The False Claims Act can be a powerful tool to combat fraud, waste and abuse, but it is often misunderstood and used ineffectively. I was a federal prosecutor who worked on multiple criminal and civil cases involving the False Claims Act and I’ve also worked on these cases in private practice, and I wanted toContinue reading “A Guide/FAQ to the False Claims Act and “Qui Tam” Cases for Non-Lawyers”
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What data reveals about the Farid Fata case
The case of Farid Fata has gotten a lot of new attention recently with season 2 of the popular Dr. Death podcast, and it is a useful example of what data can reveal about health care fraud. Data probably could have caught Fata even earlier, and data helps suggest an answer to one of theContinue reading “What data reveals about the Farid Fata case”
Willfulness – the often-overlooked element in healthcare fraud and kickback cases
When it comes to healthcare fraud and kickback cases, I believe many attorneys – both prosecutors and defense attorneys – overlook one important element – “willfulness.” There are four main federal criminal statutes covering healthcare fraud (18 U.S.C. 1347, the Anti-Kickback Statute, false statements, and obstruction). All of them require the government to prove beyondContinue reading “Willfulness – the often-overlooked element in healthcare fraud and kickback cases”
Breakdown of the Takedown 2: Was It Really the “Largest” “Takedown” Ever?
For more than a decade, the federal government has announced at least one healthcare fraud takedown each year. And on September 30, 2020, the federal government announced what it called the “largest” such action. But this claim is based on some questionable methodology that I think would surprise reporters, including changing what the government countsContinue reading “Breakdown of the Takedown 2: Was It Really the “Largest” “Takedown” Ever?”
Breakdown of the Takedown 1: “Doctor-Enabled” Fraud in DME
On September 30, the federal government announced its annual healthcare fraud takedown, which involved 345 charged defendants and a lot of work by prosecutors and agents. I wanted to offer some perspective on the takedown, based on my own time as a former federal prosecutor who handled many healthcare fraud cases and as an attorneyContinue reading “Breakdown of the Takedown 1: “Doctor-Enabled” Fraud in DME”
Healthcare Fraud Blog by Stephen Lee 