The Daniel J. Ocasio Whistleblower Law Group exists to assist individuals in reporting fraudulent activity. Our team of whistleblower experts, lawyers, and former whistleblowers work to give brave individuals the monetary rewards they deserve and hold organizations accountable for unjust actions.
We know that becoming a whistleblower is a significant undertaking and can be an arduous experience — our team is here to offer expertise and knowledge to guide you through the process.
Our team has created a guide to ensure that potential whistleblowers have the knowledge needed to begin their journey of reporting medical fraud and choose a trustworthy law firm to best fit their individual needs.
Receive A Guide to Whistleblowing: How to Protect Yourself While Doing What is Right
An Inside Look: The Downey Settlement
Daniel Ocasio, managing partner, and Christopher Piacentile, CFE, have struck again! Fresh off the $40 million Apria settlement, this is now the second identical respiratory fraud settlement they have managed.
A Downey-based provider, SuperCare Health, Inc., has agreed to settle allegations that it took advantage of public health care programs through billing for ventilator services that weren’t medically reasonable or necessary. The whistleblower in this case, a respiratory therapist who worked for SuperCare, will receive substantial compensation for his part in exposing the corrupt practices enacted by the company. Learn more about the settlement here.
An Inside Look: The Apria Healthcare Settlement
In late 2020, acting Manhattan U.S. Attorney Audrey Strauss announced a $40.5 million settlement case against Apria Healthcare for multiple counts of fraudulent billing. Wrongdoings included violations of the NIV Continued Use Conduct, PAC Mode Conduct, and Co-pay Waiver conduct.
Daniel Ocasio, managing partner, and Christopher Piacentile, Director of Investigations, played important roles in bringing this injustice to light and holding Apria Healthcare accountable.
An Inside Look: The Roswell Settlement
Between 2012 and 2018, a Roswell-based psychotherapy services provider, Carenow Services, violated the False Claims Act by billing Medicare and Medicaid for psychotherapy sessions at nursing homes that were either incorrectly documented, medically unnecessary, or billed at higher rates.
Daniel Ocasio, managing partner, and Christopher Piacentile, CFE, played key roles in the settlement by Georgia psychotherapy services to remove false claims allegations.
Reporting Healthcare Fraud
In highly regulated industries like healthcare and respiratory, there’s no room for error when it comes to failing to comply — especially if done intentionally to make a profit.
We want to help make people aware of what constitutes fraudulent activity, so they know when to come forward. When it comes to equipment usage and compliance in the respiratory industry, you can learn about what’s right and how to spot what’s wrong so you can report healthcare fraud by reading our full blog post.
Examples of Whistleblowing Cases in Healthcare
Shining a light on injustice can be scary, but the potential rewards will certainly outweigh the risks. Recent cases related to healthcare fraud have paid out as much as $2.2 billion — with a sizable reward going to the brave whistleblower(s) involved.
Some examples of whistleblowing cases in healthcare with large settlements include Johnson & Johnson, Abbott Laboratories, and Reckitt Benckiser Group.
Learn about more examples of whistleblowing cases in healthcare below.
A Closer Look at Medical Billing Fraud
Medical billing fraud is a common type of fraud our law group deals with and occurs when claims are forged, tampered with, or submitted unnecessarily in order to obtain reimbursement payments from insurance programs. Some types of medical billing fraud are:
- Billing Medicare, Medicaid, or Tricare for products or services that never occurred.
- Billing for unnecessary treatments.
- Multiple billing for home sleep testing where billing may appear as the same test under multiple CPT codes, multiple nights under the same CPT code, or billing for multiple tests when only one was done.
How to Detect Fraud and Abuse in the Respiratory Industry
Selling respiratory devices puts a tremendous amount of pressure on salespeople and organizations, with some using fraudulent tactics to get ahead. Strategies like data mining, waiving co-insurance, and offering kickbacks are some common practices used to persuade hospitals, physicians, and even patients to purchase their respiratory equipment.
These practices are illegal, unethical, and potentially dangerous. You can find tips for how to detect fraud and abuse in healthcare here.
What You Need to Know About Healthcare Fraud Attorneys
For those considering blowing the whistle, consulting the right healthcare fraud attorney is an important first step. The right law group will have experts in different types of healthcare fraud and can help you determine if you have a good case and what the best course of action is.
If you are considering blowing the whistle, experienced healthcare fraud attorneys can help answer your questions and guide you through an otherwise arduous situation.
Are Whistleblowers Protected?
It’s important for potential whistleblowers to know that discrimination and retaliation by employers against employees reporting fraud is forbidden. There are different laws and acts within different sectors that allow whistleblowers to remain anonymous and protected against retaliation. They include:
- False Claims Act (FCA)
- Whistleblower Protection Under the False Claims Act
- S. Securities & Exchange Commissions (SEC)
- Foreign Corrupt Practices Act (FCPA)
Interested in knowing more about what protections exist for whistleblowers? We have information and tips from experts to answer the question “are whistleblowers protected?” here: