In The News

Whistleblower Exposes Illegal Physician Referrals, Leading to $118.7M Settlement

In September 2015, Wilbanks & Gouinlock (W&G) secured a record $118.7 million settlement against a hospital chain for illegal physician referrals. The lawsuit, filed under the Stark Law, was brought by a corporate executivewith insider knowledge of improper physician compensation schemes that created unlawful financial incentives for referring government beneficiaries.

Insider Whistleblower Uncovers Widespread Violations

The whistleblower, a corporate executive at Adventist Health, had direct access to key decision-makers within the hospital system. Her evidence and documentation provided the government with undeniable proof of systemic Stark Law violations across multiple Adventist hospitals in several states.

This case remains one of the largest illegal physician referral settlements in history, underscoring the role of whistleblowers in exposing healthcare fraud.

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This article is for informational purposes only and should not be considered legal advice.

Forest Laboratories Settles $300M Fraud Case

Forest Laboratories agreed to a $300 million settlement following allegations of off-label marketing lawsuit and illegal kickbacks. The lawsuit, which included $106 million in civil recovery, was brought by a whistleblower sales representative who exposed unethical sales practices.

Off-Label Marketing & Kickback Scheme

The whistleblower, a former Forest sales representative, revealed that the company pressured sales staff to promote antidepressants for pediatric use, even though the drugs were not FDA-approved for children. Additionally, Forest Laboratories allegedly provided illegal kickbacks to incentivize physicians to prescribe these medications, violating federal law.

This case remains a landmark off-label marketing lawsuit, reinforcing the importance of whistleblowers in exposing pharmaceutical fraud. Read more about this case here.

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This article is for informational purposes only and should not be considered legal advice.

Whistleblower Exposes Halifax Health Fraud, Leading to $85M Settlement

A whistleblower lawsuit filed by Elin Balid-Kunz led to a record-breaking $85 million settlement against Halifax Health for illegal physician compensation and Medicare fraud. Ms. Kunz, who worked for 17 years as Halifax’s Director of Physician Services, uncovered systemic Stark Law violations and took legal action to hold the hospital accountable.

Medicare Fraud & Illegal Kickbacks

Ms. Kunz alleged that Halifax Health knowingly submitted thousands of fraudulent Medicare claims and paid illegal kickbacks to referring physicians to boost hospital admissions. The Medicare fraud case resulted in one of the largest Stark Law settlements in U.S. history.

Whistleblower’s Fight for Justice

As a compliance professional, Ms. Kunz repeatedly raised concerns with Halifax’s senior management, but her warnings were ignored. Instead, she faced harassment and retaliation for speaking out. Refusing to back down, she pursued the Medicare fraud case, ensuring accountability and justice.

For her courage and persistence, she was named “Whistleblower of the Year” in 2014 by the Taxpayers Against Fraud Education Fund.

This case remains a landmark victory in Medicare fraud cases, demonstrating the critical role of whistleblowers in exposing healthcare fraud.

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This article is for informational purposes only and should not be considered legal advice.

Whistleblower Exposes Home Health Fraud, Leading to $61M Settlement

A whistleblower lawsuit against Olsten Corporation uncovered fraudulent billing, sales, and marketing practices within home health agencies, resulting in a $61 million recovery. Olsten, acting as a management company for Columbia/HCA, was implicated in widespread home health fraud that led to significant financial penalties.

Undercover Whistleblower Uncovers Fraud

The whistleblower in this case took extraordinary measures, even wearing a wire to obtain key evidence that ultimately exposed the fraud scheme. This critical information led to a $61 million recovery from Olsten and over $100 million in penalties against Columbia/HCA.

Landmark Settlement

This case remains a landmark victory in home health fraud cases, highlighting the importance of whistleblowers in exposing healthcare fraud and holding corporations accountable for illegal billing practices.

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If you have information about fraudulent practices, contact our office for a free, confidential consultation:

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This article is for informational purposes only and should not be considered legal advice.

Whistleblower Exposes C.R. Bard Kickback Scheme, Leading to $48.2M Settlement

C.R. Bard Inc., a multinational medical device company, agreed to pay $48.2 million to the federal government to settle a whistleblower lawsuit alleging illegal Medicare kickbacks. The case exposed how Bard’s urological division and its wholly owned subsidiary, ProSeed Inc., paid doctors and hospitals kickbacks to push Bard’s products at inflated prices for treating Medicare patients with prostate cancer.

