Medicare Fraud News, Breaking Headlines and Insight from the Qui Tam Perspective
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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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The Centers for Medicare and Medicaid Services (CMS) paid about $4.4 million to Medicare Advantage plans on behalf of enrollees, after those enrollees had died. CMS made the improper payments for 2,657 deceased enrollees between January 2003 and April 2007, according to the March 2009 report “Review of Medicare Payments to Managed Care Plans on [...]
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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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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 [...]
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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 [...]
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Cooper University Hospital in New Jersey has agreed to pay $3.8 million to the federal government as the result of inflating its Medicare claims from 2001 to 2003. Specifically the Department of Justice alleged that the hospital improperly increased its charges for inpatient and outpatient care to make it appear that the charges were greater [...]
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The federal government is about to announce a national effort to fight Medicare fraud by looking at billing by medical equipment suppliers. There has been an increase in Medicare fraud, particularly in Southern California and South Florida where Medicare are plenty. The crackdown is a nationwide effort by the U.S. Department of Health and Human [...]
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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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On October 17, 2007, Florence Ubak-Offiong was indicted on health care fraud charges including violations of the anti-kickback statute. The indictment alleges that through her medical supply company fraudulently overbilled Medicare for equipment received on behalf of customers located throughout the state of Texas. Medicare supply companies are coming under continuing scrutiny for their fraudulent [...]
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