Medicare Fraud News, Breaking Headlines and Insight from the Qui Tam Perspective
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On June 15, 2010, the U.S. Government Accountability Office (GAO) released a report identifying five important areas for preventing Medicare fraud, waste and abuse. The strategies in this new report, “Medicare Fraud, Waste, and Abuse: Challenges and Strategies for Preventing Improper Payments,” are: (1) Strengthening the provider enrollment process and standards; (2) Improving the pre-payment [...]
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Many Medicare Fraud cases are jointly worked by the feds and the states, as often the cases are national in scope and involve Medicaid utilization as well as Medicare. To display the often important role played by State Medicaid Fraud Control Units (MFCUs), the OIG has developed a new section on its website specifically concerning [...]
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Robert Wood Johnson University Hospital Hamilton, a New Jersey-based hospital, has agreed to pay $6.35 million to settle allegations that the hospital defrauded Medicare, the United States Department of Justice (DOJ) announced March 19, 2010. Two lawsuits filed against the Hamilton, N.J., facility alleged that the hospital fraudulently inflated its charges to Medicare patients to [...]
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During a March 10, 2010 rally in St. Charles, Mo., President Obama blamed health care fraud, waste and abuse for costing taxpayers almost $100 billion in 2009, according to an Associated Press story published that day on Yahoo News. He said such payments, which include Medicare fraud and Medicaid fraud, amounted to more than is [...]
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Spectranetics Corporation, a medical device manufacturer, has agreed to pay the United States $4.9 million in civil damages, as well $100,000 forfeiture to resolve claims against the company, the United States Department of Justice (DOJ) announced December 29, 2009. The claims arise from allegations that the company illegally imported unapproved medical devices and provided them [...]
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HealthSouth Corporation, the nation’s largest provider inpatient rehabilitative healthcare services, allegedly paid illegal kickbacks to the Kerlan Jobe Orthopedic Clinic, a sports medicine clinic in Los Angeles. As a result, the Kerlan Jobe Orthopedic Clinic has agreed to pay the United States $3 million to settle these allegations, the United States Department of Justice announced [...]
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Working to protect taxpayers and Medicare beneficiaries, U.S. Senator Chuck Grassley has introduced legislation to give the federal government more time to pay Medicare providers when waste, fraud and abuse is suspected, according to a November 16, 2009 press release on IowaPolitics.com. Right now, federal law requires that Medicare send payment within a very short [...]
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On Thursday, June 25, 2009, Daniel R. Levinson presented testimony on the Office of the Inspector General’s (OIG’s) role in addressing health care waste, fraud and abuse, as well as its plans for health care reform. Talking before the Subcommittee on Health of the House Energy and Commerce Committee Levinson, inspector general of the U.S. [...]
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Federal prosecutors charged eight conspirators in Miami with defrauding the U.S. healthcare system by creating phony clinics that churned out $100 million of medical bills in five states, according to a June 23, 2009 Reuters news article. The sophisticated scheme involved fake clinics, which in reality were empty storefronts or post office boxes–none providing any [...]
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Earlier this week, the University of Medicine and Dentistry of New Jersey agreed to pay the federal government $2 million to settle a whistleblower lawsuit alleging that it bilked Medicaid in a double-billing scheme that started in 1993 and ended in 2003, according to the Department of Justice. The settlement was the second time UMDNJ [...]
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