17 February, 2011

Texas Increased Medicaid Fraud Collections to $500 Million

By | February 17th, 2011|Whistleblower/Qui Tam|

According to state officials, increased enforcement has helped the state of Texas recover more than $500 million in Medicaid fraud cases since 2007. David Morales, deputy first assistant attorney general, told Texas state senators earlier [...]

20 July, 2010

U.S. government sues feed dealers in False Claims Act suit

By | July 20th, 2010|Whistleblower/Qui Tam|

It often seems that government contractor fraud against the United States is limited primarily to the fields of health care and the military.  But no.  Government contractor fraud can be found quite literally in the fields, specifically the fields of Kansas – in which state the U.S. has brought a False Claims Act lawsuit against R&J Feed Co. and Carter Livestock Inc., along with Jerry Goodwin and Richard Carter.  The suit alleges that the defendants violated the federal False Claims Act by improperly exporting nonfat dry milk owned by the U.S. Department of Agriculture (USDA) and promised to U.S. livestock producers in designated drought-ridden states. […]

24 June, 2010

Iowa Senator Grassley working to beef up state False Claims Acts

By | June 24th, 2010|Whistleblower/Qui Tam|

U.S. Senator Chuck Grassley of Iowa was the primary Senate sponsor of 1986 amendments to the federal False Claims Act that bolstered and updated the statute’s whistleblower provisions.  Now, the longtime False Claims Act proponent is working to ensure that recent changes to the federal law are made part of fourteen state False Claims Acts patterned after the federal model.  Several states have enacted legislation similar to the federal statute in response to a federal incentive that allows states with whistleblower statutes to increase their share of Medicaid recoveries by ten percent. […]

7 June, 2010

Senator Grassley working to beef up state False Claims Acts

By | June 7th, 2010|Whistleblower/Qui Tam|

Senator Chuck Grassley, longtime proponent of strengthening the federal False Claims Act in order to  fight fraud against the government, is now working to ensure that recent changes to that statute are made part of fourteen state False Claims Acts patterned after the federal model.  Many states have enacted legislation similar to the federal statute in response to a federal incentive that allows states with whistleblower statutes to increase their share of Medicaid recoveries by 10 percent. […]

15 May, 2010

Senate committee investigating home-health companies’ Medicare reimbursements

By | May 15th, 2010|Whistleblower/Qui Tam|

The Senate Finance Committee is investigating whether four for-profit home-health companies purposely increased high-paying home health visits specifically to receive increased Medicare reimbursements.  The companies at issue are Amedisys, LHC roup Inc., Gentiva Health Services Inc., and Almost Family Inc. Letters sent to the home health companies state that the companies appear to have intentionally increased their utilizations patterns for therapy visits when Medicare increased reimbursements for such services.  They also voiced concerns over marketing materials that encouraged seniors to take advantage of Medicare-reimbursed services. […]

5 May, 2010

Exxon Mobil agrees to settle False Claims Act allegations of underpayment of royalties

By | May 5th, 2010|Whistleblower/Qui Tam|

Exxon Mobil Corp. has consented to pay an enormous amount to end the government’s claims that the company underpaid royalties for natural gas from federal land.  In a whistleblower case filed by Harold Wright pursuant to the federal False Claims Act, Mobil Corp. was alleged to have “systematically underreported” the value of gas extracted from the land for over a decade from March of 1988 to November of 1999.  Mobil was acquired by Exxon in December of 1999. […]

5 May, 2010

U.S. intervenes in whistleblower suit against Georgia medical facility and doctor

By | May 5th, 2010|Whistleblower/Qui Tam|

The federal government has decided to intervene in a False Claims Act suit alleging Medicare and Medicaid fraud against Satilla Health Services Inc., dba Satilla Regional Medical Center, and Dr. Najam Azmat, of Waycross, Georgia. The lawsuit alleges that the medical providers submitted claims for payment to Medicare and Medicaid for medical procedures that Dr. Azmat performed at Satilla’s Heart Center, even though the doctor was not qualified to perform the operations.  At least one patient died after the procedure and other patients received serious injuries.  The medical center is alleged to have put Dr. Azmat on staff despite its knowledge that the doctor’s surgical privileges had been restricted by the hospital where he previously worked because the rate of complications on his surgical procedures was so high.  In addition, alleges the complaint, Satilla management permitted Azmat to perform highly complex endovascular procedures at the hospital even though the physician had insufficient experience in performing them.  Endovascular surgery , which requires specialized training, is performed in the body’s arteries and veins.  According to the complaint, one patient died during surgery after Dr. Azmat perforated her renal artery and she bled to death. The physician allegedly was so incompetent that he did not recognize the perforated artery and neglected to remedy the complication. […]

