Welcome to the award-winning FCPA Compliance Report, the longest-running podcast in compliance. In this episode, I am joined by with Mary Inman, a 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 discusses how whistleblowers can still launch cases, even if the government does not join in, and encourage listeners to report fraud to their respective insurance departments if it later results in higher premiums for their organizations.
Key Topics:
· The Increase of Managed Care Plans in Medicare [00:04:16]
· The Power of Whistleblowing and the Impact of Joining Government Cases [00:08:19]
· Medicare and Medicaid Fraud in California and Florida [00:12:21]
· Impact of Insurance Fraud on Premiums [00:16:44]
· The False Claims Act and the Escobar Decision [00:26:09]
Notable Quotes
1. “And they were basically paying kickbacks to their they know who the physicians are, who are the 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 the drug they developed in 1990 was a new drug in 2013. And so that allowed them to greatly decrease the amount of the rebate 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 shifting costs that it shouldn’t have reimbursed onto the Florida Medicaid program.
Resources:
Mary Inman on Linkedin
Tom Fox on LinkedIn