The Lincoln Law and the Contagion of Deceit: A Practitioner’s Journey into the Systemic Nature of Corporate Fraud

Introduction: The Whack-a-Mole Problem

For one practitioner, a litigator specializing in whistleblower cases, the journey from idealism to a new understanding of corporate fraud began with a case that felt like a clear victory.

The client was a nurse, a person of immense integrity who had witnessed systematic upcoding and billing for services never rendered at the hospital where she worked.

The case was a textbook example of a qui tam lawsuit under the False Claims Act.

After months of meticulous work, the outcome was a success: a significant financial recovery for the government and a substantial, life-changing award for the nurse who had risked her career to do the right thing.

It felt like a dragon had been slain, a small piece of justice restored to the system.

Eighteen months later, that feeling of triumph evaporated with a single phone call.

The caller was another employee from the very same hospital, describing an almost identical fraud scheme flourishing in a different department.

The victory had not cured the disease; it had merely treated a single, visible symptom.

The fraud, it seemed, was a game of whack-a-mole.

Cutting off one head did nothing to stop another from emerging.

This heartbreaking realization forced a fundamental question that would reshape a career.

Was corporate fraud merely the work of isolated “bad apples,” a collection of individual moral failures that could be rooted out one by one? Or was there something deeply wrong with the “barrel” itself—a systemic sickness within the organization that made such behavior not just possible, but predictable? The search for an answer revealed that the traditional legal framework for understanding fraud was incomplete.

A new paradigm was needed, one that viewed fraud not as a series of discrete crimes, but as a contagious disease, spreading through organizations with predictable, and preventable, patterns.

Part I: The Anatomy of the Pathogen – Deconstructing the False Claim

To understand the disease, one must first understand the pathogen.

The primary legal instrument for combating fraud against the United States government is the False Claims Act (FCA), a law with deep historical roots and profound modern relevance.

The Lincoln Law: A Civil War Remedy for Modern Corruption

The FCA is often called the “Lincoln Law” for good reason.

It was enacted in 1863 during the American Civil War to combat rampant fraud by contractors who were selling the Union Army defective rifles, sick mules, and rotten rations.¹

Its original purpose—to protect the integrity of government spending during a time of national crisis—remains its core function today.⁴

The modern FCA imposes staggering civil liability on those who defraud the government, mandating penalties of three times the government’s actual damages, plus additional penalties for each false claim submitted, which are linked to inflation.³

This powerful deterrent applies to a wide spectrum of misconduct, far beyond simple false billing.⁶

The “Knowing” Standard: A Trap for the Reckless, Not Just the Malicious

Central to any FCA case is the requirement that the defendant acted “knowingly.” However, the law defines this term far more broadly than its everyday meaning might suggest.

Specific intent to defraud the government is not required.⁶

Instead, under 31 U.S.C. § 3729(b)(1), “knowingly” is established by proving any one of three distinct mental states ⁶:

1. Actual Knowledge: This is the most straightforward prong. The person has direct, actual knowledge that the information or claim is false. For example, a physician bills Medicare for a patient visit she knows never occurred.⁷
2. Deliberate Ignorance: Often called the “ostrich” defense, this applies when a person consciously avoids learning the truth. A classic example is a billing department manager who hears credible rumors that his team is fabricating invoices but intentionally refuses to conduct an audit because he does not want to confirm the wrongdoing.⁶
3. Reckless Disregard: This is the most nuanced and systemically important standard. It captures conduct that is a gross deviation from the standard of care, where a person acts with such carelessness concerning the truth or falsity of the information that their actions are deemed reckless. This does not require any intent to defraud, only a failure to make a reasonable inquiry when red flags are present.⁶

The legal architecture of the “knowing” standard is more than just a set of liability triggers; it is a diagnostic for organizational pathology.

The inclusion of “deliberate ignorance” and “reckless disregard” is a legislative acknowledgment that pervasive fraud often arises not from a single, malicious actor, but from profound systemic dysfunction.

Proving “reckless disregard” is often equivalent to proving the existence of a broken system—one that lacks the necessary controls, training, or oversight to prevent such carelessness.

“Deliberate ignorance” points directly to a failure of leadership and a culture where turning a blind eye is implicitly encouraged.⁹

The law itself guides practitioners to look beyond individual culprits and examine the systemic conditions that allow fraud to fester.

Materiality: The Lie That Matters

Not every falsehood is legally actionable.

To violate the FCA, a false statement must be “material,” meaning it has “a natural tendency to influence, or be capable of influencing, the payment or receipt of money or property” by the government.²

This requirement ensures that the law targets significant deceptions that could actually affect the government’s decision to pay a claim.¹

This standard was complicated by the Supreme Court’s decision in Universal Health Services, Inc. v.

