Whenever a customer or bank notices signs of fraud on the customer's account, the bank is required by law to perform an investigation. It must determine whether criminal activity has occurred and whether the customer was involved. When the customer is involved, the bank immediately closes the account. When the customer is an innocent victim, the bank typically offers at least some assistance in retrieving the stolen money.
Seven years ago, two doctors stood up to powerful players in the emergency medical field by blowing the whistle on Medicare fraud. Their courage and hard work contributed to settlements of more than $33 million between two large physician groups and the Justice Department. As a result, the two whistleblowers will receive over $6.2 million.
A whistleblower will receive more than $600,000 after federal authorities obtained a $2 million+ settlement from Progressive Insurance in relation to alleged Medicare and Medicaid fraud. Progressive Casualty Insurance Co., of Cleveland, Ohio, and Progressive Garden State Insurance Co., of West Trenton, New Jersey, improperly submitted claims under the company's "health first" auto insurance policies.
A whistleblower has filed suit against a chain of Massachusetts mental health care centers, claiming the company defrauded the state and federal governments of $130 million. The accusation is that the company allowed "unlicensed, unqualified, and unsupervised employees" to treat patients. Doing so would be in clear violation of Medicaid regulations and requirements, the suit says.
President Trump has signed into law legislation that strengthens whistleblower protections at the VA. The legislation is called the Dr. Chris Kirkpatrick Whistleblower Protection, named after a 38-year-old Wisconsin psychologist who was fired (and then committed suicide) after having revealed that the Tomah VA facility had been overprescribing opioid medications to veterans.
A new study published in the journal Organization Science, says that high-pressure production goals within companies often set the stage for ethics violations and misconduct.
A bill strengthening whistleblower protections for federal employees has unanimously passed the House after passing the Senate in May. It now heads to President Trump's desk for signing or veto.
Visiting Nurse Service of New York, which claims to be the largest nonprofit home health agency in the U.S., will have to face a False Claims Act lawsuit, a federal judge has ruled. The company is accused of defrauding Medicare and Medicaid and also of failing to provide the care prescribed by patients' doctors.
As a beneficiary of Medicare or Medicaid, you use these entitlements to pay for important medical bills or gain access to necessary prescriptions. Protecting the future of these programs remains a top social priority for many, but fraud continues to threaten resources. According to the Coalition Against Insurance Fraud, more than 2,500 people have been charged with Medicare fraud in the past decade, totaling nearly $8 billion in false claims.
A New York City pharmacist is facing both a civil complaint and criminal charges after allegedly bilking Medicaid out of $11 million. The pharmacist is accused of giving kickbacks to Medicaid patients in exchange for the opportunity to refill their prescriptions -- or to buy the prescriptions outright and bill Medicaid despite never intending to fill them. The patients were typically poor and the prescriptions were often for expensive HIV medications.