Illegal Pay-for-Play Scheme Uncovered

A whistleblower represented by Wilbanks & Gouinlock (W&G) provided hundreds of key documents proving Bard’s involvement in an illegal Medicare kickback scheme. These kickbacks created improper financial incentives, leading to Medicare overbilling and violations of federal fraud laws.

Major Victory In Medicare Kickback Lawsuit

The Medicare kickback lawsuit resulted in a $48.2 million settlement, holding Bard accountable for its fraudulent financial practices. This case serves as a landmark example of how whistleblowers help expose corporate fraud in the healthcare industry.

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This article is for informational purposes only and should not be considered legal advice.

Whistleblowers Expose JP Morgan Chase Veteran Mortgage Fraud, Leading to $45M Settlement

JP Morgan Chase agreed to pay $45 million to settle a whistleblower lawsuit alleging that the bank defrauded military veterans and taxpayers by hiding illegal fees in home refinancing mortgages for veterans. The case, filed by Wilbanks & Bridges on behalf of Victor Bibby and Brian Donnelly, revealed a widespread mortgage fraud scheme affecting veterans nationwide.

Illegal Fees in Veteran Mortgages

The whistleblowers, both experienced professionals in the mortgage refinance industry, uncovered evidence that JP Morgan Chase and other major banks systematically charged hidden fees to military veterans seeking home loan refinancing. These deceptive practices resulted in millions of dollars in improper charges, violating federal regulations designed to protect veterans.

Landmark Veteran Mortgage Fraud Settlement

As a result of this case, JP Morgan Chase agreed to a $45 million settlement, while seven lenders identified in the lawsuit collectively paid over $250 million in penalties. This case stands as a landmark victory in veteran mortgage fraud lawsuits, reinforcing the importance of whistleblowers in protecting veterans from financial exploitation.

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• Call (404) 842-1075, ext. 123 or 122.

This article is for informational purposes only and should not be considered legal advice.

Whistleblowers Help Secure $45M Settlement in Countrywide VA Mortgage Fraud Case

Bank of America/Countrywide Mortgage agreed to pay $45 million to settle allegations of veteran mortgage fraud, marking another major recovery resulting from a broader VA loan fraud complaint. The case alleged that Countrywide improperly charged hidden and illegal fees to military veterans seeking home loan refinancing, violating federal guidelines designed to protect veteran borrowers.

Part of a Larger VA Loan Fraud Scheme

This settlement was part of a series of lawsuits filed by Wilbanks & Gouinlock (W&G) whistleblowers, who exposed widespread veteran mortgage fraud involving multiple national lenders. Their insider knowledge helped uncover the scope of deceptive practices targeting military families.

Landmark Win Against Veteran Mortgage Fraud

The $45 million recovery from Bank of America/Countrywide adds to over $250 million recovered from seven lenders involved in the broader scheme. This case highlights the critical role whistleblowers play in exposing veteran mortgage fraud and protecting those who have served. Read more about this case here.

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If you have information about fraudulent practices, contact our office for a free, confidential consultation:

• Fill out our consultation form by clicking here.
• Email us at info@wilbanksgouinlock.com.
• Call (404) 842-1075, ext. 123 or 122.

This article is for informational purposes only and should not be considered legal advice.

Whistleblowers Expose PNC Mortgage Fraud, Leading to $38M Settlement

PNC Financial Services agreed to pay $38 million to settle allegations of mortgage fraud involving military veterans, in a case filed by Wilbanks & Gouinlock on behalf of whistleblowers Victor Bibby and Brian Donnelly. The lawsuit revealed that PNC charged improper and illegal fees to veterans under a government-backed mortgage refinance program.

Veteran Loan Fraud Uncovered

The whistleblowers, both industry insiders, exposed how PNC engaged in mortgage fraud by tacking hidden fees onto VA-backed refinance loans—a direct violation of federal guidelines designed to protect veterans from financial exploitation.

Major Recovery in Mortgage Fraud Case

This $38 million settlement adds to the growing list of recoveries in a broader effort to stop PNC mortgage fraud and protect veteran borrowers. The case underscores the vital role of whistleblowers in holding major financial institutions accountable for deceptive lending practices.

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If you have information about fraudulent practices, contact our office for a free, confidential consultation:

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• Call (404) 842-1075, ext. 123 or 122.

This article is for informational purposes only and should not be considered legal advice.

