Medicare and Medicaid fraud is the largest type of fraud combatted by the False Claims Act (FCA).  According to the Centers for Medicare and Medicaid Services (CMS), $45.8 billion was improperly billed between July 2012 and June 2013.  (CMS, Medicare Fee-For-Service 2014 Improper Payments Report, 1–2 (2014).)  This represents nearly 13 percent of all [...]

HIPAA Exceptions in Whistleblower Cases Whistleblowers’ access to and disclosure of HIPAA-protected information are exceptions to rules that normally bar access to sensitive health information. People reporting healthcare fraud may need to access evidence protected under the Health Insurance Portability and Accountability Act (HIPAA), such as medical records and identifying information. Whistleblowers combatting [...]