Medicare Fraud News, Breaking Headlines and Insight from the Qui Tam Perspective
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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 [...]
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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 [...]
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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 [...]
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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 [...]
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HealthSouth is the nation’s largest provider of inpatient rehab services and was formerly one of the largest providers of outpatient rehab services, ambulatory surgery services and diagnostic imaging services until it sold those businesses earlier this year. However, illegal Kickbacks and False Claims have cost HealthSouth Corporation and two of its physicians nearly $15 million. [...]
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The Department of Health and Human Services Office of Inspector General Semiannual Report to Congress reports that the OIG will recover nearly $3 billion for Medicare fraud reports that the OIG will recover nearly $3 billion for , Medicaid fraud , and other healthcare federally-funded programs for the first half of fiscal year 2007. The [...]
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An owner of All Medical Billing Solutions, Inc (All Medical Billing) located in Miami, Florida, was sentenced to 10 years imprisonment after being convicted of conspiracy to defraud Medicare, pay health care kickbacks and laundering health care fraud proceeds. Sotto’s company submitted fraudulent Project New Hope (a Miami HIV medical clinic) claims to Medicare in [...]
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Westchester Medical Center received a subpoena on January 31, 2007 from Office of Inspector General of the U.S. Department of Health and Human Services, asking for information going back to 1997, primarily related to the hospital’s relationships with its doctors. Under Stark and anti-kickback laws, hospitals are not permitted to give physicians inducements for patient [...]
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In one of the largest Medicare fraud cases in California history, the owner of Tri-Regional Home Health Care and Provident Home Health Services cheated Medicare of approximately $40 million through a network of paid recruiters and falsification of documents. A payroll clerk working for the company filed a qui tam action in the case after [...]
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In five weeks, CMS Administrator Mark McClellan is going to leave and focus on improving the health care system in the United States. McClellan is leaving a post he held since March 2004. Previously he was the FDA Commissioner from 2002 through 2004. As part of his job McClellan oversees a federal budget of approximately [...]
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