Orthopedic and Reconstructive Center Will Pay $3.5 Million
June 18, 2009 by casey
NewsOK reported on June 9, 2009, the payment of $3.5 million by Orthopedic and Reconstructive Center of Oklahoma (Center) to settle allegations of healthcare fraud. The suit, filed by three former workers, alleged that the Center filed thousands of false claims to receive funds from Medicare, Medicaid and TRICARE for services it did not perform.
As part of the agreement, four Center employees will refrain from participation in any federal health care programs for three years. Despite agreeing to the terms, the Center claims no wrongdoing on its part and has declared that the settlement was a “business decision” that was “in the best interest of the practice and the patients,” said Drew Neville, and attorney for the Center.
U.S. Attorney John Richter said health care fraud will not be tolerated. ”Health care providers can and will be held accountable for their billing practices,” Richter said. “We are firmly focused on vigorously pursuing allegations of fraud and abuse, which divert the scarce resources of Medicare and other government health care programs away from necessary patient care.”
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.
Whistleblowers Rewarded For Revealing Healthcare Fraud
June 18, 2009 by casey
One June 3, 2009, The United States Attorney Office, District of Hawaii, announced that Queen’s Medical Center (QMC) of Honolulu has paid $2.5 million to resolve allegations that it overbilled Medicare, Hawaii’s Medicaid, and TRICARE. This marks the settlement of two congruent lawsuits that were filed by two “whistleblowers” that were former pharmacy technicians at QMC.
Under the federal and State of Hawaii False Claims Acts, the government is able to recover up to triple damages, plus penalties, for fraudulent claims made to government programs. Of the $2.5 million QMC has paid, the government received $2 million, of which it shared $400,000 with the whistleblowers. United States Attorney for the District of Hawaii Edward H. Kubo, Jr., praised the two technicians for their courage in coming forward with the case.
As part of the settlement, QMC, the largest private hospital in Hawaii, will maintain a compliance program to ensure its fulfillment of all applicable program rules and requirements for the next five years. The hospital has pledged to continue its efforts to provide high quality health care while complying with health care rules.
In the case, the former technicians alleged that QMC submitted false bills for medications it dispensed and billed federal programs for services the hospital was not eligible to perform. While QMC has agreed to the settlement, it has denied the government’s contentions.
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.
Three HealthEast Hospitals Will Pay $2.28 Million For Fraudulent Policy
June 4, 2009 by casey
On Thursday, May 21, the Department of Justice announced a $2.28 million settlement between three HealthEast Care System hospitals and the United States. It was alleged that the hospitals, all of which are located in the Minneapolis/St. Paul area of Minnesota, performed kyphoplasties on an inpatient basis in order to increase their Medicare billings.
Kyphoplasties, which are minimally-invasive procedures used to treat osteoporosis-evoked spinal fractures, are typically performed on an outpatient basis. “Outpatient” procedures do not require admission to a hospital and can even be performed outside hospital facilities. By performing kyphoplasties on an inpatient basis, patients were unnecessarily admitted to the hospital and closely monitored before, during, and after the procedure.
In this fashion, the hospitals overcharged Medicare thousands of dollars for each kyphoplasty they performed.
“By keeping patients overnight, hospitals could seek greater reimbursement from Medicare and make much larger profits on kyphoplasty,” said Kathleen Mehltretter, Acting U.S. Attorney for the Western District of New York in Buffalo.
The whistleblower suit was brought under the False Claims Act, which permits private citizens to bring lawsuits on behalf of the United States and receive a portion of the proceeds of any settlement or judgment awarded against a defendant. The lawsuit was filed in 2008 in federal district court in Buffalo, N.Y. by Craig Patrick and Charles Bates. Mr. Patrick of Hudson, Wis., is a former reimbursement manager for Kyphon, and Mr. Bates was formerly a regional sales manager for Kyphon in Birmingham, Ala.
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.
Regency Nursing and Rehabilitation Centers Will Pay $4 Million for Submitting False Claims
June 4, 2009 by casey
The Department of Justice released the settlement of a False Claims Act on Thursday, May 21, involving the Texas-based nursing home chain, Regency Nursing and Rehabilitation Center Inc. The company will pay $4 million to the United States to settle allegations that it submitted false claims to Medicaid and the Texas Medicaid program.
According to the case, Regency sought Medicare and Medicaid reimbursement for services that nursing home residents did not qualify for, were unnecessary, and were unsupported by required certification.
“With the number of Medicare and Medicaid beneficiaries increasing every year, we will take whatever action is necessary to make certain healthcare providers are reimbursed only for legitimate services provided to qualified beneficiaries,” said Tim Johnson, Acting U.S. Attorney for the Southern District of Texas.
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.
