Kaiser Scores First-to-File Dismissal in Medicare Advantage Fraud Suit

Medicare Advantage Organizations have come under increased fire as their parent companies continue to acquire more healthcare practices across the country.  Experts suggest that this vertical integration has led to inflated Medicare spending, with providers facing new pressure to diagnosis chronic conditions that fetch more money for Medicare Advantage plans.

The SEC Announces Another Record-Breaking Year for its Massively Successful Whistleblower Program

Key Takeaways

  • Largest year ever for whistleblower awards (nearly $600 million in total)
  • Largest single whistleblower award ever ($279 million to an individual whistleblower)
  • Largest year for whistleblower tip volume (over 18,000 tips submitted to the SEC)
  • The SEC underscores its whistleblower protection efforts through Rule 21F-17 enforcement

On November 14,

Eleventh Circuit Confirms that SEC Whistleblower Award Eligibility is Determined Under an Actual Causation Standard

On August 14, 2023, in a rare whistleblower award opinion, the Eleventh Circuit affirmed the Securities and Exchange Commission’s (SEC) denial of a whistleblower award in Granzoti v. Securities and Exchange Commission, 2023 WL 519503 (11th Cir.). The opinion establishes that eligibility for SEC whistleblower awards follows an actual causation standard – i.e.

Congress Fixes Major Hole in Treasury’s Nascent Whistleblower Program While Expanding its Scope to Sanctions Evaders

Takeaways:

  • The Treasury Whistleblower Program now provides for guaranteed awards of 10% to 30% of the government recovery in covered actions
  • The Treasury Whistleblower Program has been expanded to include not just tips concerning anti-money laundering violations but also those regarding various forms of sanctions evasion
  • The new law goes hand-in-hand with the government’s aggressive crackdown on Russian sanctions evaders and those that assist them

During the holidays,

PPP Loan Fraud at the Beach

It’s not always sunny for everyone on the Florida beaches. On January 30, 2023, the United States Attorney’s Office for the Middle District of Florida announced that Al Clint LaRoche of West Palm Beach pleaded guilty to two counts of bank fraud involving more than $1 million from the Paycheck Protection Program (PPP) loan program.

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Experienced Attorneys

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.

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