U.S. ex rel.

Escobar.

The Court stated that if the government pays a particular claim in full despite having actual knowledge that certain requirements were violated, it is “very strong evidence” that those requirements are not material.²

This created a potential defense where companies could argue that the government’s continued payment, despite knowing of non-compliance, effectively rendered the falsehood immaterial.

This highlights a persistent tension between strict technical compliance and the overarching purpose of anti-fraud statutes.

The Spectrum of Fraud: From Overbilling to Reverse False Claims

The FCA’s reach is broad, covering a wide array of schemes across numerous industries.

The most common involve healthcare (e.g., billing Medicare or Medicaid for unnecessary services or services not rendered), defense contracting (e.g., providing substandard goods or inflating costs), and general procurement fraud.¹

A critical but often overlooked provision covers “reverse false claims.” This occurs when a person knowingly uses a false statement or record to avoid or decrease an obligation to pay money to the government.⁴

For example, a hospital that received overpayments from Medicare and then knowingly files a false cost report to avoid having to make a refund would be liable under this provision.⁷

Similarly, an importer who knowingly undervalues goods on a customs declaration to pay lower duties is committing a reverse false claim.⁴

This demonstrates the law’s comprehensive design to protect the Treasury from both fraudulent payments and fraudulent underpayments.

Table 1: The False Claims Act at a Glance
Key Provision	Legal Definition/Standard (31 U.S.C. § 3729)	Plain-English Example
False Claim	Knowingly presenting, or causing to be presented, a false or fraudulent claim for payment or approval.8	A defense contractor bills the Army for 100 helmets but only delivers 80.
False Record or Statement	Knowingly making, using, or causing to be made or used, a false record or statement material to a false or fraudulent claim.8	A lab technician falsifies test results to justify a medically unnecessary but expensive procedure billed to Medicare.
“Knowing” Standard: Actual Knowledge	The person has actual knowledge of the information’s falsity.8	A CEO signs and submits a grant report that she personally knows contains fabricated data.
“Knowing” Standard: Deliberate Ignorance	The person acts in deliberate ignorance of the truth or falsity of the information.8	A manager is told his billing department has “irregularities” but refuses to authorize an audit because he doesn’t want to find out.
“Knowing” Standard: Reckless Disregard	The person acts in reckless disregard of the truth or falsity of the information.8	A company has no system to verify invoices from a subcontractor known for overbilling, and it pays them without question.
Materiality	Having a natural tendency to influence, or be capable of influencing, the payment or receipt of money or property.6	A contractor falsely certifies it used U.S.-made steel, a specific and non-negotiable requirement for payment under the contract.
Reverse False Claim	Knowingly making a false statement to conceal, avoid, or decrease an obligation to pay money to the government.8	A company underreports its taxable income to the IRS to pay less in taxes.3
Penalties	Treble damages (3x the government’s loss) plus a civil penalty (e.g., $5,000-$10,000, adjusted for inflation) per false claim.5	If a company defrauds the government of $1 million, it could be liable for $3 million plus penalties for every single false invoice.
Statute of Limitations	Generally, within 6 years of the violation or 3 years after the government knew or should have known about it, not to exceed 10 years.1	A fraud committed in 2020 must typically be sued upon by 2026.

Part II: The Vulnerable Host – Why Organizations Get Sick

The False Claims Act describes the pathogen, but a pathogen needs a vulnerable host to thrive.

The “whack-a-mole” problem arises because legal actions often target the manifestation of the disease without addressing the underlying conditions within the organization that make it susceptible to infection.

The Compromised Immune System: Failures of Governance and Internal Controls

Fraud takes root where an organization’s immune system—its governance and internal controls—is compromised.

This breakdown often starts at the top, with ineffective board oversight, a lack of independence in audit committees, and senior management that fails to champion ethical principles.⁹

These leadership failures create the “opportunity” described in the classic fraud triangle model, leaving the organization vulnerable.¹¹

Many companies point to internal reporting mechanisms, like anonymous hotlines, as evidence of a healthy system.

However, these are often an illusion of security.

Employees frequently do not use them for fear of retaliation, or because they question the system’s confidentiality and independence.¹²

When reports are made, they often result in no meaningful action, breeding cynicism.¹²

The data is stark: one study found that over 90% of corporate whistleblower retaliation cases filed under major statutes like Sarbanes-Oxley and Dodd-Frank stemmed from employees who first tried to report the misconduct

internally.¹⁴

This creates a perverse disincentive, punishing those who try to use the prescribed channels and teaching others that silence is the safest option.

The Cultural Petri Dish: Unethical Pro-Organizational Behavior (UPB)

Beyond weak controls, a specific cultural element can actively cultivate fraud: Unethical Pro-Organizational Behavior (UPB).

