Right before the holidays, we proudly announced a settlement of up to $100 million with Independent Health, a Western New York-based insurer, and one of its former executives. Several news outlets have since highlighted the settlement and the importance of whistleblowers in the healthcare industry, which is unfortunately a hotbed of fraud. In its case […]
Whistleblower Partners is proud to announce that our client, Teresa Ross, and the United States, have reached a settlement with Independent Health (“IH”), a Medicare Advantage Organization in Western New York, as well as its former subsidiary, DxID, and that subsidiary’s former CEO Betsy Gaffney. The settling parties will pay up to $100 million, with […]
C-Quest’s cookstove project seemed like a win-win: a low-cost carbon credit initiative with the promise of real climate impact and better living conditions for impoverished communities in Mozambique. The project? Distribute cheap, efficient cookstoves that use less wood than traditional campfires. These stoves were expected to reduce deforestation, cut carbon emissions, and lower the risk […]
The National Highway Traffic Safety Administration (NHTSA), the nation’s auto-safety regulator, finalized a new rule for its whistleblower program, which pays monetary awards to auto-industry insiders for providing information about critical safety defects. At long last, auto-safety whistleblowers can know the rules of the road for blowing the whistle. NHTSA’s New Whistleblower Program Rule In […]
Medicare Advantage, or Medicare Part C, is an extremely popular alternate model to traditional Medicare. In traditional Medicare, the government directly pays for services provided, known as a “fee for service” model. Under the Medicare Advantage program, the government contracts with private insurers and pays them premiums to provide coverage for Medicare-eligible beneficiaries. In this […]
Medicare, like many other insurers, often pays doctors a standardized rate based on the service they performed. Open heart surgery costs $Z, a blood test for cholesterol costs $Y, and a physical costs $X. Upcoding is a fraud that centers on healthcare providers submitting improper medical codes to insurers for reimbursement, generally for improperly high […]
The basic principle of the False Claims Act (FCA) is simple. The law empowers whistleblowers to sue contractors that are allegedly defrauding the government and share in any recovery. The goal was to incentivize those with information about fraud against the government to come forward, report the fraud, help recover taxpayer dollars lost to fraud, […]
Many international whistleblowers labor under the false impression that they must be American or work in the U.S. to be eligible to participate in the various U.S. whistleblower reward programs. Whistleblower Partners attorneys Mary Inman and Ari Yampolsky spoke with Welt reporter Laurin Meyer to disabuse Welt readers of this notion and discuss the risks […]
A recent federal government report on Medicare Advantage (MA) plans reveals a concerning issue: billions of dollars are being funneled into MA companies through inflated, risk-adjusted payments based on questionable diagnoses. This situation not only drains taxpayer dollars but also raises potential issues in patient care and program integrity. If you're aware of specific misconduct […]
The Securities and Exchange Commission (SEC) has outlined its examination priorities for fiscal year 2025, aiming to bolster investor protection and market integrity. These priorities serve as a crucial resource for potential whistleblowers who may witness violations within the financial sector, particularly as the SEC intensifies its focus on areas that pose risks to investors. […]
