Taxpayer money is everywhere. And where there is money, there are people willing to cheat to get more than their fair share. Fortunately, there are also upstanding humans interested in calling out wrongdoers gaming the system and stealing tax dollars. Also fortunately, we have whistleblower rewards!
The primary law used to assist those blowing the whistle on bad behavior is the federal False Claims Act. The SEC also has a whistleblower program that has grown significantly over the past decade. The last year has brought a record number of whistleblower claims under the FCA and SEC ...Read More ›
Despite courthouse doors closing throughout California starting in March 2020 due to the COVID-19 pandemic and making in-person jury trials nearly impossible, tens of thousands of Plaintiffs have made monumental progress in their individual cases against Southern California Gas Company – the largest distributor of natural gas in the United States – related to the largest uncontrolled release of natural gas in U.S. history.Read More ›
Polyfluoroalkyl substances; It’s a mouthful, which is why they go by the acronym, PFAS. These substances are also known as “forever chemicals” because they persist “forever” in groundwater, and thus in drinking water. For decades, PFAS chemicals were widely used in the manufacturing of household products and for industrial uses, leading to widespread contamination of groundwater, water treatment plants, and landfills across the U.S. As a result, PFAS contamination is an emerging environmental crisis across the country, which has given rise to litigation in many states.Read More ›
Corporate Defendants may try to block the depositions of top-level executives and agency heads on the basis that the witness is an “apex witness.” The general rule in California and federal court is that agency heads and other top governmental executives are not subject to deposition absent compelling reasons. “The general rule is based upon the recognition that an official’s time and the exigencies of his everyday business would be severely impeded if every plaintiff filing a complaint against an agency head, in his official capacity, were allowed to take his oral deposition.” Contractors’ State License Bd. v. Superior Court (2018) 23 Cal.App.5th 125, 131. Further, top-level corporate executives are generally considered apex witnesses for the same reasons. See Liberty Mut. Ins. Co. v. Superior Court (1979) 10 Cal. App. 4th 1282.Read More ›
A recent trend among defendants in False Claims Act cases is to argue that their violations are not "material"--in other words, that even though they may be breaking the rules, the government doesn't care. This trend was spawned by a Supreme Court case typically referred to as "Escobar": Universal Health Servs., Inc. v. United States, 136 S. Ct. 1989, 2001, 195 L. Ed. 2d 348 (2016).
In cases of upcoding and misbilling, defendants' emphasis on the Escobar materiality test is misplaced. The Escobar test was formulated to apply in “implied certification” cases, as explained by the ...Read More ›
Upcoding and misbilling cases are "factually false" claims under the False Claims Act. The distinction between a "legally false” claim, and a “factually false” claim, was recently explained by the Fifth Circuit Court of Appeals, as follows:
FCA claims can be either legally false or factually false. E.g., United States v. Sci. Applications Int’l Corp., 626 F.3d 1257, 1266 (D.C. Cir. 2010) (recognizing factually false claims as “the paradigmatic case” and legally false claims as the “certification theory”). A claim is factually false when the information ...Read More ›
Most outpatient healthcare services are billed to Medicare, Medicaid, and other payers on a “CMS-1500” form, using Current Procedural Terminology (CPT) codes to identify the services performed. CPT codes, and their definitions, are published by the American Medical Association (AMA). Misbilling of CPT codes is one of the most common forms of False Claims Act violations in the healthcare field.
The Court of Appeals for the Sixth Circuit described the importance of CPT codes in poetic terms: “The Rosetta Stone for the billing codes is found in an American Medical Association ...Read More ›
Investors who invested in Initial Coin Offerings (ICOs) or purchased “digital tokens” may be wondering whether their investment is governed by any laws. Likewise, investors may be wondering if they have any recourse when they expect fraud or the ICO disclosures failed to provide material information.Read More ›
With a greater demand to access for healthcare services also comes the need for reliable and honest physicians and healthcare facilities. Unfortunately, throughout the country healthcare kickback schemes are becoming more prominent in the healthcare system.
Kickbacks are incentives, usually bribes or anything of value, paid to a physician or healthcare facility to induce the referral of items or services reimbursable by Medicare, Medi-Cal or private insurers. Now more than ever, whistleblowers are encouraged to exercise their duty and right to disclose fraudulent or wrongful conduct.Read More ›
Social media is a deeply embedded part of our culture. The rise and use of social media applications (apps) has become as common as having a smart phone or a computer. The prevalence of these apps is especially persistent in use by minors and young adults.
TikTok is a video-sharing social networking service owned by ByteDance, a Chinese company. The application is used to create short, “fun” videos typically featuring the user performing a song, dance, or themed monologue. Largely targeted at, and used by teenagers, TikTok is one of the most downloaded social media applications of the decade. As of 2019, 41% of TikTok’s 800 million users were between the ages of 16 and 24, with 90% of this group using the app daily.Read More ›