This academic term describes “actions that are intended to promote the effective functioning of the organization…and violate core societal values, norms, laws”.¹⁵

This is the psychological mechanism that allows employees to rationalize misconduct as a pro-social act done

for the company.

It is the sales team that exaggerates a product’s capabilities to land a crucial contract or the finance department that misrepresents figures to meet quarterly targets and boost stock prices.

This behavior is highly influenced by leadership.

Research demonstrates a significant positive correlation between a leader’s engagement in UPB and the same behavior in their employees.¹⁵

When managers model or implicitly condone cutting corners “for the good of the team,” they are not just committing a single unethical act; they are cultivating a fraudulent culture.

This effect is even stronger when employees have high “leader identification” and see their own identity as tied to their manager’s approval.¹⁵

The Social Contagion Effect: How Fraud Spreads

This leads to the central epiphany that solves the “whack-a-mole” puzzle: fraud is contagious.

The traditional “Fraud Triangle” model—Pressure, Opportunity, and Rationalization—is a useful but static snapshot.¹¹

It explains why one person might commit fraud at one point in time, but it fails to explain how fraud becomes a pervasive, department-wide, or even company-wide phenomenon.

The missing dynamic element is

Transmission.

A more accurate framework is a “Fraud Epidemic Model,” which views the spread of misconduct through an epidemiological lens:

1. Susceptible Host: An organization with weak controls (Opportunity) and a high-pressure culture (Pressure).
2. Pathogen Introduction: An individual or small group commits an initial act of fraud—the “index case.”
3. Normalization and Rationalization: The act is justified using UPB logic (“We have to do this to save the company/make our numbers”). This serves as the Rationalization component.
4. Transmission: The behavior spreads to others through social contagion. Peers observe that the behavior is tolerated or even rewarded and begin to imitate it.¹⁸ This occurs through direct peer influence, especially in cohesive work groups, and through the “ambient impact” of a climate where misconduct becomes normalized.¹⁹

This model explains why simply removing one “bad apple” is futile.

The litigator in the opening story removed an infected individual, but the organizational environment remained contaminated.

The pressures were the same, the weak controls persisted, and the culture that normalized the behavior was unchanged.

The disease of fraud simply found a new host.

The focus must shift from asking “Why did this person do this?” to “What are the transmission vectors in this organization, and how do we interrupt them?”

Part III: The First Responders – The Whistleblower’s Story

When an organization’s internal immune system fails, the law provides for an external one.

The whistleblower, known in legal terms as a “relator,” acts as a first responder, a courageous but vulnerable T-cell exposing a sickness the body cannot cure on its own.

The Qui Tam Provision: A Private Army Against Public Fraud

The FCA’s most powerful feature is its qui tam provision, which empowers private citizens to act as a private army against public fraud.⁶

The term derives from a Latin phrase,

qui tam pro domino rege quam pro se ipso in hac parte sequitur, meaning “he who sues for the king as well as for himself”.¹

The process is unique.

A relator with non-public, original information about fraud against the government files a lawsuit in the name of the United States.¹⁰

To protect the investigation, the complaint is filed

in camera (under seal) and is not served on the defendant.

It remains sealed for at least 60 days, though this period is often extended, giving the Department of Justice (DOJ) time to investigate the allegations without tipping off the target.¹

The DOJ then decides whether to intervene and take over the primary prosecution of the case.

If the government intervenes and the case is successful, the relator is entitled to a share of the recovery, typically between 15% and 25%.⁷

If the government declines to intervene, the relator has the right to pursue the case on their own.

If they succeed, their share can be as high as 30% of the recovery.²³

This financial incentive is an explicit and crucial part of the law’s design, created to motivate individuals with inside knowledge to accept the profound risks of coming forward.³

The Price of a Conscience: The Brutal Reality of Retaliation

The decision to blow the whistle comes at an immense personal cost.

These individuals are not merely filing a lawsuit; they are often detonating their careers and personal lives.

Whistleblowers routinely face professional isolation, smear campaigns, harassment, demotion, and ultimately, termination.²⁴

Statistics confirm this reality, with one survey indicating that 22% of employees who reported misconduct experienced some form of retaliation.²⁶

The psychological toll is devastating.

Research has shown that whistleblowers suffer from severe anxiety, depression, and post-traumatic stress disorder (PTSD) at rates comparable to or even exceeding those of cancer patients or individuals with work disabilities.²⁷

They are often ostracized by former colleagues and may find their personal support networks strained, as family and friends must also live with the consequences of their decision.²⁴

The very existence of the FCA’s robust qui tam framework is a tacit admission by the legal system that corporate self-governance has failed.

