An experienced whistleblower attorney, successful trial attorney, former criminal prosecutor, and former reporter Representing whistleblowers reporting fraud on the Federal State Governments

A report just issued by the U.S. Department of Health and Human Services Office of Inspector General reveals that the Government overpaid chiropractors for their services an average of $257 million to $304 million per year over a 6 year period.  During this period Medicare paid a total of $2.9 BILLION for chiropractic services.  The improper payments were made for services that were medically unnecessary or not sufficiently documented.   Hundreds of millions of dollars in taxpayer moneys were paid to chiropractors for services that did not meet Medicare requirements.

The OIG concluded that chiropractic fraud is a major concern. One of the problems is the way payments are made, according to the report. Most Medicare claims are processed and paid without a review of the underlying medical records to support the claim.

Scrutiny of chiropractors invoicing of Medicare will increase now. In addition, fraud investigations have resulted in criminal cases where the chiropractic claims were submitted where services that were never performed and where the services were performed without a valid chiropractic license. In addition, criminal cases were brought where patient records were falsified or where chiropractic services were billed where they are not covered by Medicare, as with massage or acupuncture. These investigations resulted in 11 chiropractors being incarcerated and $7.6 million in restitution.


Three major banks, Deutsche Bank, UBS and HSBC have agreed to pay $46.6 million to settle allegations of schemes to manipulate precious metals futures market trading, the Commodity Futures Trading Commission said. Also eight people  charged  have been charged with federal crimes, the Department of Justice announced. Charges included conspiracy, wire fraud, commodities fraud, commodities fraud and spoofing offenses. German banking giant Deutsche Bank AG and its Deutsche Bank Securities will pay a $30 million civil penalty and undertake remedial action, the CFTC said. Some Deutsche Bank traders allegedly “engaged in a scheme to manipulate the price of precious metals futures contracts by utilizing a variety of manual spoofing techniques” and by trading in a manner to trigger customer stop-loss orders.

Jeffrey Newman represents whistleblowers

fraud-300x188A Civil War Era Law Puts Customs Fraud in The Spotlight

The False Claims Act is shining a light on customs fraud and reshaping lawsuits around the country. Whistleblower attorneys are expecting to see an uptick in the customs fraud cases they handle related to importing goods, according to the Wall Street Journal.

Last year, a U.S. appeals-court ruling made room for more whistleblower lawsuits related to the Civil War-era law known as the False Claims Act. The Supreme Court backed the appeals court, agreeing it has broader implications.

Atlantic-Blue-Crabs-300x200The owner of a Newport News seafood business was charged today by criminal information with conspiring to commit Lacey Act violations for blending foreign crab meat with Atlantic blue crab meat, then labeling the blended crab meat as “Product of USA”.

James R. Casey, 74, of Poquoson, is the owner and President of Casey’s Seafood, Inc. According to court documents, from at least July 2012 through June 2015, Casey knowingly conspired to replace Atlantic blue crab with crab meat from Indonesia, China, Thailand, Vietnam, and Central and South America. Casey and his co-conspirators falsely labeled at least 397,917 pounds of crab meat, with a retail value in the millions of dollars, as Atlantic blue crab and “Product of the United States”. According to court documents, Casey directed employees to remove foreign crabmeat from the original shipper’s packaging containers, blend and combine foreign crab meat from one processor with crab meat from another processor, and place it into different packing containers with a label declaring that the contents were a “Product of USA,” despite knowing that the contents were imported crab meat. Casey also directed employees to place labels with “Product of the USA” on containers that covered up labels that stated “Product of Brazil” or “Product of China”.

Casey has been charged with conspiracy to defraud the United States, and faces a maximum penalty of five years in prison, if convicted. Actual sentences for federal crimes are typically less than the maximum penalties. A federal district court judge will determine any sentence after taking into account the U.S. Sentencing Guidelines and other statutory factors.

Medicare fraudFighting Medicaid Fraud

Hearing the term Medicaid fraud may conjure up images of lawyers and government officials, but the true cost is actually much closer to home for many people. Fraud and abuse in Medicaid cost taxpayers billions of dollars every year. Funds intended to help the sick end up being wasted.

But worse than the wasted time is the risk to patients caught up in unnecessary procedures that just line the pockets of unscrupulous health care companies. Imagine if you found out that your child had an unnecessary surgery just so that agency could make a few hundred dollars.

