell me. For the right reasons or wrong ones, I know it’s coming. There’s nothing preventing most salespeople from some upselling. After
Referral or Kickback?
The Anti-Kickback Statute (AKS) is a federal law in the United States that prohibits the exchange of anything of value in an effort to induce or reward the referral of federal healthcare program business. It is designed to prevent fraud
Fraud is … creating two sets of invoices.
We make some things—computers, couches, cauliflower—in this country, and we’re making more things in this country, but we still import many things, perhaps most things, from abroad. When we import things, we have to pay a customs duty on them.
How to gather evidence as a whistleblower.
Whistleblowers play a crucial role in exposing and addressing misconduct within organizations. Gathering evidence is a key aspect of their role as it substantiates their claims, enhances credibility, and provides a foundation for investigation and corrective action.
Do it the
King Kong ain’t got nothing on the DOJ
My old friends and colleagues in the Northern District of Georgia have been doing some good work. This time, they’ve settled a customs fraud qui tam case.
The scheme: The scheme is straightforward and lucrative: King Kong, a tool company,
Heart Lessons
Cardiac Imaging Inc. (CII) and its founder, owner, and CEO, Sam Kancherlapalli have agreed to pay a total of $85,480,000 to settle allegations of violating the False Claims Act. These allegations stemmed from CII’s practice of paying excessive fees to
Florida Sleep Center to pay whistleblower $300,000 and attorneys fees
Sometimes the scheme is simple. Here, a Florida Sleep Center just did not provide adequate physician supervision for six years.
Willard Revels, a former employee, informed the United States and it did not intervene. He persisted anyways with his qui
Common schemes exposed by whistleblowers in False Claims Act cases
The False Claims Act (FCA) is a federal law in the United States that allows individuals to bring lawsuits on behalf of the government against individuals and entities that defraud government programs. In the context of healthcare, there are several
Bogus Basements and Fake Foundations: The $100 Million Hurricane Katrina Whistleblower Case
Qui tam cases are not limited to healthcare fraud. In fact, the false claims act was originally passed to respond to widespread fraud in the procurement of weapons and materials for the Union Army. The Union Army would contract for