A healthy organization with a strong ethical culture and effective internal reporting mechanisms would identify and resolve these issues internally.

The fact that an employee feels their only recourse is a high-stakes, high-risk federal lawsuit is a clinical sign that the organization’s internal immune system is either non-existent or actively hostile to the truth.

The presence of a qui tam relator is more than a legal event; it is a biopsy revealing a deep-seated malignancy within the corporate body.

The whistleblower’s courage is a direct measure of the organization’s dysfunction.

The Shield of the Law: Anti-Retaliation Protections

Recognizing these immense risks, the FCA includes a powerful anti-retaliation provision.

Under 31 U.S.C. § 3730(h), any employee, contractor, or agent is protected from being “discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against” because of lawful acts done in furtherance of an FCA action.⁶

If retaliation is proven, the remedies are designed to make the whistleblower whole.

They can include reinstatement to their position with full seniority, two times the amount of back pay plus interest, and compensation for any special damages sustained, such as litigation costs and emotional distress.⁶

Cases like that of Carla LeBlanc, a nurse allegedly fired after criticizing her hospital’s unsafe staffing levels on a podcast, illustrate how these protections are invoked to defend healthcare professionals who speak out on matters of patient safety and potential fraud.²⁹

Table 2: The Whistleblower’s Journey – Risks vs. Rewards
The Potential Rewards (The Incentive to Speak)	The Inevitable Risks (The Price of Speaking)
Financial Award: A share of 15-30% of the total government recovery, which can be millions of dollars.7	Job Loss & Blacklisting: Termination is a common form of retaliation, and whistleblowers may find it difficult to find work in their field again.24
Anti-Retaliation Remedies: Legal recourse for reinstatement, double back pay with interest, and other damages if retaliation is proven.6	Professional Isolation: Ostracized by colleagues and superiors, leading to feelings of alienation and powerlessness.25
Professional & Moral Vindication: The satisfaction of stopping illegal and often harmful conduct, protecting taxpayers, and upholding the law.1	Smear Campaigns & Legal Battles: Employers may launch retaliatory investigations or expensive defamation lawsuits to discredit the whistleblower.24
Protecting Public Good: Whistleblowers are critical to uncovering fraud that harms public programs like Medicare and endangers public safety.3	Severe Psychological & Emotional Stress: Documented high rates of anxiety, depression, and PTSD, comparable to those of cancer patients.27
	Impact on Family: The financial and emotional strain extends to loved ones, who must also live with the consequences.24

Part IV: The Public Health Crisis – Measuring the Epidemic

Zooming out from the individual organization reveals a public health crisis of staggering proportions.

The fraud visible to the public is only a small fraction of the true problem.

The Hidden Iceberg: The Pervasiveness of Undetected Fraud

Official statistics on fraud enforcement can be dangerously misleading.

They only measure what has been found, not what is there.

Groundbreaking academic research has provided a more realistic estimate by using the 2002 collapse of accounting giant Arthur Andersen as a natural experiment.³²

When former AA clients were forced to hire new auditors, they came under intense and sudden scrutiny.

This led to a dramatic spike in the detection of pre-existing frauds.

By comparing the detection rate for this group against a control group, researchers came to a shocking conclusion: in normal times, only about one-third of corporate frauds are ever detected.³²

This means that for every fraud case that makes the news, two others continue to operate in the shadows, completely unseen.

Extrapolating from this data, studies estimate that at any given time, approximately

10% to 11% of all large, publicly-traded U.S. corporations are actively committing securities fraud.³²

This “iceberg” reality completely reframes public enforcement data.

The DOJ’s announcement of recovering $2.68 billion from fraud cases in fiscal year 2023, with whistleblowers responsible for $2.3 billion of that, is certainly impressive.³

However, if these recoveries represent only the one-third of fraud that is detected, the true scale of the problem is astronomically larger.

The DOJ’s press releases are akin to a city hospital boasting about the number of flu patients it has treated, while ignoring the vast, silent epidemic raging outside its walls.

The statistics on

enforcement are a poor proxy for the prevalence of the disease.

The Staggering Economic Toll: A Multi-Billion Dollar Drain

The economic consequences of this hidden epidemic are immense.

When the pervasiveness of fraud is combined with the per-firm cost of discovery (which includes reputational damage and drops in equity value), the total annual cost of corporate fraud in the United States is estimated to be in the hundreds of billions of dollars.

One recent study calculated the 2021 price tag to be as high as $830 billion.³³

This is not a victimless crime; it is a massive, hidden tax on the entire economy, ultimately borne by investors, consumers, and taxpayers.

Despite these costs, the FCA has proven to be an effective tool for recovery.