Massachusetts False Claims Act lawsuit revealed that unqualified unsupervised South Bay employees provided “mental health treatment” to thousands of Massachusetts residents

BOSTON, MA. Mental health services provider South Bay Mental Health, Inc. and its parent companies Community Intervention Services, Inc. and Community Intervention Services Holdings, Inc. have agreed to pay $4 million to the Commonwealth of Massachusetts to settle the Commonwealth’s allegations that South Bay used unqualified, unsupervised mental health workers and unqualified Supervisors to treat its patients in Massachusetts, and they fraudulently billed MassHealth (Medicaid) and its payor contracted companies for these services.

The whistleblower who originally brought the action, Christine Martino-Fleming, is represented by Jeffrey A. Newman of Jeffrey Newman Law Boston and Marblehead and his co-counsel Waters & Kraus of Dallas, Texas. In the Complaint, Ms. Martino Fleming, a former Job Coach and later Coordinator of Staff Development and Training for South Bay, revealed detailed information alleging that South Bay was well aware of its wrongdoing. and that in fact it commissioned its own internal investigation through “Tiger Teams” which issued reports specifically concluding that South Bay’s Supervisors and Mental Health workers were not qualified in accordance with laws and regulations. In addition, in many cases, the Directors of the various South Bay clinics located in various parts of the state, themselves were not properly qualified and credentialed, according to the Complaint. When Ms. Fleming realized the extent of the wrongdoing, she sent several emails to her superiors notifying them of the problems but nothing was done. The Complaint alleges that the Defendants Scanlon, Sheehan and South Bay had specific knowledge of the ongoing fraud. The Complaint says that during the period 2009-2015 “South Bay allowed its unlicensed, inexperienced and unqualified counselors to treat patients with mental health issues without the supervision of qualified Supervisors, many of whom were unlicensed.”  According to South Bay’s web site, over 35,000 individuals are treated each year.

By Jeffrey A. Newman

The United States customs authorities are well aware that thousands of Chinese and other foreign goods are being illegally shipped into the U.S. in ways designed to evade U.S. customs duties on such things as steel, honey, furniture, clothing, shrimp, catfish and much more. These products are being “transshipped” from China into other nations and re-labeled to hide their actual country of origin. The countries accepting the Chinese products and sending them here include Mexico, Malaysia, Vietnam, Philippines, Sri Lanka, India and others.  The injection of these goods into the stream of America commerce without payment of U.S. tariffs harms American businesses and our economy at large.

While U.S. customs laws are strong and can be effective, the process is slow. Now, however, Whistleblower cases filed under The False Claims Act (FCA) are being used by U.S. companies to combat this unfair competition. In addition, the Federal Government is now coming to rely on whistleblowers who report tariff evasion to reveal the details of the fraudulent schemes. U.S. Customs and Border Protection (CBP) knows these illegal activities are ongoing, but they do not know enough about the players and plans to bring actions. However, now many U.S. companies and their C-level employees are becoming aware of the details through their contacts in China and elsewhere and through their own trading partners who are also placed in a weakened position by the schemers who evade US customs laws and sanctions. In addition, the False Claims Act has real teeth in that the Government may seek up to three times the amount the companies have evaded in customs tariffs. This has a great potential for deterrence. The defendants are not just the foreign companies but also the importers when it can be shown that they knew and were therefore complicit in the tariff evasions.

1-1-300x198Upcoding In The ER Could Be Stealing U.S. Tax Dollars

It’s an old and shady practice that has been in the forefront of Medicare and Medicaid fraud for years. Upcoding can hit taxpayers hard and drive emergency room bills to the thousands.

What is Upcoding?

The Securities and Exchange Commission today announced that the Miami-based businessman behind an alleged scheme involving investments in a Vermont-based ski resort has agreed to pay back more than $81 million of investor money that he used illegally.

According to an SEC complaint filed in 2016 in federal court in Miami, Ariel Quiros allegedly misused more than $50 million in investor funds to purchase a different ski resort and to fund personal expenses such as income taxes and two luxury New York City condominium purchases. Investors were told their money would specifically be used for construction projects at the Jay Peak Resort and a nearby proposed biomedical research facility.

Companies owned by Quiros also allegedly failed to contribute approximately $30 million in investor funds toward Jay Peak construction, with two projects going uncompleted. This jeopardized investors’ investments as well as their participation in the EB-5 Immigrant Investor Program under which Quiros and his businesses solicited the money.

paradise papersThe Paradise Papers Offer a Glimpse of Ultra Rich Money Practices

Swirling around in the media and online is a leak of financial documents called The Paradise Papers. Within the terabits of information lies the documented offshore accounts of politicians, celebrities, multinational corporations and even royalty. There is something else buried in the data according to The Gateway—money laundering and tax evasion.

The Trail of Money