Edward “Ned” Arens, a partner at Phillips & Cohen, has extensive experience in representing whistleblowers, focusing on “qui tam” whistleblower cases and claims filed with the Securities and Exchange Commission and the Internal Revenue Service.
Recognized as one of Lawdragon’s “500 Leading Plaintiff Financial Lawyers” and one of the “Best Lawyers in America®,” Arens has returned hundreds of millions of dollars to the U.S. Treasury.
Mr. Arens has represented whistleblowers in a number of significant victories under the False Claims Act and SEC whistleblower program, spanning a wide range of industries. Recent successes include a $90 million settlement in 2024 of a whistleblower case against Humana, Inc. for allegedly submitting fraudulent bids to operate a Medicare Part D plan. Other recent successes include a whistleblower case against KBR for allegedly defrauding the United States Army in connection with a contract to supply troops in Iraq and Afghanistan. The case returned $108.75 million to the U.S. government in 2023. Mr. Arens also successfully represented a whistleblower in a managed care case related to California’s Medicaid expansion that resulted in settlements totaling $95.5 million. Mr. Arens also recently secured significant victories in cases against Lincare Holdings, which paid $29 million for overcharging the Medicare Advantage program for oxygen equipment, and NextGen Healthcare, a large EHR software vendor, which paid $31 million to settle claims of fraud under the Meaningful Use program.
Mr. Arens’ other successes include a whistleblower case against Prime Healthcare, its CEO, and a cardiologist over alleged Anti-Kickback Statute (AKS) and Stark Law violations. The case is likely the largest settlement ($37.5 million) by a hospital in a case involving alleged kickbacks paid to a single physician. Mr. Arens also settled ($32.5 million) a qui tam case against two Medicare Part C plans, Freedom Health and Optimum Healthcare, over alleged risk adjustment fraud.
Under the SEC and CFTC whistleblower programs, Mr. Arens has secured awards for whistleblowers on several multi-million-dollar SEC recoveries, including one case that resulted in a pathbreaking SEC enforcement action under the Dodd-Frank Act.
Other victories include a whistleblower case against Office Depot for allegedly overcharging more than 1,000 cities, counties, school districts, and other government entities for office supplies that settled for $68.5 million and a lawsuit against Alliant Techsystems for selling the U.S. Air Force defective flares that settled for $37 million.
Mr. Arens’ areas of expertise include fraud against Medicare and Medicaid managed care programs, including Medicare Advantage and Medicare Part D. For over a decade, Mr. Arens has handled complex cases involving risk adjustment fraud, medical loss ratio (MLR) fraud, and fraud in securing Medicare Advantage and Medicare Part D contracts. He is responsible for several pathbreaking recoveries in the area, including the first successful case against a healthcare supplier for overcharging Medicare Advantage plans for its services.
Mr. Arens has similarly deep experience with other types of healthcare fraud cases, including AKS violations by hospitals and pharmaceutical companies, violations of the Medicaid Drug Rebate Program, and fraud involving the government’s certification and subsidization of EHR technology.
Mr. Arens’ experience under the False Claims Act also includes numerous cases involving procurement fraud, including cases against defense contractors for overcharging the U.S. military for supplies, as well as evasion of customs duties.
Under the securities and commodities laws, Mr. Arens has represented whistleblowers in a wide range of matters, including claims relating to accounting fraud, disclosure failures, misleading financial products, Foreign Corrupt Practices Act violations, and violations of U.S. sanctions laws.
Mr. Arens also has extensive experience with IRS whistleblower claims, including claims involving complex tax shelters used by the financial industry and wealthy taxpayers. He is co-author of Tax Whistleblower Laws and Programs, which is part of Bloomberg BNA’s Tax Management Portfolios. The portfolios are considered the gold standard in the legal world for those dealing with tax matters. He won an important victory in US Tax Court for an IRS whistleblower client that will benefit other IRS whistleblowers who challenge IRS award determinations.
