The DOJ-OIG Guidelines establish frameworks for detecting and deterring fraud, waste, and abuse in federal healthcare programs. They provide voluntary compliance guidance to help healthcare entities design effective programs that prevent violations of the False Claims Act, Anti-Kickback Statute, and other federal laws. The General Compliance Program Guidance (GCPG) covers seven core elements of an […]
More than 30 states have enacted False Claims Acts, but their strength varies dramatically. California offers the nation’s largest whistleblower reward—up to 50% of total recovery, far exceeding the federal 15-30% range—and covers fraud against private insurers. New York has recovered over $4 billion since 2011 and applies its FCA broadly to “almost any situation
The surge in qui tam litigation — lawsuits brought by private individuals on behalf of the government — represents one of the most important shifts in healthcare law. We’ve witnessed how these cases have reshaped accountability, returning billions to taxpayers while empowering insiders to act against fraud. Before the 1986 amendments to the False Claims
For whistleblowers in healthcare, few topics cause more confusion or concern than HIPAA — the Health Insurance Portability and Accountability Act. While HIPAA protects patient privacy, it also includes specific exceptions that allow whistleblowers to report fraud and abuse lawfully. Under HIPAA, healthcare workers are generally prohibited from disclosing protected health information (PHI). However, 45
At Barrett Johnston, we regularly advise whistleblowers on navigating one of the biggest risks to reporting fraud: retaliation. The evolution of retaliation protections in U.S. law tells the story of how society gradually learned to value — and legally defend — those who speak out. Early federal protections were minimal. It wasn’t until the Civil
Evolution of Retaliation Protections for Employees Read More »
The DaVita Healthcare Partners settlement of 2014 was a defining moment in the fight against illegal financial relationships in healthcare. It is a key case in demonstrating how whistleblowers can expose physician kickback schemes hidden behind legitimate-looking business deals. DaVita, one of the largest kidney care/dialysis providers in the U.S., agreed to pay $389 million
Beyond expanding coverage, the Affordable Care Act (ACA) reshaped healthcare fraud enforcement. At Barrett Johnston, we see its fraud provisions as some of the most impactful reforms in modern healthcare law. The ACA strengthened the False Claims Act (FCA) and the Anti-Kickback Statute (AKS), clarifying that any claim tainted by a kickback is automatically a
The Anti-Kickback Statute (AKS) has long been a cornerstone of healthcare fraud prevention — but it wasn’t always enforced with the rigor we see today. The expansion of the AKS over time reflects a growing national commitment to ethical healthcare practices. Originally enacted in 1972, the AKS made it illegal to knowingly offer or receive
In 2012, Abbott Laboratories agreed to pay $1.5 billion to resolve criminal and civil allegations related to the unlawful promotion of its anti-seizure drug, Depakote. For Barrett Johnston, this case stands as a powerful example of how whistleblowers can hold even the largest pharmaceutical companies accountable for deceptive practices. Abbott was accused of marketing Depakote
Abbott Laboratories $1.5 Billion Settlement (2012) Read More »
When the Dodd-Frank Wall Street Reform and Consumer Protection Act became law in 2010, it introduced sweeping financial reforms — and its impact went far beyond Wall Street. At Barrett Johnston, we view Dodd-Frank as a landmark in the evolution of whistleblower protections and incentives across all industries, including healthcare. The Act established the Securities
