Article by Peter Budetti and Colette G. Matzzie published in Journal of Insurance Fraud in America, 1/15/16.
“For many in the insurance industry, it may seem farfetched to suggest insurance companies embrace whistleblower lawsuits. After all, whistleblower lawsuits alleging fraud long have targeted health insurers with Medicare and Medicaid contracts.
But the experience in two states suggests it can be in insurance companies’ best interests to use state qui tam laws to file whistleblower lawsuits that recover funds stolen by schemes. This includes upcoded health-insurance claims, phantom services, staged vehicle crashes, medical mills and false workers-compensation injury claims.”