Medicare Fraud News, Breaking Headlines and Insight from the Qui Tam Perspective
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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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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 [...]
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The U.S. Department of Justice announced March 12, 2009, that San Mateo County, Calif., will pay the United States $6.8 million to resolve allegations that the San Mateo Medical Center (SMMC) submitted false claims to the United States in connection with payments from the Medicare and Medicaid programs. The government alleges that SMMC engaged in [...]
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In order to settle allegations that the Scooter Store submitted false claims to Medicare, the New Braunfels, Texas company agreed to pay the federal government $4 million and forego another $13 million in Medicare payments. The payments resolve several lawsuits including a whistleblower complaint from a former Scooter Store employee. The whistleblower will receive $3.2 [...]
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The FBI is apparently investigating allegations that a Maryland cardiologist, Dr. John “Jack” McLean was performing unnecessary stent implantations on his patients. Officials have stated that most of the patients involved are Medicare patients. On average, Medicare pays between $11,184 to $14,287 for a drug-eluting stent procedure. The investigation which involves the FBI as well [...]
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A corporate insider is in a unique position to know the details about how their employer has cheated the United States Government. Nothing beats the knowledge an insider can impart. Whistleblowers are the real heroes in the fight against fraud. The person (plaintiff) who brings an action under the False Claims Act is called a [...]
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CMS recently announced multiple accomplishments and projects, all designed to reduce fraud and abuse: the Los Angeles office of CMS revoked the billing numbers of 117 providers who had presented false claims or suspicious business operations, saving $200 million, editing the system to stop payment on claims using billing numbers from deceased providers saved another [...]
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As a result of violating Stark Laws and submitting improper bills to Medicare, Medicaid and TRICARE, the Marion County Medical Center in South Carolina will pay $3.75 Million arising out of a qui tam False Claims Act case filed by a whistleblower. For more information click here.
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A new Taxpayers Against Fraud Report confirms the success of the Qui Tam provisions of the False Claims Act in fighting health care fraud. To see the full Report, click here.
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In an article that appeared in The Baltimore Sun (Jonathan D. Rockoff, Improper sales of medicines targeted; Drug firms have paid fines of $3.5 billion since 2001 for wrongful promotions, The Baltimore Sun, May 7, 2006 at 1A), it is reported that since 2001, pharmaceutical companies prosecuted under the False Claims Act have paid nearly [...]
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