‘Qui Tam Whistleblower’ Category

Healthcare reformer and former administrator of the Centers for Medicare and Medicaid Services Dr. Donald Berwick is the Class Day speaker at this year’s Harvard Medical and Dental School graduation ceremony. Dr. Berwick is known for his efforts toward healthcare reform.

Dr. Berwick has been a champion for patients and an advocate for eliminating waste in healthcare. Berwick has...

Jonathan Felix, a resident of Narberth, Pennsylvania, has been convicted in federal court of filing false income tax returns between 1999 and 2002, reports the Philadelphia Inquirer. Mr. Felix owned and operated United Professional Plans, Inc., which processed dental claims and resolved disputes that labor union members had with dental service providers.

Mr. Felix engaged in wrongdoing...

A report by the Health and Human Services (HHS) inspector general has revealed that $5.6 billion in Medicare funds have been paid out to 2,600 pharmacies that show suspicious billing patterns. For example, a single Kansas pharmacy billed Medicare for over 1,000 prescriptions each for just two patients in one year.

The report provides the first comprehensive investigation into Medicare...

Illinois Senator Kirk Dillard recently wrote in response to an AP story concerning Illinois Medicaid cuts. Sen. Dillard argued—contrary to the AP story—that almost 10% of Medicaid claims in the U.S. and in Illinois could be fraudulent. To support his position, Sen. Dillard pointed to the 2010 report from the U.S. Government Accountability Office (GAO) that looked at Medicaid fraud...

Naushad Buksh, a California resident, faces 45 counts of tax fraud. The charges include 41 counts of aiding in the preparation of false federal income tax returns and 4 counts of filing false tax returns. Authorities claim that he failed to report his business and its profits from 2007 until 2010.

According to The Oakland Tribune, Mr. Buksh is accused of providing false information...

Rose Cancer Center in Summit, Mississippi has allegedly been involved in serious Medicare and Medicaid fraud. Three individuals connected with the clinic—Dr. Meera Sachdeva,Monica Weeks, and Brittany McCoskey—have been accused of participating in a $15.1 million conspiracy to commit healthcare fraud. The charges also included conspiracy and witness tampering.

Ms. McCoskey, a former...

Drug manufacturer GlaxoSmithKline has agreed to pay a total of $2.6 million to settle claims by the State of Idaho regarding the “average wholesale prices” reported for its drugs. Idaho Attorney General Lawrence Wasden reports that, with this settlement, the total recovery of 14 disputes with pharmaceutical companies concerning average wholesale prices is now over $20...

Last year, the State of North Carolina spent approximately $10 billion paying Medicaid claims. A certain percentage of those claims were fraudulent, but identifying the false claims can be hard. The chances of catching Medicaid fraud has been substantially increased by the implementation of the new IBM fraud detection computer program. The program uses mathematical and statistical analysis to...

New TAF report reveals flaws in Chamber’s proposed whistleblower incentive caps

There is no doubt that fraud costs taxpayers money, but stopping this fraud can be difficult and costly. State and federal governments often rely on whistleblowers to come forward with helpful information. Qui tam provisions in the False Claims Act (FCA) allow those individuals...

New York Attorney General Eric Schneiderman has filed suit under the New York False Claims Act against Sprint Nextel Corp. for underpaying sales tax to the State of New York and to local tax authorities. The allegations involve sales due on flat-rate access charges in wireless calling plans.” According to Capitol Confidential, New York alleges that Sprint failed to collect and pay...