DOJ to Prosecutors: Show Tough Love to Whistleblowers with Weak Cases

A newly leaked internal Justice Department memo signals a new prosecution policy that may make it harder for whistleblowers to bring qui tam whistleblower lawsuits under the False Claims Act (FCA). … [Read more...]


Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry

ACLA Seeks Decisive Blow in PAMA Challenge Case Case: Attorneys for the American Clinical Laboratory Association asked the federal court for summary judgment in its lawsuit challenging the legality … [Read more...]


Enforcement Trends: Whistleblowers Get in on the EHR “Meaningful Use” Action

Wrongful payment of electronic health records (EHR) "meaningful use" incentives has become a growth area in government health fraud enforcement. (See GCA, July 10, 2017). And now private … [Read more...]


Case of the Month: FMC Settlement Is Poster Child for False Billing of Lab Tests

In the grand scheme of things, $2 million is fairly small potatoes for false billing of lab tests—especially considering that it allegedly went on for 10 years. Even so, if you're running your lab's … [Read more...]


Fixing a Hole in Whistleblower Retaliation Protection

SITUATION Fictional Laboratories (FL) plans to deliberately bill Medicare for tests it does not actually provide. To carry out the scheme, it orders Pathologist A to falsely attest that she performed … [Read more...]


Tool: Model Hotline Allegations Investigation Procedure

The OIG Model Compliance Plan for Clinical Laboratories requires labs to establish mechanisms for not only receiving but promptly investigating internal complaints and reports of potential compliance … [Read more...]


New Laws: House Bans Firing Whistleblowers for Disobeying Orders to Break the Law

It's clearly against the law to fire an employee in retaliation for filing a whistleblower suit against your lab. So it goes without saying that the ban on retaliation also prevents you from firing an … [Read more...]


FISH Test Crackdown against 21st Century Oncology Nets Nearly $25 Million… and Counting

$24.86 million. That's how much a whistleblower has made for the government and herself—so far—in a case against 21st Century Oncology for alleged fraudulent billing of fluorescence in situ … [Read more...]


OIG Highlights Hotline to Encourage Fraud Reporting

Reporting compliance concerns is a key component of effective compliance plans. A recent U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) podcast highlights the … [Read more...]


Tread Carefully When Disciplining Employees Who Have Blown the Whistle

The False Claims Act (FCA) has become the federal government's primary weapon in combating fraud and abuse. However, most FCA cases are initiated not by the government but private individuals filing … [Read more...]