Medicare Fraud News, Breaking Headlines and Insight from the Qui Tam Perspective
Posts tagged as:
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 [...]
{ 0 comments }
In April 2009, the American Association for Homecare presented Congress with its 13-point legislative action plan, called the Medicare Anti-Fraud Legislative Plan, aimed at eliminating waste, fraud and abuse in Medicare’s home medical equipment sector. The plan’s steps, according to the homecare association, would eliminate most of the Medicare fraud attributed to the home medical [...]
{ 0 comments }
Methodist Hospital in Houston has agreed to pay the United States $9.99 million to settle allegations that it defrauded the federal Medicare program, the U.S. Department of Justice announced March 26, 2009. The government alleged that, between January 2001 and August 2003, Methodist improperly inflated charges for inpatient and outpatient care to make its costs [...]
{ 0 comments }
Four Miami-area physicians and medical assistants pleaded guilty March 23, 2009 to a $10 million Medicare fraud scheme involving HIV infusion clinics, according to a Department of Justice (DOJ) press release. The four defendants worked at Midway Medical Center Inc. a Miami clinic that purported to specialize in the treatment of HIV patients. One of [...]
{ 0 comments }
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 [...]
{ 0 comments }
Medicare spending on home health was $12.9 billion in 2006—that’s up 44% since 2002, according to Government Accountability Office (GAO) report released March 13, 2009. Upcoding, by home health agencies, as well as other fraudulent and abusive practices, such as kickbacks and billing for services not rendered, contributed to the rise in Medicare spending for [...]
{ 0 comments }
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 [...]
{ 0 comments }
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 [...]
{ 0 comments }
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 [...]
{ 0 comments }
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 [...]
{ 0 comments }
