Takeaway: From 2018 to 2020, the New York False Claims Act yielded an impressive $216,936,354 in recoveries and returned $130,161,812 to New York State’s Medicaid Program.
New York is one of 32 states with its own qui tam statute.
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.
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.
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.
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.
Takeaway: Based on data reported by the State Attorney General, New Jersey’s False Claims Act (NJFCA) has been a legislative success. Between 2010 and 2019, the State netted $147 million under the NJFCA, while relators received $8.8 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.
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The Fourth Circuit becomes the most recent Circuit Court to adopt the test for the Anti-Kickback Statute 42 U.S.C. § 1320a-7b(b) “that at least one purpose of the remuneration was to induce the referral of services, rather than the primary purpose of the remuneration.” United States v.
If you are aware of any person, corporation or entity that you think may be violating the Federal False Claims Act or a State False Claims Act, contact us today.