Welcome to the award-winning FCPA Compliance Report, the longest running podcast in compliance. In this episode, I am joined by with Mary Inman, partner at Constantine Cannon. We discuss the recently released US Fraud statistics and preventative measures with Inman. Inman explains that the US Department of Justice put out statistics on the False Claims Act for 2022, with healthcare dominating the recovered funds. Inman goes on to discuss how whistleblowers can still launch cases, even if the government does not join in, as well as encourage listeners to report fraud to their respective insurance department if it later results in higher premiums for their organization.

Key Topics:

·      The Increase of Managed Care Plans in Medicare [00:05:16]

·       The Power of Whistleblowing and the Impact of Joining Government Cases [00:09:19]

·      Medicare and Medicaid Fraud in California and Florida [00:13:21]

·       Impact of Insurance Fraud on Premiums [00:17:44]

·      The False Claims Act and the Escobar Decision [00:26:09]

1.      "And they were basically paying kickbacks to their they know who the physicians are, who are their largest prescribers of their drugs. And they were paying kickbacks to encourage them to basically discourage them from prescribing their competitors’ products and to direct it to them." 

2.     "What happened here is that Mallinckrodt improperly calculated their rebate by claiming that drug that they developed in 1990 was actually termed a new drug in 2013. And so that allowed them to greatly decrease the amount of the rebate that they would have owed to the Medicaid program."" 

3.    "It's another kind of false billing scenario. It was notable to me that we had 2 big settlements."

4.     "The whistleblower had accused the Association of basically shifting costs that it shouldn't have been reimbursing onto the Florida Medicaid program. 

 Resources:

Mary Inman on Linkedin

Constantine Cannon

Tom Fox on LinkedIn

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