29 April, 2010

Parker, Arizona doctor settles False Claims Act allegations

By | April 29th, 2010|Whistleblower/Qui Tam|

Parker, Arizona physician Kevin S. Klopfenstein, M.D., has consented to pay the federal government a considerable sum to settle an inquiry concerning False Claims Act violations in the submission of bills to Medicare.  The government had alleged that Dr. Klopfenstein and his medical practice, KSK, made false claims to Medicare for Thoracic Electrical Bioimpedance (TEB) (also called Biothoracic Impedance (BTI)) testing.  According to the government, the doctor falsely claimed that the patients who had received the tests satisfied governing Medicare coverage requirements when this was not the case. […]

29 April, 2010

South Carolina hospital on trial in False Claims Act suit

By | April 29th, 2010|Whistleblower/Qui Tam|

At the end of March, a jury returned a split verdict against Tuomey Healthcare System, of Sumter, South Carolina in a federal False Claims Act suit by the Justice Department.  The jury’s verdict—that the hospital violated the Stark Law but not the False Claims Act—has left both sides asking the judge for relief this week. The lawsuit alleged that the hospital acted to inflate its profits in violation of the False Claims Act and that the defendants violated the Stark Law.  The Stark Law prohibits doctors from referring patients to medical facilities in which they have any interest.  The government has alleged that the facility created a near-monopoly by stifling competition among local doctors, forming employment contracts with doctors who then referred patients to the facility, and then obtaining illegal higher payments for certain medical procedures. […]

23 April, 2010

Justice Department settles Medicare fraud suit in Melbourne, Florida

By | April 23rd, 2010|Whistleblower/Qui Tam|

The United States has settled a whistleblower lawsuit filed against Florida doctor Todd J. Scarbrough, MD and Melbourne Internal Medicine Associates P.A. (MIMA).  The doctor and MIMA have consented to pay an enormous sum to resolve the suit’s claims that they violated the federal False Claims Act by presenting false claims for payment to Medicare and TRICARE, the military’s federal health care program. […]

23 April, 2010

Federal court slaps Nashville-based Medicare supply company with enormous damages and penalties

By | April 23rd, 2010|Whistleblower/Qui Tam|

In a whistleblower lawsuit filed under the federal False Claims Act, a federal judge has imposed enormous damages and penalties on companies furnishing medical supplies to patients with advanced kidney disease.  The defendants in the suit were Renal Care Group (RCG) and Fresenius Medical Care (FMC), with which RCG had merged.  RCG’s home was Nashville, Tennessee, but the company had operations in many states, including St. Louis, where the whistleblower lawsuit was originally filed before it was transferred to Tennessee. […]

16 April, 2010

Rush University Medical Center enters into False Claims Act settlement

By | April 16th, 2010|Whistleblower/Qui Tam|

Rush University Medical Center in Illinois has settled allegations made in a whistleblower lawsuit that the provider made real estate deals with physicians and medical groups in violation of the Stark Law.  The Stark law forbids Medicare payments to hospitals for inpatient and outpatient services and other services such as lab work and radiology when patients are referred for the services by doctors who have a financial relationship with the hospital.  Leases between hospitals and referring physicians violate the statute unless certain safeguards of fairness and neutrality are met, such as a written lease signed by the parties, commercially reasonable terms and fair-market value payments.  The purpose of the Stark law is to make sure that a doctor’s medical judgment is influenced solely by the patient’s best interests and not by improper financial motivations.  Medicare claims to the government are considered false under the federal False Claims Act if they seek reimbursement for services performed by a hospital for a physician whose relationship is not Stark-compliant. […]