Mr. Arens graduated magna cum laude from the University of California, Hastings College of the Law, where he was a senior production editor of the Hastings Law Journal. While in law school, he was a legal intern with the U.S. Department of Health and Human Services, Office of the General Counsel, and with the U.S. Department of Justice, Antitrust Division.
Mr. Arens is admitted to the bar in California.
- “Humana settles allegations of Medicare fraud for $90 million,” Health Exec, August 21, 2024.
- “Humana to pay $90 million to end 8-year Medicare Drug Battle,” Law 360, August 16, 2024.
- “Humana pays $90 million to federal government to settle whistleblower lawsuit,” Louisville Courier Journal, August 16, 2024.
- “Humana pays $90 million to settle whistleblower Medicare fraud case,” WDRB, August 16, 2024.
- “Attys Want These 3 Changes to the IRS Whistleblower program,” Law 360, January 10, 2024.
- “IRS Funding Could Revive Flagging Whistleblower Program,” Law 360, August 30, 2021.
- “Athira cited altered studies in $15 million NIH grant application, creating legal risk,” STAT News, August 5, 2021.
- “Prime Healthcare, CEO, Cardiologist Settle FCA Allegations Over Payments for Referrals,” Report on Medicare Compliance, July 26, 2021.
- “Prime Healthcare, doctors to pay $37.5M to settle lawsuit alleging kickback scheme involving Desert Valley Hospital,” Victorville Daily Press, July 24, 2021.
- “Prime Healthcare settles kickback claims,” MedPage Today, July 22, 2021.
- “Emerging details in Prime whistleblower case; company responds,” High Desert Daily News, July 21, 2021.
- “Calif. Hospital Chain, Docs Paying $37.5M In Kickback Deal,” Law360, July 20, 2021.
- “Prime Health Care and Dr. Reddy part of $37.5 million settlement over alleged kickbacks and false claims,” Victor Valley News Group, July 20, 2021.
- “Tax Court to review IRS denial of whistleblower claim,” Accounting Today, March 29, 2019.
- “HCA Fights Revival of Kickback Suit Over Office Building Deals,” Bloomberg Law, January 31, 2019.
- “IRS could still do more for its whistleblower program, tax attorneys say,” MLex’s Tax Watch, September 11, 2018.
- “Congress settles ‘collected proceeds’ question on IRS whistleblower awards,” US Tax Watch, March 23, 2018.
- “Whistleblower Triggers $32.5 Million Settlement with Florida Managed Care Organization,” RACMonitor, May 31, 2017.
- “Insurers pay $32M to settle Medicare Advantage fraud case,” FierceHealthcare, May 31, 2017.
- “Freedom Health To Shell Out $32.5M In Medicare FCA Deal,” Law 360, May 30, 2017.
- “How I.R.S. Can Tighten the Tax Gap” – The New York Times
- “Giving Credit Where Credit Is Due: Requiring the IRS to Properly Attribute Its Recoveries to Whistleblowers” – Bloomberg BNA: Tax Management Memorandum (2017)
- “Tax Whistleblower Laws and Programs” – Bloomberg BNA
- “IRS Whistleblower Program Has More Problems than the GAO Found” – Accounting Today
- Straight from the Horse’s Mouth: Issues Potential Whistleblowers Are Calling about- King & Splading’s Annual Health Law & Policy Forum West – September 30, 2024.
- False Claims Act Enforcement: Northern California Federal and State Spotlight – ABA White Collar Crime Committee, Northern California Regional Subcommittee and the Northern District Chapter of the Federal Bar Association – September 19, 2023.
- Giving Credit Where It Is Due: Requiring The IRS To Properly Attribute Its Recoveries To Whistleblowers – US Income Tax Advisory Board Meeting – October 2017
- Best Lawyers in America” – Best Lawyers, 2024
- “500 Leading Plaintiff Financial Lawyers” – Lawdragon, 2023, 2024