The Harris County Hospital District in Houston Texas has agreed to pay over $15 million to the United States and the State of Texas in a settlement that was brought under the False Claims Act.

An employee in the Patient Billing Services filed the lawsuit after observing false statements and claims being made in regards to Medicare and Medicaid from 2000 through 2005. He filed the lawsuit under the qui tam division of the False Claims Act.

The employee alleged that the Hospital District had been filing claims under Medicare and Medicaid without first seeking payment from primary carriers. He also alleged that the Hospital District was submitting claims for incarcerated individuals who received medical treatment. Incarcerated individuals usually pay for their bill themselves, and only in limited situations does Medicare and Medicaid cover them.

The terms of the settlement stipulated that $12,095,839 will go to the federal government, and $3,353,287 to the State of Texas. In a second part of the settlement, the Hospital District agreed to fully comply with all Medicare and Medicaid regulations in the future.

“The settlement reached in this case restores more than $15 million to the taxpayers of the United States and Texas, but more importantly, results in the Hospital District agreeing to properly invoice Medicare and Medicaid in the future,” said United States attorney Don GaBrielle.

November 29, 2006

United States Attorney Richard B. Roper announced that Integris Baptist Medical Center, Inc. and Integris Health, Inc. have agreed to pay the United States $12,200,000.00 to resolve allegations they violated the False Claims Act by submitting inflated claims to the Medicare program in their annual cost reports.

Integris Baptist Medical Center is a not-for-profit health organization located in Oklahoma City, Oklahoma and it operates the state’s largest Medicare certified Heart, Liver, and Kidney transplant program. Integris Health, Inc. is the parent corporation for Integris Baptist Medical Center.

This settlement resolves allegations that Integris Baptist Medical Center and Integris Health (“Integris”) submitted false claims in their annual Medicare cost reports that included inflated costs related to Integris’ organ transplant department. The complaint alleged that Integris improperly sought payment from Medicare for post-transplant and non-transplant related costs that Integris knew were not reimbursable under the Medicare program. It was also alleged Integris sought Medicare reimbursement for liver and heart organ acquisition costs related to transplant services that were provided to patients who were not Medicare beneficiaries.

Read the rest of the article here.

The clip, which has since been removed by De Kort pending legal action, (view an updated clip at YouTube) has reportedly been seen by over 800,000 viewers around the country. The corporation has many military contracts, and one is the refurbishing of Coast Guard ships. De Kort alleges that faulty equipment and dangerously inadequate security systems are being knowingly allowed by the corporation on these boats.

Probably to no one’s surprise, Lockheed is denying this. De Kort was laid off from the company shortly after he went public in this innovative manner.

While his blowing the whistle is admirable, and could ultimately save the lives of American sailors, this startling, news-making method is not really a good idea. It would be much more effective if he had quietly copied the key documents showing the faults, and especially the corporation’s knowledge, and gone to the key federal investigators and U.S. attorneys.

With the guidance of experienced False Claims Act attorneys, he likely would have had the right federal investigators digging in and helping him prove the allegations. He would then also likely have been in a position to recover a good percentage of the monetary penalties the corporation would have to pay if he was correct about the faults and the cover up.

Public exposure is good for our safety, and often even our national defense. However, public exposure through the media is nearly always better after a good case has been put together and presented to the key federal investigators.