Author: Alexander Owens

Tax Court: IRS Whistleblower Claims Survive Even Death

In Insinga v. Commissioner of Internal Rev. Service, 9011-13W, 2021 WL 4983084 (U.S. Tax Ct. Oct. 27, 2021), the United States Tax Court recently tackled an issue of first impression: whether an IRS whistleblower’s claim may survive death such that the claim may be pursued by his or her estate in the U.S.

The CFTC Breaks All Records –$200 Million Whistleblower Award

Takeaway: Misconduct in the multitrillion dollar derivatives market can lead to massive recoveries for the government and whistleblowers alike.   Even when the CFTC is already on the case, a whistleblower who tips off the government during an ongoing investigation may remain eligible for an award if they provide original information that “substantially contributes” to a successful enforcement action. 

Landmark Qui Tam Recovery: Private Equity Firm H.I.G. Capital Settles FCA Case for $20 Million

Takeaway: The H.I.G. case will no doubt embolden the Department of Justice and whistleblowers going forward.  Now DOJ and relators have a strong summary judgment opinion to ground liability in future cases and several sizeable recoveries against PE firms to use as comparators for settlement purposes.  With a more rigorous regulatory environment under the Biden administration,

SEC Whistleblower Payouts Top $1 Billion

Takeaway: 2021 has been a record year for the SEC’s whistleblower program with awards for fiscal year 2021 topping $500 million and total awards now exceeding $1 billion. This reflects both a pro-whistleblower administration and a growing private-public partnership in exposing corporate malfeasance. As the SEC’s whistleblower program matures and knowledge of its existence spreads,

Whistleblower Lawsuit Yields Second Largest Medicare Advantage Settlement – $90 Million

Takeaway: This recovery makes it very clear that the federal government and whistleblowers continue to aggressively pursue fraud allegations involving the Medicare Advantage Program. We can expect to see robust enforcement and sizable recoveries to continue.

On August 30, 2021, the United States Department of Justice announced a $90 million settlement with Sutter Health and certain of its affiliates (collectively Sutter Health) relating to allegations that Sutter Health had defrauded the federal government’s huge Medicare Advantage (Part C) Program. 

2020 False Claims Act Recoveries: $2.2 Billion in Recoveries and Over $309M in Awards to Whistleblowers

Takeaways:

  • Over $300 million awarded to whistleblowers.
  • Dip in recoveries reflects pandemic and economic challenges.
  • Number of FCA filings hits a record.
  • Healthcare continues to dominate FCA recoveries with kickbacks a major focus.
  • Rebound in recoveries is likely as defendants regain financial footing.

Genetic Testing Gold Rush Gives Rise To Fraud Allegations

On Sept. 27, the U.S. Department of Justice announced criminal charges against 35 individuals across various jurisdictions, allegedly involved in genetic testing fraud schemes that cost taxpayers over $2.1 billion.

The government asserted that the individuals had engaged in audacious schemes to target seniors and the disabled through the ordering of cancer genetic screening,

Storm Clouds: Private Equity and the False Claims Act

The United States recently filed a False Claims Act Complaint in Intervention against Florida-based compounding pharmacy Patient Care America (“PCA”), two PCA employees, as well as the private equity (“PE”) firm that acquired PCA and helped manage the company.1 The scheme alleged by the government was a common one: the payment of kickbacks for referrals of expensive compound drugs,

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