Tip Sheets

Duff Wilson: Investigating health care fraud

Duff Wilson, an investigative reporter at The New York Times, detailed the anatomy of a health care fraud investigation and pointed reporters to useful Web sites and resources as part of the "Master class in health care fraud" at Health Journalism 2009. He also included resources in his PowerPoint presentation.

Duff Wilson is the author of the 2001 award-winning book "Fateful Harvest: The True Story of a Small Town, a Global Industry, and a Toxic Secret" (HarperCollins, Sept. 4, 2001). He and the Seattle Times' Susan Kelleher wrote a series, "Suddenly Sick," showing how pharmaceutical companies placed favored doctors in key position to influence the very definition of disease, resulting in millions more Americans considering themselves sick and being sold expensive drugs they may not need. Wilson wrote "Uninformed Consent" about what patients at the Fred Hutchinson Cancer Research Center hospital weren't told about the experiments in which they died" with Seattle Times staff reporter David Heath in 2001.

  • Start with a new idea.
  • Competitors. Whistleblowers. Doctors. Patients.
  • Federal and state law enforcement.
  • Personal injury lawsuits and discovery materials.
  • Securities and Exchange Commission filings and business lawsuits.
  • Public records through FOIA, state record laws, CFR and state regulations.
  • Investigate somebody: Who is John Doe? http://www.reporter.org/desktop/tips/johndoe.htm
  • Journals, studies, press articles.

Pharma - helpful Web sites and blogs:

Health care fraud - helpful Web sites:

Federal leads

More resources

  • EthicSolutions LLC: Consulting firm that assists law firms and the federal government with civil and criminal health care fraud cases
  • John W. Schilling: licensed CPA with 18 years of health care financial experience. Confidential undercover informant and a key witness in the FBI probe and subsequent prosecution of Columbia/HCA, resulting in a civil settlement of more than $1.7 billion. Currently a partner with EthicSolutions LLC.
  • The Flex Monitoring Team monitors and evaluates the Medicare Rural Hospital Flexibility Grant Program (Flex Program).
  • Critical Access Hospitals program, designed to improve rural health care access and reduce hospital closures.

Research Resources