Investigations
Every investigation we've published, newest first — each one built on primary documents and classified under our evidence standard.
Institutions — 17 June 2024 — 7 min read
An HHS investigation found that NextCare Urgent Care had systematically submitted claims to Medicare and Medicaid at evaluation and management code levels higher than patient encounter complexity supported — a upcoding practice that generated millions in overpayments and resulted in False Claims Act liability for the urgent care chain.
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Institutions — 14 June 2024 — 6 min read
The DOJ alleged Fidelis Care New York submitted unsupported diagnosis codes and inaccurate risk adjustment data to inflate the per-member-per-month payments it received from the state and federal Medicaid program.
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Fraud & Deception — 12 June 2024 — 7 min read
The DOJ and SEC charged Outcome Health and its founders with wire fraud and securities fraud after finding the company billed pharmaceutical clients for advertising on clinic screens it had not installed, then raised hundreds of millions from investors on the basis of inflated performance metrics.
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Fraud & Deception — 10 June 2024 — 7 min read
Covenant Auto Warranty Group placed millions of illegal prerecorded calls implying affiliation with vehicle manufacturers, sold service contracts with coverage terms far narrower than the sales pitch described, and received a permanent industry ban.
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Institutions — 6 June 2024 — 7 min read
HHS found Concentra Health Services had failed to implement encryption on laptop computers containing protected health information for thousands of patients — a risk assessment failure that resulted in a breach of 870,000 patient records when an unencrypted laptop was stolen, and a $1.725 million HIPAA resolution agreement.
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Corporations — 4 June 2024 — 6 min read
The EPA cited Heritage Crystal Clean for Resource Conservation and Recovery Act violations in the management of hazardous waste generated by its industrial parts cleaning services at customer facilities, finding the company's handling, storage, and disposal practices did not meet federal hazardous waste regulations.
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Fraud & Deception — 3 June 2024 — 7 min read
The SEC charged SMC Global Securities and its principals with coordinated trading that created artificial price and volume in penny stocks on behalf of undisclosed promoter clients — allowing insiders to sell shares into the inflated market while retail investors on the other side of those trades bore the losses when the manipulation ended.
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Institutions — 28 May 2024 — 7 min read
The FDA recall of Exactech orthopedic implant components covered approximately 147,000 devices worldwide after the company disclosed a packaging defect that allowed oxygen infiltration, accelerating polyethylene insert oxidation and dramatically increasing the risk of premature component failure requiring revision surgery.
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Institutions — 22 May 2024 — 7 min read
Continuum Rx paid physicians under consulting and data-sharing agreements whose amounts correlated with prescription referrals rather than genuine advisory services. A whistleblower complaint and $15.4 million settlement followed.
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Corporations — 22 May 2024 — 6 min read
The SEC found that National Western Life's variable annuity disclosures materially understated the cost to customers of maintaining the products over time, including surrender charges and ongoing fee structures that were described in ways the agency concluded were misleading to retail investors.
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Corporations — 22 May 2024 — 7 min read
Vroom, the online used-car retailer, listed vehicles with condition descriptions and financing terms that did not match what customers actually received — a pattern regulators said constituted deceptive trade practices affecting thousands of buyers.
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Corporations — 15 May 2024 — 7 min read
Before anyone signs a franchise agreement, federal law requires a specific disclosure document. Regulators say one seller of computer display rack franchises simply never provided it.
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