Whistleblower Exposes Medicare Billing Violations at Saint Joseph’s, Leading to $26M Settlement

Saint Joseph’s Hospital of Atlanta agreed to pay $26 million to settle a whistleblower lawsuit filed by Tami Ramsey, a registered nurse and former hospital employee. The case alleged that Saint Joseph’s engaged in Medicare billing violations by improperly classifying patients as inpatient or outpatient, resulting in inaccurate and excessive claims submitted to the federal government.

Medicare Billing Violations Uncovered

Ms. Ramsey filed the case through Wilbanks & Bridges, alleging that Saint Joseph’s failed to follow Medicare regulations that determine whether a patient’s status should be classified as inpatient or outpatient. These Medicare billing violations led to improper reimbursements and triggered federal scrutiny.

Corporate Integrity Agreement and Major Settlement

As part of the $26 million settlement, Saint Joseph’s Hospital was also required to enter into a Corporate Integrity Agreement with the U.S. government. This case marks a significant accountability win in combating Medicare billing violations, thanks to the efforts of a dedicated healthcare whistleblower.

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If you have information about fraudulent practices, contact our office for a free, confidential consultation:

• Fill out our consultation form by clicking here.
• Email us at info@wilbanksgouinlock.com.
• Call (404) 842-1075, ext. 123 or 122.

This article is for informational purposes only and should not be considered legal advice.

Whistleblower Exposes Shands Hospital Overbilling, Leading to $26M Settlement

Wilbanks & Gouinlock (W&G) successfully prosecuted a qui tam lawsuit against Shands Healthcare in Florida, resulting in a $26 million settlement. The case alleged that Shands improperly billed Medicare and Medicaid by admitting patients for inpatient care when outpatient treatment was medically appropriate—a scheme designed to collect higher reimbursements from the government.

Inpatient vs. Outpatient Billing Abuse

At the heart of the case were medical necessity violations, where Shands routinely admitted patients unnecessarily to maximize profits. These outpatient overbilling practices led to a $22 million settlement related to improper inpatient admissions, and an additional $3 million was recovered for outpatient billing fraud.

Major Win in Outpatient Overbilling Case

This case remains a landmark example of outpatient overbilling, underscoring the critical role whistleblowers play in protecting public healthcare funds. The Shands Hospital settlement sends a clear message that fraudulent billing practices will not be tolerated.

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• Email us at info@wilbanksgouinlock.com.
• Call (404) 842-1075, ext. 123 or 122.

This article is for informational purposes only and should not be considered legal advice.

Whistleblower Lawsuit Exposes Loan Certification Fraud, Leading to $16M Settlement

Wilbanks & Gouinlock filed a whistleblower lawsuit involving serious allegations of loan certification fraud. The case centered on a lender that fraudulently bundled and concealed financial information, leading the government to guarantee loans under false pretenses. These guarantees were based on certifications that the lender claimed were accurate—when in fact, they were not.

Government Misled by Fraudulent Certifications

As a result of the loan certification fraud, the U.S. government incurred significant financial losses. The certifications provided by the lender were knowingly false, causing federal loan guarantees to be issued on high-risk or misrepresented loans.

Loan Certification Fraud Settlement

Thanks to the efforts of Wilbanks & Gouinlock, the case was successfully resolved with a $16 million settlement. This outcome underscores the importance of whistleblower actions in identifying and exposing loan certification fraud that threatens public funds.

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If you have information about fraudulent practices, contact our office for a free, confidential consultation:

• Fill out our consultation form by clicking here.
• Email us at info@wilbanksgouinlock.com.
• Call (404) 842-1075, ext. 123 or 122.

This article is for informational purposes only and should not be considered legal advice.

Whistleblowers Expose Citi Mortgage Fraud, Leading to $7.5M Settlement

Wilbanks & Gouinlock filed a whistleblower lawsuit on behalf of clients with insider knowledge of illegal lending practices at Citi Mortgage. The suit alleged that Citi Mortgage defrauded the government by failing to follow federal rules governing refinance loans for military veterans. These violations resulted in improper treatment of veterans and financial harm to taxpayers.

Military Veterans Targeted by Mortgage Fraud

The whistleblowers provided substantial evidence showing that Citi Mortgage knowingly violated regulations designed to protect military veterans. These Citi Mortgage fraud practices included the mishandling of refinance loans backed by government guarantees, leading to widespread noncompliance and financial abuse.

