Qui Tam

Upcoding and unbundling are common types of healthcare fraud. What is upcoding? “Upcoding” occurs when a healthcare provider submits codes to Medicare, Medicaid or private insurers for more...

Phillips & Cohen has been very successful in pharmaceutical fraud whistleblower cases against many pharma companies. Companies engaged in pharmaceutical fraud may be liable under the False Claims Act...

Medicare Part D fraud can happen in many ways. Whistleblowers can stop Medicare Part D fraud by using the False Claims Act, whether the fraud is committed by Part D prescription drug plan sponsors, pharmacy...

How Medicare Advantage fraud & risk adjustment fraud can occur – upcoding, chart review, chart mining and more Medicare Advantage plans commit fraud when they knowingly submit — or have a contractor...

Improper cost allocation is a more subtle version of the cross‑charging scheme. If a company has both government contracts and private commercial contracts (like most large aircraft companies), they...

Companies that supply goods and services to the federal government may be liable under the False Claims Act if they falsely certify they are complying with government contract terms in their Multiple Award...

The federal and state governments fund a variety of research and other specialized projects in the health care area. Typically, government funds are targeted for a specific and narrow purpose, a specialized...

Medicare reimburses health care institutions for certain costs in addition to paying for individual procedures and treatment. Virtually every hospital and many other providers submit cost reports to Medicare,...

The federal government spends billions on public works projects and construction of federal buildings. Fraudulent practices by contractors include bid-rigging, overcharging for contracts and failing to...

Mortgage companies and other lenders must certify that mortgage applicants meet a range of criteria, such as income and funds available to invest in a home, in order for the Federal Housing Administration...