Condell Health Voluntarily Discloses Fraud and Will Pay $36 Million
December 23, 2008 by casey
On December 1, MarketWatch.com reported that Condell Health Network has agreed to pay the United States and the State of Illinois $36 million after voluntarily disclosing that its facility in Libertyville, IL, received improper Medicare and Medicaid payments after filing false claims for reimbursement. The disclosures came in the midst of Condell’s acquisition by Advocate Health Care, which is now complete.
Through their cooperation, Condell avoided a government lawsuit under the False Claims Act that would have resulted in higher penalties for their violations.
The settlement involved three fraudulent practices in the relationships between Condell and its physicians that took place from 2002 through 2007. Condell: leased medical office space to physicians at below fair market value rates, which is a violation of federal laws and regulations governing Medicare and Medicaid reimbursement; improperly allowed physicians to “work off” loans the hospital gave to them through hourly rates above fair market value and activities that did not benefit the community; and extended loans without assessment of need that benefitted the physicians and doctors who received them, not the community.
The settlement also alleges that Condell gave incentive bonuses to its physician recruiters, and its financial support agreements forbid doctors from admitting privileges at any other hospitals.
“We commend Condell for bringing these practices to our attention. We expect health care providers to come forward when they discover issues that could rise to the level of fraud without waiting for us to catch up to them, and when they do so, they may well benefit,” said U.S. Attorney Fitzgerald.
If you are witnessing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.
Tennessee Hospitals Will Pay $8 Million To Settle Medicare Fraud Allegations
December 23, 2008 by casey
On December 1, the Memphis Business Journal reported that two Tennessee hospitals will pay $8 million to resolve Medicare fraud allegations. The U.S. Department of Justice argued that claims submitted by the Jackson-Madison County and Milan General Hospitals violated the Federal False Claims Act.
Between July 1997 and June 2002, Jackson-Madison County General Hospital was found to have submitted claims to Medicare that did not meet medical necessity and documentation requirements. The hospital will pay $2.6 million to resolve these charges.
Milan General was charged with improperly admitting Medicare patients into its psychiatric unit and billing Medicare for lengths of stay in units that exceeded coverage criteria. These offenses were reported to have happened between July 1999 and December 2003. Milan General will pay $5.3 million to settle the allegations.
“These settlements with Jackson Madison General and Milan General should serve as a warning to other health care providers who seek to defraud Medicare or any other federal health care programs,” said Lawrence Laurenzi, acting U.S. Attorney for the Western District of Tennessee.
If you are witnessing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.
Bank Involved in Mortgage Fraud To Pay Nearly $11 Million
December 23, 2008 by casey
The U.S. Department of Justice announced on November 25 the settlement of a False Claims Act case involving a mortgage-fraud ring. RBC Mortgage Co., a subsidiary of the Royal Bank of Canada, has agreed to pay nearly $11 million to the United States to settle the case.
The allegations were made in response to actions taken by a branch of the bank in Rockford, Illinois. The bank, which was operating under RBC Mortgage’s former name, Prism Mortgage, was found to have made fraudulent statements to the U.S. Department of Housing and Urban Development regarding the credit, employment or source of equity on 219 loans made by three loan officers and 22 other defendants from February 2001 through April 2004. All 219 loans resulted in foreclosures.
RBC Mortgage has not initiated a mortgage loan since September 2005, and all 25 defendants were convicted on federal charges. One of the three loan officers was sentenced to 20 months in federal prison and ordered to repay nearly $500,000. The other two loan officers were sentenced to probation and restitution. Others sentenced to prison include two real estate agents who contributed to the scam, and the employees and owners of R&J Renovations, which provided fraudulent employment documents.
If you are witnessing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.
MedQuist Overbilled VA, DOD, Others; Settles for $6.6 Million
December 23, 2008 by casey
On December 3, the U.S. Department of Justice reported that MedQuist, the world’s largest Medical Transcription Service Organization, has paid $6.6 million to the United States to resolve False Claims Act allegations.
The suit alleged that the New Jersey-based company fraudulently overbilled numerous federal government clients, including the Department of Veterans Affairs (VA), the Department of Defense (DOD), and the Public Health Service (PHS), a sector of the Department of Health and Human Services (HHS).
“The federal government relies on its contractors to provide accurate billing information and it thus will act vigorously against allegations of knowing overbilling,” said Gregory G. Katsas, Assistant Attorney General of the Civil Division of the Department of Justice.
Whistleblowers Christopher Foley and Susan Purdue, who were permitted to file their lawsuits on behalf of the U.S. through the False Claims Act, will receive $450,000 and $144,000, respectively.
If you are witnessing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.
