Fraud By The Numbers Series
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CFTC Whistleblowers: An Underfunded Program For an Underfunded Agency
The Commodity Futures Trading Commission (CFTC) is fifty years old this year. Its whistleblower awards program is fourteen years old. But this long-established agency and its whistleblower program remain perennially underfunded. The CFTC’s jurisdiction is broad and expanding with the advent of cryptocurrencies. The CFTC regulates the derivatives markets, including futures contracts, options, and swaps,…
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Based on Past, DOJ’s New Whistleblower Program Could Yield Big Recoveries for Taxpayers
The Department of Justice (DOJ) recently unveiled a new whistleblower program, the Criminal Division Corporate Whistleblower Awards Pilot Program, on August 1, 2024. This new program enables eligible whistleblowers who report information about corporate and financial misconduct potentially to receive an award from the resulting forfeiture. The new program is designed to fill gaps that…
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Troublesome Trends in Crypto Crime
Since the launch of Bitcoin in 2009, cryptocurrency has surged in popularity, generating immense wealth for some individuals and immense financial losses for others. Though its resounding volatility has caused some traders and investors to reap significant gains, it has likewise caused immense losses, significantly so from the 2022 crypto crash. Volatility is not the…
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Fraud is Taxable, Too!
What happens when a fraudster not only defrauds a Government program, but then fails to pay taxes on the ill-gotten gains? The Government’s primary fraud-catching tool, theFalse Claims Act,[1] doesn’t apply to the tax side. Instead, the IRS has its own Whistleblower Program (WP), administered by its Whistleblower Office, to address tax fraud.[2] In Fiscal…
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Kickbacks Come in All Shapes and Sizes
As we reported earlier this month, 2023 marked a banner year in False Claims Act recoveries. The government and whistleblowers were party to 543 settlements and judgments, “the highest number of settlements and judgments in a single year,” totaling over $2.68 billion. Notably, as in prior years, “unlawful kickbacks,” remained a stated government priority: Unlawful…
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The “Why” of SEC Whistleblower Awards: Analyzing the Rationale for Denials and Award Amounts in the SEC Whistleblower Program in 2024
In just eight months in 2024, the SEC’s whistleblower award program has generated awards ranging from $200,000 to $37 million, and a whole slew of unique cases. Out of the forty-six (46) Final Orders for Whistleblower Award Determinations in 2024 to date (September 2nd), twenty-five (25) involved the denial of one or more claimants’ applications…
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How Fraudsters Are Taking Advantage – of Medicare Advantage
Medicare Advantage (MA), also known as Medicare Part C, is extremely popular. In fact, the Centers for Medicare and Medicaid Services (CMS) recently reported that 2023 was the first year in which a majority of Medicare beneficiaries – 52% — opted for MA instead of traditional, fee-for-service (FFS) Medicare, provided by Parts A and B.…
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Telehealth: A New Trend in both Healthcare and Healthcare Fraud
Prior to the COVID-19 pandemic, telehealth was extremely limited, with one study clocking these “virtual” doctors’ visits as rounding to zero percent before 2020. At the time, America’s largest insurer, Medicare, only covered telehealth in narrow circumstances that usually still involved a physical visit to a healthcare facility, like a telehealth visit with a specialist…
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Private Equity Will See You Now
Despite growing public concern, expansion of private equity into healthcare continues. In its 2024 annual report, Bain reported global private equity investment in healthcare entities of $105 billion in 2020, $202 billion in 2021, $98 billion in 2022, and $67 billion in 2023. Private equity has invested more than $1 trillion in healthcare entities in…
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Why Is the Government’s Best Weapon Against Fraud So Rarely Deployed to Combat Defense Fraud
Sometimes the numbers don’t add up. Like when we’re talking about fraud involving the Department of Defense (DOD). In Fiscal Year (FY) 2022: – “DOD obligated[1] more money on federal contracts ($415 billion in current dollars) than all other government agencies combined spent on contracts.” – Five companies (Boeing, General Dynamics, Lockheed Martin, Northrup Grumman,…
