Medicare Fraud News, Breaking Headlines and Insight from the Qui Tam Perspective
Posts tagged as:
Three HealthEast Care System hospitals have agreed to pay the United States $2.28 million to settle allegations that the health care facilities submitted false claims to Medicare, the U.S. Justice Department announced May 21, 2009. According to the DOJ press release, the settlement resolves allegations that the St. Paul, Minn.-based hospitals overcharged Medicare from 2002 [...]
{ 0 comments }
Executives and employees at WellCare Health Plans Inc. engaged in an elaborate scheme to defraud the Florida Medicaid program and the Florida Healthy Kids Corporation, according to a press release by the U.S. Department of Justice. In order to avoid a health care fraud conviction on these charges WellCare must, among other things, consent to [...]
{ 0 comments }
On April 22, 2009, New York Medicaid Inspector General James Sheehan testified before the U.S. Senate Committee on Homeland Security and Governmental Affairs Subcommittee on Medicare and Medicaid about waste and fraud. New York was the most successful state in the nation in Medicaid program integrity in the past year, measured by fraud and abuse [...]
{ 0 comments }
Methodist Hospital in Houston has agreed to pay the United States $9.99 million to settle allegations that it defrauded the federal Medicare program, the U.S. Department of Justice announced March 26, 2009. The government alleged that, between January 2001 and August 2003, Methodist improperly inflated charges for inpatient and outpatient care to make its costs [...]
{ 0 comments }
Four Miami-area physicians and medical assistants pleaded guilty March 23, 2009 to a $10 million Medicare fraud scheme involving HIV infusion clinics, according to a Department of Justice (DOJ) press release. The four defendants worked at Midway Medical Center Inc. a Miami clinic that purported to specialize in the treatment of HIV patients. One of [...]
{ 0 comments }
Medicare spending on home health was $12.9 billion in 2006—that’s up 44% since 2002, according to Government Accountability Office (GAO) report released March 13, 2009. Upcoding, by home health agencies, as well as other fraudulent and abusive practices, such as kickbacks and billing for services not rendered, contributed to the rise in Medicare spending for [...]
{ 0 comments }
The Government announced today that a former employee of Victory Memorial Hospital’s qui tam lawsuit has resulted in a settlement with the United States of at least $2.3 million to resolve claims that the hospital defrauded the Medicare program. The Medicare Fraud settlement covers allegations that Victory Memorial submitted Cost Reports for 1996 and 1997 [...]
{ 0 comments }
President Obama’s fiscal year 2010 proposed budget estimates that reducing health care fraud, waste and abuse could save the government about $5 billion in a decade’s time. The budget pledges nearly $1.5 billion for its Health Care Fraud and Abuse Control Program (HCFAC), including a $311 million increase in HCFAC funding. The budget takes aim [...]
{ 0 comments }
Chicago, Illinois— Cardiologist Sughil Sheth received $13.4 million over a period of five years (2002-2007) by billing Medicare for reimbursement of extensive cardiac care that was not, according to U.S. Attorney Patrick Fitzgerald, ever performed. Sheth allegedly performed Medicare Fraud by hiring individuals to falsify patient names, insurance data, and dates in order to bill [...]
{ 0 comments }
Improperly billed claims paid by Medicaid payments has resulted in a $60 million settlement by CoxHealth. This settlement resulted from allegations that beginning as far back as January 1996, CoxHealth allegedly entered into prohibited financial agreements that violated Medicare cost report requirements, Stark Laws and the Anti-Kickback Statute. John F. Wood, the U.S. Attorney for [...]
{ 0 comments }