Since its modernization in 1986, the law has been used to recover over $70 billion for U.S. taxpayers.¹

Focus on a Hot Zone: The Healthcare Fraud Epidemic

Nowhere is the fraud epidemic more virulent than in the healthcare sector.

With total U.S. healthcare spending approaching $5 trillion annually, the sector is a prime target.³⁵

Conservative estimates place annual losses due to healthcare fraud at 3% of total expenditures, or over $100 billion, while some government agencies believe the figure could be as high as 10%, or more than $300 billion per year.³¹

These losses translate directly into higher insurance premiums, reduced benefits, and, most disturbingly, unnecessary and potentially harmful medical procedures performed on patients for profit.³¹

The DOJ’s 2025 National Health Care Fraud Takedown serves as a stark case study.

The coordinated effort resulted in charges against 324 defendants for their alleged roles in schemes totaling over $14.6 billion in intended losses—more than double the prior record.³⁸

These schemes spanned the industry, from massive telemedicine and genetic testing frauds to illegal opioid distribution and scams involving durable medical equipment.³⁸

To ground these staggering numbers in human terms, consider the case of Dr. Ajay Aggarwal, a pain medicine doctor who agreed to pay over $2 million to settle allegations that he billed Medicare for surgical implants he never actually performed.⁴¹

In response, government agencies like the DOJ and the Department of Health and Human Services (HHS) have established a “Fusion Center” to leverage advanced data analytics for proactive fraud detection.³⁹

By mining vast datasets of claims, these systems can identify statistical anomalies and billing patterns that deviate from the norm.⁴³

While powerful, this approach presents a new challenge: the algorithms detect outliers, not necessarily fraudulent intent.

This means that providers with legitimate but unusual patient populations or innovative care models may be flagged for investigation, highlighting the ongoing tension between enforcement and the complexities of medical practice.⁴³

Part V: The Systemic Cure – An Epidemiological Approach to Corporate Integrity

The diagnosis is clear: corporate fraud is a systemic, contagious disease.

The treatment, therefore, cannot be a simple, case-by-case legal remedy.

It requires a fundamental shift in perspective—from a reactive, punitive model to a proactive, public health model focused on prevention and organizational immunity.

Beyond Whack-a-Mole: From Retribution to Inoculation

The “whack-a-mole” experience that began this journey reveals the profound limitations of a purely legalistic approach.

It is like treating sick patients one by one without ever addressing the contaminated water supply that is making them Ill. The goal must be to build organizations that are resistant to the disease in the first place.

This requires applying systems thinking—a holistic approach that examines the interconnectedness of all parts of an organization, including its culture, controls, incentives, and leadership.⁴⁴

Rather than simply punishing a failure, this approach seeks to identify the high-leverage points within the system where a small intervention can produce a lasting, positive change, thereby inoculating the organization against future outbreaks.⁴⁶

A Prescription for a Healthy Organization: The Three Pillars of Prevention

A systemic, epidemiological approach to corporate integrity rests on three core pillars designed to build a robust organizational immune system.

Pillar 1: Fortifying the Immune System (Dynamic Controls & Risk Assessment)

This pillar moves compliance beyond a static, check-the-box mentality.

Organizations must implement dynamic risk assessment processes that are constantly searching for emerging threats and mapping vulnerabilities across the enterprise in real-time.47 Internal controls must be adaptive, not rigid.

This means leveraging the same technologies used by fraudsters and enforcers, such as artificial intelligence and machine learning, to detect anomalous patterns and red flags long before they escalate into catastrophic losses.48

Pillar 2: Cultural Vaccination (Ethical Leadership & Psychological Safety)

This is the most critical pillar, as culture is the medium in which the fraud pathogen either thrives or dies.

It begins with an unwavering commitment from leadership to model and enforce ethical conduct.47 The single most effective preventative measure an organization can take is to cultivate

psychological safety—an environment where employees feel empowered to speak up, ask questions, and report concerns without any fear of retaliation.⁵⁰

Data shows that for every unit increase in measured psychological safety, the likelihood that an employee will report misconduct increases by 2.4 times.⁵⁰

This is the true antidote to the failed internal hotlines and the culture of fear.

It also requires aligning incentives by tying compensation and promotion not just to financial performance, but to ethical behavior and risk management.³⁷

Pillar 3: Proactive Surveillance (Intelligent Internal Data Use)

This pillar involves turning the government’s enforcement tools inward for the purpose of prevention.

By using internal data analytics to monitor for the same kinds of anomalies the DOJ looks for, an organization can get ahead of problems.43 The crucial difference in mindset is this: when a department shows a spike in high-cost billing codes, the first question should not be, “Who is committing fraud?” but rather, “What pressure, incentive, or weakness in our system is causing this pattern to emerge?” This transforms data from a tool for punishment into a diagnostic for identifying and treating systemic stress before it becomes malignant.

