Medicare Fraud 101 » Nolan & Auerbach http://medicare-fraud.net Medicare Fraud News, Breaking Headlines and Insight from the Qui Tam Perspective Fri, 03 Feb 2012 22:32:12 +0000 en hourly 1 http://wordpress.org/?v=3.2 President Obama Vows to Eliminate Healthcare Fraud and Reduce Waste http://medicare-fraud.net/president-obama-vows-to-eliminate-healthcare-fraud-and-reduce-waste/ http://medicare-fraud.net/president-obama-vows-to-eliminate-healthcare-fraud-and-reduce-waste/#comments Thu, 10 Sep 2009 22:09:29 +0000 Nolan and Auerbach http://medicare-fraud.net/?p=236 On Wednesday, September 9, 2009, President Barack Obama addressed Congress on the current debate over healthcare reform. In his speech, the President vowed he would eliminate “the hundreds of billions of dollars in waste and fraud.” Under his plan, an independent commission of doctors and medical experts would be appointed the task of uncovering fraud and abuse in the coming years.

President Obama’s speech further confirms that the fight against healthcare fraud is a top priority for the government, and its recently heightened efforts to recoup healthcare dollars by prosecuting violators underscores that message. Simply put, in order to afford a viable healthcare system unnecessary spending must be eliminated. We’ve said it before – the government is keeping a watchful eye on Medicare and Medicaid fraud, as well as fraud within the pharmaceutical industry. In fact, just last week the Office of Inspector General announced Medicaid Fraud Control Units recovered $1.3 billion in 2008.

Needing all the help they can get, federal regulators see whistleblowers as crucial players in the fight against healthcare fraud. As Marcella Auerbach pointed out in an interview with PBS in July, the healthcare industry receives a $15 return for every dollar the government spends on efforts to fight fraud. By spotting fraud early on, significant money can be recovered for patients and taxpayers.

For the entire transcript of President Obama’s speech, go to:
http://www.whitehouse.gov/the_press_office/Remarks-by-the-President-to-a-Joint-Session-of-Congress-on-Health-Care/

For more information about qui tam law and health care fraud, contact Nolan and Auerbach, PA.

]]> http://medicare-fraud.net/president-obama-vows-to-eliminate-healthcare-fraud-and-reduce-waste/feed/ 0 Fighting Medicare Fraud http://medicare-fraud.net/fighting-medicare-fraud/ http://medicare-fraud.net/fighting-medicare-fraud/#comments Thu, 30 Jul 2009 20:20:04 +0000 Nolan and Auerbach http://medicare-fraud.net/?p=228 PBS business news correspondent Jeff Yastine interviewed Marcella Auerbach for his broadcast news segment titled, “Dozens Arrested For Medicare Fraud,” which aired nationally during the July 30, 2009 nightly news cast. Marcella was also quoted in Jeff’s related news article titled, “Fighting Medicare Fraud.”

In celebration of the 44th anniversary of Medicare, the segment reported that a multi-state crackdown on Medicare fraud resulted in 32 arrests in Houston, Boston, and Miami, recovering approximately $370 million.

Marcella was quoted on the financial benefits of fraud investigations, suggesting that costs for health care reform – a topic of current heated controversy – could be significantly defrayed by recovering more money from Medicare fraud and similar healthcare violations.

Marcella pointed out that, with the Federal government’s strengthened efforts to fight Medicare fraud in particular, the system has received a $15 return for every dollar spent on investigations and prosecution.

To view the full segment, go here: http://www.pbs.org/nbr/info/local-player.html?s=nbre07s2dccq669

To read the related article, go here: http://www.pbs.org/nbr/blog/2009/07/fighting_medicare_fraud.html

]]> http://medicare-fraud.net/fighting-medicare-fraud/feed/ 0 Teaching Hospital Settles Physician Billing Case http://medicare-fraud.net/teaching-hospital-settles-physician-billing-case/ http://medicare-fraud.net/teaching-hospital-settles-physician-billing-case/#comments Thu, 16 Jul 2009 19:11:03 +0000 Nolan and Auerbach http://medicare-fraud.net/?p=222 In the July 13 edition of the Report on Medicare Compliance, Editor Nina Armstrong quoted Ken Nolan in her article titled, “Teaching Hospital Settles Physician Billing Case, Signs Second Agreement with OIG.” The article reported that Louisiana State University Health Sciences Center in Shreveport (LSUHSC-S) recently settled a dispute alleging it billed Medicare for surgery on behalf of physicians who were not present when residents performed the procedures.

 

LSUHSC-S agreed to pay more than $700,000 to resolve the False Claims Act allegations. The complaint was initiated by two employees-turned-whistleblowers who both plan to file another suit to collect lost wages, benefits, and damages for their damaged reputations.

 

Ken was quoted on the connection between this settlement and Physicians at Teaching Hospitals (PATH), the Department of Justice (DOJ) and Office of Inspector General’s (OIG) national enforcement project in the area of teaching physicians. While the goal of PATH was to target major offenders, Ken does not find it surprising that smaller offenders like LSUHSC-S are showing up with independent whistleblower cases. This is one of the several beneficial scenarios to taxpayers that the qui tam law was intended to capture. Ken also highlighted that many settlements are now originated with whistleblowers, instead of the DOJ or OIG like with PATH.

]]> http://medicare-fraud.net/teaching-hospital-settles-physician-billing-case/feed/ 1 Physicians Snared By Growing Medicare Fraud Strike Team http://medicare-fraud.net/physicians-snared-by-growing-medicare-fraud-strike-team/ http://medicare-fraud.net/physicians-snared-by-growing-medicare-fraud-strike-team/#comments Wed, 15 Jul 2009 19:02:27 +0000 admin http://medicare-fraud.net/?p=218 Marcella Auerbach was quoted by Amy Lynn Sorrel in her article “Physicians snared by growing Medicare fraud strike team,” which appeared in the July 6 online edition of American Medical News. The article discussed the announcement by the Department of Justice and Health & Human Services that criminal charges were filed against 53 doctors and healthcare professionals for allegedly scheming to submit false Medicare claims in the Detroit area.

These indictments come immediately after the government recently publicized the creation of a Medicare anti-fraud task force aimed at reducing the millions of dollars wasted every year in healthcare fraud. The task force has said it will focus on all participants in fraud, be it the corporation, the physician, or even patients.  

Marcella pointed out that she believed there will be many more similar Medicare fraud indictments and cases in the near future. Meanwhile, whistleblowers will continue to play an important and crucial role in the government’s crackdown on healthcare fraud. When employees or physicians who are aware of misconduct do not come forward, the government will initiate investigations proactively, often resulting in a large number of indictments against the company or hospital, as demonstrated by this bellwether case in Detroit.

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