Qui Tam

The government frequently specifies that its defense contractors build products using a certain grade or quality of parts. There often is a further requirement that the parts be purchased from American...

The municipal finance industry is rife with fraud, and it’s often industry insiders who expose fraudulent schemes. Yield-burning is one way banks can defraud both the federal and municipal governments....

Upcoding and unbundling are common types of healthcare fraud. What is upcoding? “Upcoding” occurs when a healthcare provider submits codes for more serious (and more expensive) diagnoses or...

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...

Upcoding, chart review, chart mining and other ways risk-adjustment and Medicare Advantage fraud can occur Medicare Advantage and PACE 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,...