Table 3: A Systems-Based Fraud Prevention Framework
Common Systemic Failure (The Symptom)	Traditional Reaction (The Ineffective Treatment)	Systemic Intervention (The Inoculation)
Intense pressure from leadership to meet aggressive quarterly financial targets.	Punish or terminate lower-level managers and employees who fail to meet the targets.	Restructure compensation to reward long-term value creation and ethical conduct; publicly celebrate leaders who achieve goals without cutting corners.37
Employees are afraid to report bad news or potential compliance issues.	Promote the “anonymous” internal hotline while punishing those who are identified as raising difficult issues.14	Actively build and measure psychological safety as a key leadership metric; reward managers whose teams identify and resolve issues openly.50
A major control failure occurs in one business unit, leading to significant losses.	Fire the head of the responsible unit and implement stricter, more rigid controls in that silo alone.	Create a cross-functional risk committee to analyze the root cause and determine if similar vulnerabilities exist elsewhere in the enterprise.47
A new, fast-growing division is celebrated for its revenue but lacks compliance oversight.	Ignore potential risks as long as the division is profitable, addressing compliance only after a crisis emerges.	Embed compliance and risk assessment functions into the new division from day one; ensure its growth is sustainable and aligned with ethical standards.52

Conclusion: The End of Whack-a-Mole

The journey that began with a single, frustrating phone call led to a complete reframing of corporate fraud.

The initial view of a litigator—hunting individual wrongdoers one by one—has been replaced by the perspective of a diagnostician examining sick systems.

The “whack-a-mole” problem is not a sign of failure, but a symptom of a flawed model.

In this new light, the False Claims Act is transformed.

It is not merely a weapon for punishment but a powerful diagnostic tool.

A qui tam lawsuit is a biopsy, a tissue sample that reveals the nature and extent of the cancer within an organization.

It tells us not only that a problem exists, but where the internal immune system has failed.

The ultimate goal, therefore, cannot be simply to win more lawsuits or secure larger recoveries.

The true measure of success will be a reduction in the need for such lawsuits in the first place.

It is to use the knowledge gained from these painful biopsies to help build organizations that are so systemically healthy, so culturally robust, and so structurally sound that they are no longer hospitable environments for the disease of fraud.

The goal is to put the whack-a-mole mallet away for good.

