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Consumer Fraud 1449 articles

Whistleblower Doctor Who Led U.S. to $84.5 Million Settlement ‘Risked Everything’

A neuroscientist whistleblower who witnessed corruption within the Detroit-area hospital system where he worked and took legal action despite the serious risks to his career has helped the U.S. government recover nearly $85 million for the Medicare, Medicaid and TRICARE programs. Dr. David Felten filed a False Claims Act lawsuit against William Beaumont Hospitals in 2010 alleging the regional hospital system engaged in improper financial relationships with eight referring physicians, resulting in the submission of false claims to federal health care programs as well as violations of the Anti-Kickback Statute and Stark Law. Dr. Felten, a leading figure in the ... Read More

Another Tesla Whistleblower Files SEC complaint

A second Tesla whistleblower has filed a formal complaint with the U.S. Securities and Exchange Commission (SEC), alleging a Mexican drug cartel operated within the automaker’s Nevada Gigafactory, while others stole $37 million in copper and other raw materials. Instead of properly notifying investors and regulators, Tesla CEO Elon Musk responded to the predicaments by illegally wiretapping and hacking employee cell phones and computers, whistleblower Karl Hansen alleges. Mr. Hansen, who worked for Tesla’s internal security department and investigations division, says he voiced his concerns internally, urging Tesla to take proper action in responding to the issues. But instead of ... Read More

U.S. Fights Opioid Epidemic With New Newark/Philadelphia Strike Force

The federal government is expanding its efforts to combat the nation’s opioid crisis and health care fraud with a new regional Medicare Fraud Strike Force operation for the Newark and Philadelphia areas. The Newark/Philadelphia Medicare Strike Force location is the tenth region-specific operation. All of the Strike Force locations monitor health care activity in a specific region for fraud affecting government health care programs. The growing crisis of opioid abuse and addiction has not just harmed tens of thousands of individuals and their families across the U.S., it has also taken its toll on the Medicare program, which loses billions ... Read More

Whistleblower Key in Mississippi Hospital’s $1.1 Million Medicare Fraud Settlement

A Mississippi public hospital has agreed to pay the U.S. more than $1.1 million to settle a whistleblower lawsuit alleging it unlawfully billed Medicare for services patients didn’t need. Grenada Lakes Medical Center, which is operated by the University of Mississippi Medical Center, agreed to settle the government’s False Claims Act allegations accusing the hospital of falsely billing Medicare for medically unnecessary and unreasonable psychotherapy services it provided to beneficiaries of the government health care program. According to the U.S. Justice Department, starting in January 2005 and continuing until April 2013, the Grenada Lakes Medical Center submitted claims for intensive ... Read More

Wells Fargo Blames Hundreds of Home Foreclosures on Calculating Error

Wells Fargo said a software glitch in its mortgage loan modification underwriting tool led to hundreds of its customers losing their houses to foreclosure. In its latest quarterly filing with the U.S. Securities and Exchange Commission (SEC), Wells Fargo said that the calculation error caused about 625 customers to either be incorrectly denied a government-sponsored mortgage loan modification or not offered a loan modification when they would have qualified. “In approximately 400 of these instances, after the loan modification was denied or the customer was deemed ineligible to be offered a loan modification, a foreclosure was completed,” Wells Fargo said ... Read More

Whistleblower Awarded $17 Million for Exposing Medicare Fraud

A whistleblower who filed a False Claims Act lawsuit against Prime Healthcare Services, one of the nation’s largest hospital chains, and its founder and chief executive officer, has received an award of $17,225,000 for helping the U.S. recover $65 million in Medicare funds. The U.S. Department of Justice said that Karin Berntsen, the former Director of Performance Improvement at Alvarado Hospital Medical Center in San Diego, brought the suit under the whistleblower provisions of the False Claims Act. Ms. Berntsen alleged that Prime Healthcare Services, Prime Healthcare Foundation, Prime Healthcare Management, and CEO Dr. Prem Reddy routinely admitted Medicare patients ... Read More

Medicaid Fraud: NC Home Health Co. To Pay $2.9 Million For False Claims Act Violations

A North Carolina home health care company and its owners were hit with a judgment of nearly $3 million for defrauding Medicaid by billing the program for services they never provided and for services that were ineligible for reimbursement. In a July 31 announcement, U.S. Attorney for the Eastern District of North Carolina said federal judge James Dever III ordered Compassionate Home Care Services of Lumberton, North Carolina to pay the U.S. $2.9 million for the Medicaid fraud charges. The government’s False Claims Act lawsuit against Compassionate Home Care also named the company’s owner, Carol Anders, and her son Ryan ... Read More

Jury Sides With Whistleblowers in School Board Retaliation Case

Two whistleblowers who were allegedly fired from California’s Montebello Unified School District (MUSD) in East Los Angeles in retaliation for calling out “lies, fraud, and corruption” within the Board’s leadership have been awarded more than $3 million. A Los Angeles Superior Court jury heard the whistleblower retaliation complaint, brought by Susanna Contreras Smith the ex-superintendent of the school district, and Cleve Pell, the district’s former operations officer, in June 2017. The plaintiffs argued they were wrongfully fired for standing up to cronyism and other misconduct by then-Board of Education and Chief Business Officer Ruben J. Rojas. Lawyers for the whistleblowers ... Read More

SEC Proposes Changes to its Whistleblower Program

The Securities and Exchange Commission (SEC) has proposed a series of changes to its whistleblower program that the agency says will boost the efficiency and overall performance of its informant-driven enforcement actions. The SEC added the proposed amendments to the whistleblower program to the Federal Register July 20. The changes would provide the SEC with additional tools to ensure that whistleblowers are appropriately rewarded for their efforts, the agency said. The SEC also proposed ways to increase efficiency in the whistleblower claims review process and to clarify the requirements for whistleblower anti-retaliation protections. The SEC’s whistleblower program was established by ... Read More

Whistleblower Blows Open Medical Device Fraud Scheme

A whistleblower who sued medical device maker AngloDynamics on behalf of the U.S. government was instrumental in recovering millions of dollars in Medicare, Medicaid, and other government health care funds, the U.S. Justice Department said. Whistleblower Ryan Bliss, who formerly worked in the marketing departments of AngloDynamics and affiliated firm Biocompatibles, filed the False Claims Act lawsuit alleging the companies unlawfully peddled the LC Bead as a drug-delivery device for chemotherapy patients – a use that the U.S. Food and Drug Administration (FDA) refused to approve twice. According to the whistleblower complaint, AngloDynamics routinely made false and misleading marketing claims ... Read More