Fraud By The Numbers Series

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Private Insurers May Dole More Than $200 Billion Each Year to Fraudsters
The federal and state False Claims Acts permit whistleblowers to file lawsuits alleging that someone has committed fraud against the government. In the context of healthcare, this means government healthcare programs such as Medicare and Medicaid. But private health insurance companies are also susceptible to fraud. Private health insurance plays a significant role in America’s…
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Let’s Take a Look at Fraud Against State Medicaid Programs
In the last few days, we’ve been discussing the impact of fraud on the federal healthcare programs, but whistleblowers also play an important role in fighting fraud in state healthcare programs like Medicaid. Some experts estimate that fraud accounts for as much as 20 percent of government healthcare spending.[1] This means that, through Medicaid and…
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Let’s Take a Look at How DOJ Task Forces Fight Fraud
Healthcare and defense, while massive, are not the government’s only expenditures susceptible to fraud. The vast array of government programs and the enormous sums expended to advance those programs means the government needs ways to efficiently and effectively root out fraud. Oftentimes, the government attempts to do so by forming a task force to address…
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Why Combatting Healthcare Fraud Is Getting More Important
For fiscal year 2021, $1.2 trillion was allocated to Medicare (which in 2019 covered more than 58 million people). By 2028, Medicare expenditures are projected to reach $1.56 trillion (to cover approximately 75 million people). There are a number of drivers of this growth, but the primary one is the anticipated growth in Medicare enrollment.…
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Highlighting Whistleblowers on Patient Safety Day
Today, we are turning back to healthcare because the World Health Organization has declared September 17th Patient Safety Day. Established in 2019, Patient Safety Day was created to raise awareness of the need to make patient safety a global health priority and to bring stakeholders together in an effort to reduce the incidence and severity…
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How the Government Combats Tax Fraud
Any discussion about fraud on the government would not be complete without a discussion about tax fraud. Tax fraud may involve a failure to pay federal taxes, but it also includes cheating states and localities out of revenue they rely on to operate critical programs. According to the IRS, about $1 trillion in federal taxes…
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How Whistleblowers Can Combat COVID-19 Fraud
Although we are all weary of the widespread disruption caused by the COVID-19 pandemic, it continues to affect our daily lives. Unfortunately, the tragic loss of life and economic turmoil caused by the pandemic have been compounded by fraud in COVID-19 relief efforts. When state and local governments began ordering COVID-19 shutdowns starting in March…
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The Success of The SEC Whistleblower Program
Of the major federal whistleblower programs, the SEC Whistleblower Program is the newest, dating back to only 2011. However, in this relatively short period of time, the program has grown quickly. In fact, the number of whistleblower tips has increased year-over-year, including an increase of over 32% in 2020. In addition to garnering an increasing…
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How The SEC Regulates $29 Trillion in Equities
Willie Sutton, a notorious bank robber in the 1930’s was once asked why he robbed banks. His answer, found on the FBI’s Famous Cases page, was: “Because that’s where the money is.” Today’s FBI identifies corporate fraud, including securities fraud, as one of its highest criminal priorities because of the potential for significant losses to…
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Diving Into Defense Fraud
September 11, 2001 ushered in a new era of U.S. defense spending, marked by the wars in Iraq and Afghanistan. Over the last 20 years, the United States has spent more than $6.4 trillion on those wars. We do not know how much of this enormous sum has been lost to fraud. But as of…