Works cited

1. Understanding the Basics of Qui Tam Law – Federal Bar Association, accessed on August 12, 2025, https://www.fedbar.org/blog/understanding-the-basics-of-qui-tam-law/
2. Protect the False Claims Act – National Whistleblower Center, accessed on August 12, 2025, https://www.whistleblowers.org/protect-the-federal-false-claims-act/
3. False Claims Act: A Step-by-Step Whistleblower Guide, accessed on August 12, 2025, https://kkc.com/frequently-asked-questions/what-is-the-false-claims-act/
4. What is the False Claims Act? – National Whistleblower Center, accessed on August 12, 2025, https://www.whistleblowers.org/protect-the-false-claims-act/
5. The False Claims Act – Civil Division – Department of Justice, accessed on August 12, 2025, https://www.justice.gov/civil/false-claims-act
6. A Guide To The Federal False Claims Act | Whistleblower Law, accessed on August 12, 2025, https://www.whistleblowerllc.com/resources/whistleblower-laws/the-federal-false-claims-act/
7. The False Claims Act (“FCA”) provides, in pertinent part, that: (a) Any person who (1) knowingly presents, or causes – CMS, accessed on August 12, 2025, https://downloads.cms.gov/cmsgov/archived-downloads/smdl/downloads/smd032207att2.pdf
8. 31 U.S. Code § 3729 – False claims – Law.Cornell.Edu, accessed on August 12, 2025, https://www.law.cornell.edu/uscode/text/31/3729
9. (PDF) The Failure of Governance and Internal Controls in Preventing Fraud in the Company, accessed on August 12, 2025, https://www.researchgate.net/publication/389028482_The_Failure_of_Governance_and_Internal_Controls_in_Preventing_Fraud_in_the_Company
10. What is Qui Tam? A Guide for Whistleblowers, accessed on August 12, 2025, https://kkc.com/frequently-asked-questions/what-is-qui-tam/
11. Revisiting the Fraud Triangle in Corporate Frauds: Towards a Polygon of Elements – MDPI, accessed on August 12, 2025, https://www.mdpi.com/1911-8074/18/3/156
12. ROBUST INTERNAL REPORTING PROGRAMS – Basel Institute on Governance, accessed on August 12, 2025, https://baselgovernance.org/sites/default/files/2019-02/first_to_know_0.pdf
13. Full article: Strengthening Internal Reporting Systems: A Qualitative Study into the Role of Dutch Confidential Advisors – Taylor & Francis Online, accessed on August 12, 2025, https://www.tandfonline.com/doi/full/10.1080/10999922.2023.2251247
14. Internal Whistleblowers Make up Over 90% of Corporate Retaliation Cases, accessed on August 12, 2025, https://whistleblowersblog.org/corporate-whistleblowers/sec-whistleblowers/internal-whistleblowers-make-up-over-90-of-corporate-retaliation-cases/
15. The Contagion of Unethical Pro-organizational Behavior: From Leaders to Followers, accessed on August 12, 2025, https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2018.01102/full
16. (PDF) The Contagion of Unethical Pro-organizational Behavior: From Leaders to Followers, accessed on August 12, 2025, https://www.researchgate.net/publication/326151357_The_Contagion_of_Unethical_Pro-organizational_Behavior_From_Leaders_to_Followers
17. Liminality of Fraud: Reimagining Fraud Theory to Inform Financial Crime Prevention | The British Journal of Criminology | Oxford Academic, accessed on August 12, 2025, https://academic.oup.com/bjc/article/65/3/618/7831281
18. The Contagion of Unethical Behavior and Social Learning: An Experimental Study – PMC, accessed on August 12, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC9951996/
19. From Bad to Worse: A Social Contagion Model of Organizational Misbehavior | Request PDF, accessed on August 12, 2025, https://www.researchgate.net/publication/228181756_From_Bad_to_Worse_A_Social_Contagion_Model_of_Organizational_Misbehavior
20. Is Fraud Contagious? Career Networks and Fraud by Financial Advisors – Federal Reserve Bank of New York, accessed on August 12, 2025, https://www.newyorkfed.org/medialibrary/media/research/conference/2015/econ_culture/Dimmock_Gerken_Graham.pdf
21. AN OVERVIEW OF “QUI TAM” ACTIONS – Federal Law Enforcement Training Centers, accessed on August 12, 2025, https://www.fletc.gov/sites/default/files/imported_files/training/programs/legal-division/downloads-articles-and-faqs/research-by-subject/civil-actions/quitam.pdf
22. 31 US Code § 3730 – Civil actions for false claims | US Law | LII, accessed on August 12, 2025, https://www.whistleblowers.org/wp-content/uploads/2018/11/31u.s.code3730.pdf
23. False Claims Act | Wex – Law.Cornell.Edu, accessed on August 12, 2025, https://www.law.cornell.edu/wex/false_claims_act
24. Whistleblower Survival Tips, accessed on August 12, 2025, https://whistleblower.house.gov/whistleblower-survival-tips
25. Common Challenges Often Faced By Whistleblowers – Bartz Law Group, accessed on August 12, 2025, https://bartzlawgroup.com/common-challenges-faced-by-whistleblowers/
26. The Rise of Retaliation: Whistleblowing’s Ugly Sidekick, accessed on August 12, 2025, https://www.caseiq.com/resources/the-rise-of-retaliation-whistleblowings-ugly-sidekick/
27. Mental Health Problems Among Whistleblowers: A Comparative Study – PMC, accessed on August 12, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC6604402/
28. False Claims Act Retaliation Lawyers – Katz Banks Kumin LLP, accessed on August 12, 2025, https://katzbanks.com/practice-areas/whistleblower-law/false-claims-act-retaliation/
