Medicare Fraud 101 » Medicare Fraud Case http://medicare-fraud.net Medicare Fraud News, Breaking Headlines and Insight from the Qui Tam Perspective Thu, 10 May 2012 17:55:57 +0000 en hourly 1 http://wordpress.org/?v=3.3.2 Texas-Based Nursing and Rehabilitation Centers to Pay U.S. $4 Million for Alleged False Medicare and Medicaid Billings http://medicare-fraud.net/alleged-false-medicare-and-medicaid-billings/ http://medicare-fraud.net/alleged-false-medicare-and-medicaid-billings/#comments Thu, 21 May 2009 19:11:01 +0000 Nolan and Auerbach http://medicare-fraud.net/?p=192 Regency Nursing and Rehabilitation Centers Inc. nursing home chain will pay the United States $4 million to settle allegations that Regency submitted false claims to Medicare and the Texas Medicaid program, the Justice Department and the U.S. Attorney’s Office for the Southern District of Texas announced May 21, 2009. The Victoria, Texas-based chain currently owns and operates 24 nursing home facilities located through the state, according to the release.

The False Claims Act settlement resolves allegations that Regency submitted claims for reimbursement to Medicare and Medicaid for rehabilitation and skilled nursing services that were not reimbursable because the nursing home residents were not qualified for the services, the services were not medically necessary, or they were not supported by adequate documentation, according to the release.

For the full press release, go to: US DOJ.

For more information about Qui Tam law and Health Care Fraud, contact Nolan and Auerbach, PA.

]]> http://medicare-fraud.net/alleged-false-medicare-and-medicaid-billings/feed/ 0 Attorney General and HHS Secretary Announce New Interagency Health Care Fraud Prevention and Enforcement Action Team http://medicare-fraud.net/attorney-general-and-hhs-secretary-announce-new-interagency-health-care-fraud-prevention-and-enforcement-action-team/ http://medicare-fraud.net/attorney-general-and-hhs-secretary-announce-new-interagency-health-care-fraud-prevention-and-enforcement-action-team/#comments Thu, 21 May 2009 17:41:20 +0000 Nolan and Auerbach http://medicare-fraud.net/?p=187 The government has created a new interagency health care fraud prevention and enforcement team, according to a May 20, 2009 announcement by Attorney General Eric H. Holder, Jr. and Health and Human Services (HHS) Secretary Kathleen Sebelius.

The new interagency effort, called the Health Care Fraud Prevention and Enforcement Action Team (HEAT), is charged with combating Medicare Fraud. The government will also expand Strike Force team operations to in some high-risk fraud areas to fight Medicare fraud on a targeted local level.

Fraud prevention efforts are also strengthened in President Obama’s proposed Fiscal Year 2010 budget. The President’s budget invests $311 million – a 50 percent increase from 2009 funding – to strengthen program integrity activities within the Medicare and Medicaid programs. Combined, the anti-fraud efforts in the President’s budget could save $2.7 billion over five years by improving oversight and stopping fraud in the Medicare and Medicaid programs, including the Medicare Advantage and Medicare prescription drug programs, according to the announcement.

To read the full release, go to: US DOJ For more information about Qui Tam law and health care fraud, contact Nolan and Auerbach, PA.

]]> http://medicare-fraud.net/attorney-general-and-hhs-secretary-announce-new-interagency-health-care-fraud-prevention-and-enforcement-action-team/feed/ 0 Hospitals Accused of $50 Million Medicare Fraud http://medicare-fraud.net/hospitals-accused-of-50-million-medicare-fraud/ http://medicare-fraud.net/hospitals-accused-of-50-million-medicare-fraud/#comments Mon, 19 Jan 2009 17:44:37 +0000 Nolan and Auerbach http://medicare-fraud.net/?p=7 Albany N.Y.—According to The Associated Press, recent lawsuits allege that four New York hospitals (Columbia Memorial Physicians Hospital, Long Beach Medical Center, New York Downtown Hospital, St. Joseph’s Medical Center) paid kickbacks to elicit patients for drug treatment programs and billed Medicaid for unnecessary services that lacked state certification. Separately, the suits accuse four of the hospitals of engaging in a kickback scheme to illegally refer patients to the hospitals’ detox units. In a related series of events, Queens’ Parkway Hospital, Our Lady of Mercy, and Benedictine Hospital were accused of paying people to solicit homeless individuals for a three-day detox unit in exchange for cigarettes, beer, food, and other items.  Several of the alleged hospitals were aided by SpecialCare Hospital Management Corp., who illegally referred patients for a fee.

Collectively, the aforementioned hospitals fraudulently billed Medicaid for more than $50 million over a total of 14,000 different claims.  Attorney General Andrew Cuomo asserts that these hospitals have violated New York’s anti-kickback laws, which prohibit individuals or entities from knowingly and willfully offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid or any other federally funded program (except the Federal Employees Health Benefits Program).. As of now, the state has settled for $4.5 million with Our Lady of Mercy, which denies any wrongdoing.  Likewise, the other hospitals and their management companies have denied all charges and filed motions to have the cases dismissed.
To learn more go here or if you have a Medicare Fraud or False Claims Act case contact Nolan & Auerbach P.A.

]]> http://medicare-fraud.net/hospitals-accused-of-50-million-medicare-fraud/feed/ 0 Medicare Fraud – Motorized Wheelchairs http://medicare-fraud.net/medicare-fraud-motorized-wheelchairs/ http://medicare-fraud.net/medicare-fraud-motorized-wheelchairs/#comments Tue, 08 Aug 2006 18:12:57 +0000 Nolan and Auerbach http://medicare-fraud.net/?p=66 An Arkansas physician was sentenced to prison for his role in a Medicare fraud case involving motorized wheelchairs. The physician convinced his elderly patients to seek motorized wheelchairs which were paid for with Government funds. The wheelchair supplier was allegedly paid kickbacks as part of the scheme.

For more information,  click here.

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