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Fraudalent Orders

Discussion in 'Ask a Whistleblower Attorney' started by anonymous, Nov 23, 2019 at 7:04 PM.

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  1. #1 anonymous, Nov 23, 2019 at 7:04 PM
    anonymous

    anonymous Guest

    A VERY large and PROMINENT Pharma Company has had a very long term contract with a large CSO to sell their OTC products direct to HCPS. The sales reps place orders with their IPADS using a 3rd party ordering system. No signatures are required to authorize the order. It has been uncovered and reported that sales reps and certain district managers have been placing fake orders, both manually and on automatic shipment. The orders never go thru but they are never canceled out to reflect accurate sales reporting. Could this be a solid case? Apparently this has been going on for YEARS
     
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  2. #2 Constantine Cannon, Dec 2, 2019 at 11:15 AM
    Constantine Cannon

    Constantine Cannon Experienced Whistleblower Law Firm

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    Medical billing fraud can occur in a variety of ways. Some of the most common ones are upcoding, unbundling, and billing for services that were not provided. Many other fraudulent schemes exist, however. When a provider submits a fraudulent bill for payment, they may be liable under the False Claims Act, and whistleblowers pay a critical role in exposing this kind of fraud.

    The Government will only pay for medical services that are actually performed or for equipment that is actually delivered. It can be a violation of the False Claims Act to bill the Government for healthcare services, supplies or equipment that were not performed or delivered. While sometimes bills are submitted for completely fictional services, medical billing fraud also happens when, for example, a diagnostic testing lab submits a bill claiming it has performed both a two dimensional CAT scan and a sophisticated 3D scan and analysis, when, in fact, only the 2D scan was performed. They are billing for service that was not actually provided.

    Our law firm has compiled a FAQ resource for potential whistleblowers that may be of interest to you: https://constantinecannon.com/practice/whistleblower/i-think-i-have-a-whistleblower-case/.

    The information contained herein is for informational purposes only and is not legal advice or a substitute for legal counsel. Online readers should not act upon this information without seeking professional counsel. If you would like more information, or would like to speak to a member of Constantine Cannon’s whistleblower lawyer team, please contact us for a Confidential Consultation: https://constantinecannon.com/practice/whistleblower/team/.
     
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