Citi Mortgage Fraud Settlement

The case was resolved with a $7.5 million settlement, holding Citi accountable for its misconduct. As a result, thousands of veterans were made aware of these deceptive lending practices. This case stands as a major win in the fight against Citi Mortgage fraud, and it highlights the power of whistleblowers in exposing illegal activity within the lending industry. Read more about this settlement here.

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If you have information about fraudulent practices, contact our office for a free, confidential consultation:

• Fill out our consultation form by clicking here.
• Email us at info@wilbanksgouinlock.com.
• Call (404) 842-1075, ext. 123 or 122.

This article is for informational purposes only and should not be considered legal advice.

Whistleblower Exposes Memorial Health Overpayments, Leading to $5.08M Settlement

Memorial Health agreed to pay $5.08 million to resolve allegations that it paid excessive fees to physicians, well above fair market value, in violation of federal law. The whistleblower lawsuit, filed by Wilbanks & Gouinlock (W&G) on behalf of a physician with insider knowledge, revealed a pattern of improper physician compensation in the Savannah, Georgia area.

Improper Financial Incentives Uncovered

The whistleblower, a local physician, discovered that Memorial Health was offering illegal financial incentives to other doctors in exchange for patient referrals. These payments exceeded what is legally allowed and violated the Stark Law, which prohibits hospitals from compensating physicians in ways that could influence referral decisions.

Major Recovery in Improper Physician Compensation Case

The improper physician compensation scheme led to a $5.08 million government recovery, reinforcing the serious consequences of violating federal healthcare laws. This case is a strong example of how whistleblowers play a crucial role in uncovering and stopping improper physician compensation practices that compromise healthcare integrity.

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If you have information about fraudulent practices, contact our office for a free, confidential consultation:

• Fill out our consultation form by clicking here.
• Email us at info@wilbanksgouinlock.com.
• Call (404) 842-1075, ext. 123 or 122.

This article is for informational purposes only and should not be considered legal advice.

Whistleblower Exposes Resurgens Surgery Center Fraud, Leading to $3.8M Settlement

Resurgens Surgery Center agreed to pay $3.8 million to settle allegations of anesthesia billing fraud and Medicare and Medicaid overbilling. The case was brought by Wilbanks & Gouinlock (W&G) on behalf of a former employee who had direct access to internal records critical to proving the fraud.

Anesthesia Billing Fraud Uncovered

The whistleblower uncovered that Resurgens Surgery Center had engaged in billing fraud by submitting improper claims for anesthesia services that were either unnecessary, improperly documented, or inaccurately coded. These false claims led to overpayments from both Medicare and Medicaid.

Key Victory in Billing Fraud Case

Thanks to the whistleblower’s evidence, the government was able to recover $3.8 million, sending a clear message about the consequences of billing fraud. This case highlights the importance of insider knowledge in uncovering healthcare billing schemes and holding providers accountable. Read more about this case here.

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If you have information about fraudulent practices, contact our office for a free, confidential consultation:

• Fill out our consultation form by clicking here.
• Email us at info@wilbanksgouinlock.com.
• Call (404) 842-1075, ext. 123 or 122.

This article is for informational purposes only and should not be considered legal advice.

Whistleblower Lawsuit Recovers $2.2M in Veteran Loan Fraud Case

Wilbanks & Gouinlock filed a whistleblower lawsuit to recover funds lost by taxpayers due to veteran loan fraud. The case involved allegations that a lender violated federal rules while issuing government-backed refinance loans to military veterans—ultimately causing the government to guarantee risky or improperly certified loans.

Taxpayer Funds Misused in Veteran Loan Program

The whistleblowers alleged that improper practices by the lender led to the misuse of taxpayer-backed loan guarantees. These violations contributed to financial losses under the veteran lending program and revealed deeper issues of veteran loan fraud in the system.

Veteran Loan Settlement

The case was resolved with a $2.2 million settlement, holding the lender accountable for its misconduct. This outcome marks another important step in addressing veteran loan fraud and protecting programs intended to serve those who have served our country. Learn more about this lawsuit here.

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If you have information about fraudulent practices, contact our office for a free, confidential consultation:

• Fill out our consultation form by clicking here.
• Email us at info@wilbanksgouinlock.com.
• Call (404) 842-1075, ext. 123 or 122.

This article is for informational purposes only and should not be considered legal advice.