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Category Archives: FCA Qui Tam

July 06

How Medicare Fraud Is Detected and Why It Still Goes Undetected

The Centers for Medicare & Medicaid Services (“CMS”) oversees the largest federal health programs in the United States. In 2024, Medicare spent about $1.1 trillion to provide care to approximately 68 million elderly and disabled individuals. CMS processes more than one billion claims annually through more than 20 different payment systems. The scale and complexity of the Medicare program create significant exposure to fraud. The Government Accountability Office (“GAO”) first designated Medicare as a high-risk program in 1990, and it remains on that list today. In GAO’s…

June 26

FCA Qui Tam

Anti-Fraud Coalition Urges Pennsylvania Lawmakers to Pass State False Claims Act

On May 22, 2026, Taxpayers Against Fraud (“TAF”) published a letter to the Pennsylvania Senate Health and Human Services Committee supporting Pennsylvania House Bill No. 1697 (“HB 1697”) and Senate Bill No. 38 (“SB 38”). If passed and signed into law, these bills would create a state-level Pennsylvania False Claims Act that TAF argues would provide a multitude of benefits including, among others, supporting whistleblowers, aligning Pennsylvania law with the federal False Claims Act and many similar laws in other states, and safeguarding…

June 10

Whistleblowers, FCA Qui Tam

Stark Law Whistleblowers Expose Hospital Fraud and Recover Millions

On April 2, 2026, the Department of Justice announced that Trinity Hospital Holding Company (Trinity), which operates a hospital in Steubenville, Ohio, has agreed to pay $1.7 million to resolve allegations that it maintained improper financial relationships with two referring physicians. According to the allegations, from 2014 through 2020, Trinity made improper financial contributions to two referring physicians in the form of rental arrangements for office space that exceeded fair market value, thus violating the Stark Law. Trinity self-disclosed these arrangements to the government following an independent investigation and took action to remedy the misconduct. Trinity received…

June 02

Whistleblowers, FCA Qui Tam

IRS Whistleblower Program Reform: What Proposed Changes Mean for Tax Enforcement and Whistleblowers

The House Ways and Means Committee unanimously approved House Resolution 7959, the IRS Whistleblower Program Improvement Act, marking a significant step towards IRS whistleblower program reform. This bill aims to streamline IRS whistleblower awards, protect whistleblowers’ anonymity, and improve transparency around the largest tax avoidance schemes. For companies, individuals, and tax fraud enforcement advocates, the legislation signals a meaningful shift in how the government incentivizes and protects those who expose wrongdoing. How the IRS Whistleblower Program Currently Works The tax whistleblower program determines awards in two…

May 28

Whistleblowers, FCA Qui Tam

Wartime Fraud and the False Claims Act: Historic Solutions in Modern Times

The False Claims Act emerged from Civil War-era fraud stemming from fast-paced government spending. Over 150 years later, those same dynamics of large-scale public funding and rapid deployment, which can increase the risk of fraud, continue to shape modern false claims enforcement and highlight the importance of whistleblowers. The Origins of the False Claims Act The False Claims Act (FCA) was signed into law 163 years ago by President Abraham Lincoln. Passed during the Civil War, it was designed to curb wartime fraud…

May 21

Whistleblowers, FCA Qui Tam

Space Industry Whistleblowers: How the False Claims Act Protects Insiders in NASA’s $100 Billion Artemis Program

Artemis II launched on April 1, 2026, sending four astronauts on a lunar flyby and ultimately breaking the record for the farthest distance humans have traveled from Earth. Artemis II is also the first crewed mission beyond low Earth orbit since the Apollo 17 mission in December, 1972. The crew has also captured our hearts by unofficially naming a new lunar crater after Commander Reid Wiseman’s late wife, Carroll, and shared an emotional group hug. Behind every historic space mission is a vast supply chain of contractors and supporting…

April 13

False Claims Act, FCA Qui Tam, Whistleblowers

What Whistleblowers in Import and Manufacturing Should Know

What is import fraud, and how does it occur in manufacturing and supply chains? Import fraud (also referred to as “customs fraud”), which has fallen under the spotlight of the Department of Justice, is any attempt to evade duties, taxes, or trade regulations. This is commonly achieved through deceptive or falsified import documentation. In the manufacturing and supply chains sector, this can be done in several ways: such as undervaluing goods, misrepresenting the…

March 09

Whistleblowers, FCA Qui Tam

Understanding the Anti-Kickback Statute

What is the Anti-Kickback Statute? The Anti-Kickback Statute (“AKS”) (42 U.S.C § 1320a-7b(b)), is a federal law that prohibits healthcare providers from knowingly and willfully offering or accepting any form of remuneration to induce or reward patient referrals for services covered by federally funded health programs, including Medicaid, Medicare, or TRICARE also known as a “kickback.” Remunerations refer to anything of value such as a gift, money, or service, offered as a form of bribery whether in a direct or indirect, overt or covert, in cash or in-kind manner. The AKS is an intent-based statute that requires a…

March 04

FCA Qui Tam

SBA Oversight Under Scrutiny as Borrowers Secure Nearly 7,000 Potentially Fraudulent PPP and EIDL Loans Worth $400M

On January 1st, Small Business Administration (SBA) Administrator Kelly Loeffler announced on X that the agency suspended “6,900 Minnesota borrowers” over suspected fraudulent activity regarding the Paycheck Protection Program (PPP) and Economic Injury Disaster Loan (EIDL) payouts. Loeffler reported that these loans are worth “approximately $400M.” This article will explore PPP EIDL programs, relevant fraudulent claims in Minnesota, and how these illegally acquired loans violate the False Claims Act (FCA). How…

February 26

Whistleblowers, FCA Qui Tam

Department of Justice Announces Record Breaking Year for False Claim Act Cases & Settlements

On January 16th, the Department of Justice (“DOJ”) released the False Claims Act report for the 2025 fiscal year. The report spotlights that settlements and judgments under the False Claim Act exceeded $6.8 billion, the highest amount in a single year since the history of the False Claims Act. This was largely due to the record-breaking number of qui tam lawsuits, also known as whistleblower actions, filed. The 1,1297 qui…

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