What Does Fraud in the Medicare Advantage Space Mean for the Reverse False Claims Provision?
As the percentage of Medicare and Medicaid beneficiaries in managed care increases, there is a risk that fraudsters will misrepresent Medical Loss Ratios to the government.
A Tradition of Fraud Persists in New Types of Medicare Delivery Models
Unscrupulous medical providers, hospitals, and drug manufacturers, can and do defraud Medicare Advantage plans in the same ways they defraud “traditional” Medicare.
SEC and CFTC Whistleblower Programs Reveal Continued Success Combatting Fraud and Protecting Investors
These agencies are still confronting significant resource challenges vetting and investigating a record number of tips and adjudicating applications for whistleblower awards.
2021 IRS Whistleblower Program Numbers Fell Flat, But Hope Remains
The history of the program shows it can work. Since its inception, IRS whistleblowers have helped the U.S. Government collect $6.3+ billion from non-compliant taxpayers.