Texas Lawyers Blog

Description

The Texas Lawyers Blog provides useful information on the law and Texas lawyers. For more information on this Blog or a legal topic, please feel free to submit an inquiry or send an e-mail message to blog@texaslawyers.com

Sunday, September 6, 2009

Medicare Fraud, Tricare Fraud, Hospice Fraud, and other Health Care Fraud Qui Tam Whistleblower Actions

Health Care Fraud Whistleblower Actions (Medicare Fraud Qui Tam Claims, Tricare Fraud Qui Tam Claims, Medicaid Fraud Qui Tam Claims, and other Fraud Law Suits)

Hospital administrators, nursing home administrators, doctors, coders, benefit coordinators, nurses, chief financial officers, and other health care professionals have been stepping up and blowing the whistle on health care fraud that costs taxpayers about $100 billion each year including Medicare fraud, Tricare fraud, Hospice fraud, and other types of fraud. These health care fraud whistleblowers are American Heroes that have knowledge of false and illegal billing practices, and have had the strength & integrity to file Qui Tam Whistleblower Actions. The result of these health care professionals has been recovery of hundreds of millions of dollars that have been stolen from Medicare, Tricare, and Medicaid as well as improvements in preventing future health care fraud which helps all Americans.

Medicare Fraud, Tricare Fraud, Nursing Home Fraud, Hospice Fraud, and other Health Care Fraud in the News (Whistleblowers and Government Agents Strike Back Against Health Care Fraud)

The Department of Justice has been cracking down on Fraud and False Claims including Medicare Fraud, Tricare Fraud, Nursing Home Fraud, Hospice Fraud, and other Health Care Fraud. Below is an update on recent Department of Justice recoveries.

Pfizer to pay record $2.3B penalty over promotions Repeat offender Pfizer paying record $2.3B settlement for illegal drug promotions By Devlin Barrett, Associated Press Writer On Wednesday September 2, 2009, 3:47 pm EDT

"WASHINGTON (AP) -- Federal prosecutors hit Pfizer Inc. with a record-breaking $2.3 billion in fines Wednesday and called the world's largest drug maker a repeating corporate cheat for illegal drug promotions that plied doctors with free golf, massages, and resort junkets."

Announcing the penalty as a warning to all drug manufacturers, Justice Department officials said the overall settlement is the largest ever paid by a drug company for alleged violations of federal drug rules, and the $1.2 billion criminal fine is the largest ever in any U.S. criminal case. The total includes $1 billion in civil penalties and a $100 million criminal forfeiture.

More Than $1 Billion Recovered by Justice Department in Fraud and False Claims in Fiscal Year 2008

WASHINGTON – The United States secured $1.34 billion in settlements and judgments in the fiscal year ending Sept. 30, 2008, pursuing allegations of fraud against the federal government, the Justice Department announced today. This brings total recoveries since 1986, when Congress substantially strengthened the civil False Claims Act, to more than $21 billion.

"Now, more than ever, it is crucial that taxpayer dollars aren't lost to fraud," said Gregory G. Katsas, Assistant Attorney General for the Department’s Civil Division. "The billion dollars collected this year is only part of the story. By rooting out fraud and vigorously pursuing it, the Department, with the help of concerned citizens who report fraud in hotline calls and in qui tam complaints, undoubtedly saves the country many times that amount in aborted schemes and misconduct."

$361.5 million from Merck & Company to resolve allegations that the pharmaceutical manufacturer knowingly failed to pay proper rebates to Medicaid and other government health care programs, and paid kickbacks to health care providers to induce them to prescribe the company’s products. The settlement resulted from two lawsuits brought under the qui tam provisions of the False Claims Act.

Medicare Fraud, Tricare Fraud, Nursing Home Fraud, Hospice Fraud, and other Health Care Fraud in the News (Whistle Blowers and Government Agents Strike Back Against Health Care Fraud)

Health care fraud Whistleblowers, federal agents, and other American heroes have been striking back against Medicare Fraud, Tricare Fraud, Nursing Home Fraud, Hospice Fraud, and other Health Care Fraud. Below are some recent stories in the news regarding health care fraud and qui tam claims.

