Feds Find $295M of Fraudulent Medicare Claims—Largest Amount in Strike Force History—9/7/11

The indictment of two individuals in Houston, TX, who were charged $62 million with Medicare fraud, was the beginning to the “nationwide takedown” that took place during the week of September 5th. The takedown, announced by Attorney General Eric Holder, involved Medicare Fraud Strike Force operations in seven other cities. The task force ended up charging 91 individuals with various Medicare fraud-related offenses, which included $295 million of fraudulent billings. This is the largest amount of phony claims found in a single takedown in Strike Force history.

Read more at: http://www.examiner.com/domestic-crimes-in-national/medicare-fraud-takedown-feds-target-295-million-false-medicare-claims

Whistleblowing

A whistleblower is an individual who discloses information about wrongdoing. Often, the whistleblower does so even though the wrongdoing that s/he witnesses is considered the norm or accepted behavior for that particular environment. Because the wrongdoing is — unfortunately—considered accepted behavior, the decision to blow the whistle is a difficult one. Those in the whistleblower’s immediate environment often try to convince the whistleblower that what s/he believes is unethical, or indeed illegal, is acceptable and legal. Whistleblowers question themselves and seek information to either validate their own conclusions or to question their conclusions. This website was in part developed as a tool for whistleblowers to help them through this dilemma.

Par Pharmaceutical Engaged in Illegal Drug-Switching Scheme, U.S. Says—9/6/11

In a whistleblower lawsuit, the U.S. alleges that a leading company in drug making and distribution defrauded government healthcare systems by engaging in a nationwide illegal drug-switching scheme. The whistleblower lawsuit became public this week in a Chicago federal court. Twenty states and the District of Columbia have joined the lawsuit filed under the False Claims Act.

Read more at: http://www.bloomberg.com/news/print/2011-09-06/mylan-units-implicated-in-u-s-lawuit-against-par-alleging-drug-switching.html

Amidst Possible Firing, Miami Police Chief Demands Whistleblower Protection—9/3/11

Miami Police Chief Miguel Exposito, who may face a possible firing in the days to come, sent a letter to city manager Johnny Martinez demanding whistleblower protection against retaliation. According to Exposito, the Mayor Regalado has been unfairly targeting him since December 2010, when Exposito sent a letter to federal authorities claiming Regalado interfered with a police raid on video gaming machines. A decade ago, Exposito famously prevailed in a whistleblower suit against the city when he linked his demotion to a complaint he made that the police department was keeping files on elected officials.

Read more at: http://www.nbcmiami.com/news/Exposito-Files-For-Whisltblower-Protection-Report-129182903.html

18 Medical Professionals Charged for $28M in Fraudulent Medicare Claims—9/2/11

According to a news release from the FBI, eighteen medical professionals have been charged for committing Medicare fraud in Detroit. Their schemes involved a total of more than $28 million in fraudulent claims for medically unnecessary services and/or services that were never even provided by the individuals.

Read more at: http://www.beckersasc.com/stark-act-and-fraud-abuse-issues/18-medical-professionals-charged-with-medicare-fraud-schemes-in-detroit.html

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