Provides services to Business’s throughout the country. The firm is involved in consulting, investigations and training to support the financial and health care industries. Daniel Martino, the founder of the company, is a Former FBI Supervisory Special Agent with 34 years experience possessing a long track record of success. The Firm participates in a vast network of highly trained and experienced professionals who provide high quality services marked by integrity in a variety of disciplines. Enjoy your visit.

PI NUMBER: CA PI 25170

 

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 Media Coverage
Fraudulent Doctors ... Fraudulent Claims
JONATHAN D. GLATER
12 BCBS Plans File Suit Against California Clinics
Kaiser Daily Health Policy Report
California rogue clinics operated on kids as young as 12
Coalition Against Insurance Fraud
FBI Cites Massive Medical Fraud Investigation
Todd Zwillich
BCBSA Announces a Major Healthcare Anti-fraud Initiative
Dan Martino
Huge Billing Fraud Is Cited by Health Plans at California Clinics
Robert Pear
Feds set up health care fraud unit to address jump in scams
Laurence Darmiento
FBI, insurers target fraudulent surgeries; Clinics paying people for unnecessary operations
ROBERTO CENICEROS
Canadian Health Care Anti-Fraud Association - Third Annual Conference
CHCAA

Investiagtion Services Services - Consulting to Insurance Industry & Corporate America Corporate & health care fraud investigations Public Speaking on Fraud Prevention & Identity Theft Provider Ethics Program to educate & mitigate liability


LITIGATION SUPPORT
Daniel M. Martino, the founder of the company, possesses extensive trial experience in the Federal Court System. The firm can assist attorneys and their clients in a variety of ways. The company will provide objective investigative assistance in the Preliminary, Discovery and Trial phases of your case when deemed appropriate. This assistance may include reviewing evidence, conducting analysis of records, developing investigative leads and conducting the appropriate investigation to include locating witnesses, interviewing and preparing witness statements. The company assists clients in evaluating damage assessments, conduct risk analysis and provide investigative assistance as the legal process proceeds. Recognizing the seriousness and sensitive nature of litigation, the firm strives to handle relationships with our clients appropriately and with the utmost confidence.

Prior to accepting an investigative or consulting engagement, an internal conflict check is conducted of the parties involved in the litigation. The firm will only accept a case if it is unaware of a case conflict or in a matter where no conflict exists. In the event of an identifiable conflict, the firm may have to remove itself from the matter upon consultation with the client.

QUI TAM LITIGATION SUPPORT
A Qui Tam is a provision of the Federal False Claims Act that allows private individuals to file a lawsuit in the name of the United States Government charging government contractors and others who receive or use government funds. The provision primarily focuses on procurement and/or program fraud generally involving government contractors. Over the past several years, there has been a dramatic increase in Qui Tam filings originating from Relators also known as "Whistleblowers" alleging fraud. These cases possess the potential of having a substantial monetary impact on a business and can affect its ability to remain as a growing concern and adversely affect investor confidence. In some instances, the monetary awards available to the Relator and their legal representative in a successful Qui Tam action can be very substantial exceeding several million dollars. Generally, Qui Tam Relators are former employees or business associates of the company allegedly engaged in a fraud against the Government. During the past five years, the number of Qui Tams filed in connection with the health care industry has increased substantially. Qui Tam litigation can be very tedious, lengthy and in many cases, very expensive. Substantial penalties to include but not limited to monetary damages can be awarded and Corporate Integrity Agreements can be enforced against the wrongful party in the event that the allegations are substantiated and proved and/or a settlement is reached.

During the early stages of the preliminary investigation and development the case, it is extremely important that the facts and allegations be fully identified to indicate the existence of real evidence relating to fraudulent acts or activities. The firm can assist the client in reviewing the available evidence and statements to determine the viability of a case and provide appropriate assessments to assist the client in making their decisions. In the event of litigation, it may be necessary to conduct background checks of pertinent parties to the legal action. Even where substantial evidence exists, the challenged veracity of a witness can change the complexion of a case. In cases where the Government intervenes and accepts the case, it is extremely important that contact with the Government remain intact by the Relator and/or his representative.

Companies named in a Qui Tam Filing accepted by the Government can expect costly and protracted litigation in many of these matters. A filing may require the company or alleged party to conduct an appropriate investigation in determining potential exposure in these matters in order to make decisions in the best interests of the company.

SPECIAL INVESTIGATIVE UNIT ANALYSIS
In most states, Insurance companies are mandated to maintain Special Investigative Units (SIUs) to address Fraud and Abuse. In connection with their risk analysis programs and operations, it is the SIUs responsibility to abide by the respective compliance program established for the unit. The SIU is responsible for identifying vulnerabilities, conduct appropriate investigations, and recover losses whenever deemed appropriate. As a Former FBI Supervisory Special Agent, Daniel M. Martino supervised the largest Health Care Fraud Program in the FBI. Mr. Martino performed strategic planning and conducted on-going analysis of operations to ensure that goals and objectives were met in an efficient and effective manner. During the course of his career, Mr. Martino participated in the FBI Inspection Process and evaluated the performance of other FBI offices.

Mr. Martino, as your Consultant, is available to perform appropriate analysis to assist the SIU in its evaluation of operations and improve efficiencies as needed. The firm is in a position to provide clients with a tailored SIU Analysis Plan to evaluate and improve performance.

 

 

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California Private Investigator: CA PI 25170
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Last Modified: 11/21/2008