29. Nurse Fired After Podcast Criticizing Employer — Sues Hospital for Retaliation, accessed on August 12, 2025, https://nurse.org/news/nurse-carla-leblanc-whistleblower-lawsuit/
30. GAPS AND DISPARITIES IN WHISTLEBLOWER LAW – House.gov, accessed on August 12, 2025, https://whistleblower.house.gov/sites/evo-subsites/whistleblower-evo.house.gov/files/Gaps_and_Disparities_in_Whistleblower_Law.pdf
31. The Challenge of Health Care Fraud – NHCAA, accessed on August 12, 2025, https://www.nhcaa.org/tools-insights/about-health-care-fraud/the-challenge-of-health-care-fraud/
32. HOW PERVASIVE IS CORPORATE FRAUD? Alexander Dyck University of Toronto Adair Morse University of California at Berkeley & NB, accessed on August 12, 2025, http://faculty.haas.berkeley.edu/morse/research/papers/DyckMorseZingalesPervasive.pdf
33. Adair Morse How Pervasive is Corporate Fraud? – NYU Law, accessed on August 12, 2025, https://www.law.nyu.edu/sites/default/files/upload_documents/Adair%20Morse%20How%20Pervasive%20is%20Corporate%20Fraud.pdf
34. Frequency of Observed Corporate Fraud. We plot the prevalence rates of… – ResearchGate, accessed on August 12, 2025, https://www.researchgate.net/figure/Frequency-of-Observed-Corporate-Fraud-We-plot-the-prevalence-rates-of-corporate-fraud_fig1_366895086
35. Health Care Fraud Costs Billions Every Year. AI Can Help Fix This. | Darden Ideas to Action, accessed on August 12, 2025, https://ideas.darden.virginia.edu/artificial-intelligence-healthcare-fraud
36. Understand healthcare fraud in the U.S. – Thomson Reuters Legal Solutions, accessed on August 12, 2025, https://legal.thomsonreuters.com/en/insights/infographics/healthcare-fraud-in-the-us
37. What Should Health Care Organizations Do to Reduce Billing Fraud and Abuse?, accessed on August 12, 2025, https://journalofethics.ama-assn.org/article/what-should-health-care-organizations-do-reduce-billing-fraud-and-abuse/2020-03
38. National Health Care Fraud Takedown Results in 324 Defendants Charged in Connection with Over $14.6 Billion in Alleged Fraud – Department of Justice, accessed on August 12, 2025, https://www.justice.gov/opa/pr/national-health-care-fraud-takedown-results-324-defendants-charged-connection-over-146
39. DOJ Announces Record-Breaking National Health Care Fraud Takedown Against 324 Defendants with Over $14.6 Billion in Alleged Fraud | BakerHostetler, accessed on August 12, 2025, https://www.bakerlaw.com/insights/doj-announces-record-breaking-national-health-care-fraud-takedown-against-324-defendants-with-over-14-6-billion-in-alleged-fraud/
40. Dollars Lost to Fraud – Senior Medicare Patrol, accessed on August 12, 2025, https://smpresource.org/medicare-fraud/dollars-lost-to-fraud/
41. Surgeries he never performed: Indian-origin Houston doctor agrees to pay over $2 million to settle medical fraud allegations, accessed on August 12, 2025, https://timesofindia.indiatimes.com/world/us/surgeries-he-never-performed-indian-origin-houston-doctor-agrees-to-pay-over-2-million-to-settle-medical-fraud-allegations/articleshow/123266508.cms
42. DOJ-HHS False Claims Act Working Group, accessed on August 12, 2025, https://www.hhs.gov/press-room/hhs-doj-false-claims-act-working-group.html
43. DOJ Announces 2025 Health Care Fraud Takedown Results – The National Law Review, accessed on August 12, 2025, https://natlawreview.com/article/expanding-risk-landscape-dojs-advanced-data-analytics-and-healthcare-fraud-data
44. Policy Design and the Problem of Fraud “Some Preliminary Ideas from Considering Fraud as a System Issue” – Proceedings, accessed on August 12, 2025, https://proceedings.systemdynamics.org/1995/proceed/papersvol2/palfr776.pdf
45. Systems Thinking and Policing, accessed on August 12, 2025, https://justpolicing.org/systems-thinking-and-policing/
46. Systems Thinking for Sustainable Crime Prevention; Planning for Risky Places – DiVA portal, accessed on August 12, 2025, https://www.diva-portal.org/smash/get/diva2:1910039/FULLTEXT01.pdf
47. Failure to Prevent Fraud Under the Economic Crime and Corporate Transparency Act 2023, accessed on August 12, 2025, https://lincolnandrowe.com/2025/03/12/failure-to-prevent-fraud/
48. A new approach to fighting fraud while enhancing customer experience | McKinsey, accessed on August 12, 2025, https://www.mckinsey.com/capabilities/risk-and-resilience/our-insights/a-new-approach-to-fighting-fraud-while-enhancing-customer-experience
49. A global scoping review on the patterns of medical fraud and abuse: integrating data-driven detection, prevention, and legal responses – PubMed Central, accessed on August 12, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC11831774/
50. The contagion of culture: Why measuring ethical culture is essential for risk mitigation, accessed on August 12, 2025, https://lrn.com/blog/the-contagion-of-culture-why-measuring-ethical-culture-is-essential-for-risk-mitigation
51. Managing Fraud and Abuse Risks Through Effective Compliance Programs – American Health Law Association, accessed on August 12, 2025, https://www.americanhealthlaw.org/content-library/connections-magazine/article/47b0beec-5de8-4a30-a06c-50d0e233352d/managing-fraud-and-abuse-risks-through-effective-c
52. When Oversight Fails: What Healthcare Fraud Reveals About Risk, Compliance and Culture, accessed on August 12, 2025, https://www.navex.com/en-us/blog/article/when-oversight-fails-what-healthcare-fraud-reveals-about-risk-compliance-and-culture/