Dozens Arrested In Medicare Fraud Busts Across US digg Share this on Facebook Huffpost - Dozens Arrested In Medicare Fraud Busts Across US

KELLI KENNEDY | 07/29/09 10:31 PM | AP

"MIAMI — Federal authorities arrested more than 30 suspects, including doctors, and were seeking others in a major Medicare fraud bust Wednesday in New York, Louisiana, Boston and Houston, targeting scams such as "arthritis kits" – expensive braces that many patients never used.

More than 200 agents worked on the $16 million bust that included 12 search warrants at health care businesses and homes across the Houston area, where the bulk of the arrests were made.

Federal authorities say those businesses were giving patients "arthritis kits," which were nothing more than expensive orthotics that included knee and shoulder braces and heating pads. Patients told authorities they were unnecessary and many never even received them. But health care clinic owners billed between $3,000 to $4,000 for each kit.

Houston's other scam involved billing Medicare for thousands of dollars worth of liquid food like Ensure for patients who can't eat solid food. Authorities said clinic owners never distributed the food to patients. In some cases, clinic owners billed patients who were dead when they allegedly received the items.

It's the third major sweep since Attorney General Eric Holder, Health and Human Services Secretary Kathleen Sebelius announced in May they were adding millions of dollars and dozens of agents to combat a problem that costs the U.S. billions each year.

HOSPICE FRAUD NETS MULTIMILLION DOLLAR RECOVERY

"SouthernCare Inc. and its shareholders have agreed to pay the United States a total of $24.7 million to settle allegations that the Birmingham, Ala.-based company submitted false claims to the government for patients treated at its hospice facilities, the Justice Department announced today. SouthernCare operates approximately 99 locations that provide hospice services in 15 states."

“The Medicare hospice benefit is intended to provide compassionate end of life care to terminally ill patients,” said Gregory G. Katsas, Assistant Attorney General of the Civil Division. “This settlement sends a clear message that the Department of Justice will not allow health care providers to take advantage of beneficiaries in their attempts to game the reimbursement system.”

This settlement results from two qui tam suits filed by two former SouthernCare employees on behalf of the United States. The False Claims Act authorizes private parties to file suit against those who defraud the United States and to receive a share of any recovery. The United States will pay $4.9 million to the individuals who filed the actions against SouthernCare.

HEALTH CARE FRAUD CASE NETS RECOVERY OF $1.7 BILLION

HCA Inc. (formerly known as Columbia/HCA and HCA - The Healthcare Company) and HCA subsidiaries agreed to pay the United States over $1.7 Billion including $631 million in 2003 for civil penalties and damages arising from false claims the government alleged it submitted to Medicare and other federal health programs. In 2000, HCA subsidiaries pled guilty to substantial criminal conduct and paid more than $840 million in criminal fines, civil restitution and penalties. HCA will paid an additional $250 million to resolve overpayment claims arising from certain of its cost reporting practices. In total, the government will have recovered $1.7 billion from HCA.

Blowing the Whistle on Those that Commit Fraud Against the United States Government, First to File Provisions of the Federal False Claims Act, and Preserving Relator Rights to Share in Recovery of Funds (Qui Tam Medicare Fraud, Hospice Fraud, Nursing Home Fraud, Tricare Fraud, and other Health Care Fraud Claims)

If you are a Health Care Administrator, Hospital Administrator, Nursing Home Administrator, Doctor, Coder, Benefit Coordinator, Nurse, Chief Financial Officer, or other health care professional that has knowledge and evidence of a Health Care Provider, Hospice Provider, Nursing Home, Hospital, Medical Supply Company, or other health care contractor or subcontractor that is defrauding Tricare, Medicare, or the United States Government out of millions or billions of dollars, it is important to gather evidence of the fraud and blow the whistle on the fraud.

In blowing the whistle on health care fraud, Medicare fraud, Tricare fraud, VA fraud, or other fraud against the government, it is typically best to contact a Medicare Fraud, Tricare Fraud, and Hospice Fraud Qui Tam Whistleblower Claim Lawyer like Jason S. Coomer and the firms that he works with to help investigate the fraud and pull together a disclosure and complaint to file.

For information on this Qui Tam Whistleblower Medicare Fraud, Tricare Fraud, and Hospice Fraud Claims, go to FederalGovernmentContractorFraud.com


No comments: