Government Wants to Settle, Whistleblowers Don’t

What happens when the government wants to settle a False Claims Act case, but the whistleblowers who filed the case don’t?  That was the question before the U.S. District Court for the District of Colorado. Airport hangar owners David Shepard and William Marvel brought a whistleblower case against the …

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HHS Secretary Backs Medicare Balance Billing

Generally speaking, patients really dislike balance billing.  Sometimes called “surprise billing,” “balance billing” refers to billing a patient for the difference between the health care provider’s charge and the amount a patient’s insurance company pays.  Say, for example, the doctor charges $125 …

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Rare Physician Win in Peer Review Lawsuit

Since enactment of the Health Care Quality Improvement Act in 1986, physicians haven’t usually fared well when they go to court to stop or delay hospital peer review actions, provided the hospitals follow the procedural steps set out in the Act. But Dr. Patrick Murphy persuaded the Illinois Appellate Court …

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Should Accident Victims Recover their Medical Bills Twice?

Most of us think that accident victims should be able to recover for their medical bills.  But recover twice?  That issue is at the heart of the case argued before the United States Supreme Court on March 1. The Federal Employees Health Benefits Act (FEHBA) empowers the Office of Personnel Management (OPM) to …

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New Medicare Fraud Defense: “My Mom Made Me Do It!”

Charged with 33 counts of Medicare fraud netting some $45 million in false claims, Richard Tinimbang invoked a novel defense: “My mom made me do it!” That, according to Law360, is the gist of the opening statement of Richard’s defense attorney on February 27.  The attorney described Richard’s mother, …

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Will In-House Attorneys Reach for their Whistles?

The news is full of stories about whistleblowers collecting millions from their former employers.  Surely at least a few in-house lawyers fantasize about that kind of payday.  After all, who knows better than an in-house lawyer where the bodies are buried?  But the fantasy usually ends with recollection that …

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