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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Nine hospitals in seven states will pay the U.S. more than $9.4 Million to settle allegations that the health care facilities submitted false claims to Medicare, the U.S. Department of Justice announced May 17, 2010. The hospitals are alleged to have overcharged Medicare between 2000 and 2008 when performing kyphoplasty, a minimally-invasive procedure used to [...]
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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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Rush University Medical Center has agreed to pay $1,547,200 plus interest to resolve allegations that the facility violated the False Claims Act, the U.S. Department of Justice (DOJ) announced March 9, 2010. Rush is alleged to have submitted false claims to Medicare during the period 2000 through 2007 by entering into certain leasing arrangements for [...]
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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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The United States has settled False Claims Act allegations against FORBA Holdings LLC, a dental management company that provides business management and administrative services to 69 clinics nationwide known as “Small Smiles Centers.” Under the agreement, FORBA will pay the United States and participating states $24 million, plus interest, to resolve allegations that it caused [...]
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Thanks to the Medicare Fraud Strike Force, 30 people have been charged in three cities for their alleged roles in schemes to submit more than $61 million in false Medicare claims, according to a Dec. 15, 2009 press release by the Federal Bureau of Investigation (FBI). These individuals who were charged are accused of various [...]
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Arlington Memorial Hospital, Arlington, Texas, has agreed to pay the U.S. $990,509.50 to resolve allegations that it violated the civil False Claims Act, according to a Jan. 4, 2010 announcement by U.S. Attorney James T. Jacks of the Northern District of Texas. The Texas hospital allegedly violated the civil False Claims Act by submitting improper [...]
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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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