Qui Tam 101

Archive for the 'False Claims Act' Category

U.S. Joins Suit Against Renal Care Group Alleging False Billings to Medicare for Home Care Renal Dialysis

Last month, the United States intervened in a qui tam lawsuit accusing Renal Care Group Inc. (RCG) and Renal Care Group Supply Company (RCGSC) of fraudulently billing Medicare. The suit alleges that RCG and RCGSC fraudulently billed for supplies and equipment provided to End Stage Renal Disease (ESRD) patients who received dialysis treatments at home. Both companies are owned by Fresenius Medical Care Holdings Inc. which was also named in the lawsuit.

Feds Sue Nursing Home Company

Cathedral Rock Corporation of Ft. Worth, Texas, which operates five nursing homes in St. Louis, Missouri has to now defend itself against a medicaid fraud lawsuit brought by federal authorities for violations of the False Claims Act.  The lawsuit was brought by two whistleblower nurses who complained that patients were being neglected and that the facilities provided “worthless” health care. 

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Unlawful Use of Grant Money Costs Cancer Institute $2.3 Million

The Institute for Cancer Prevention (IFCP) has agreed to pay $2.3 million to resolve civil False Claims Act charges as well as potentially other claims arising from their improper receipt and use of federal grant money. IFCP was a not for profit medical research foundation located in Valhalla, New York. Although currently bankrupt, IFCP formerly derived approximately 90% of its funding from federal grants and contract from the National Institute of Health.

IFCP was permitted to use the grant money only for payment of specified federal grant expenses that were immediately due and owing. However, in 2002 and 2003, IFCP allegedly used approximately $5 million to pay bills from federal grant money that was not eligible for reimbursement under its federal grants. Further, IFCP submitted false reports regarding its use of grant money to the United States Department of Health and Human Services.

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Hospitals Are Giving Lessons on Blowing the Whistle on Fraud

A federal law that takes effect in January 2007 requires the country’s hospitals and nursing homes to educate their employees and officers on how to detect and report fraud. This requirement applies to companies that earn at least $5 million a year in Medicaid business. Under the False Claims Act, whistleblowers have received millions of dollars for disclosing large-scale fraud.

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Halliburton Subsidiary Pays $8 Million to Government

KBR (Kellogg Brown and Root), a subsidiary of Halliburton, has settled allegations of overcharging by paying $8 Million to the Government. According to the allegations, KBR was accused of double billing and other contract irregularities during the military operations in the Balkans in 1999 and 2000. The fraud centered around the construction of Camp Bondsteel in Kosovo. To read more on this article, click here.

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Allegations of Kickbacks and Medically Unnecessary Treatments Costs Miami Hospital $15.4 Million

$15.4 Million was paid to settle federal and state of Florida civil health care fraud claims against Larkin Community Hospital located in Miami, Florida as well as its current and former owners. The allegations involved the payment of kickbacks to physicians in exchange for patient admissions, including sending patients to Larkin Community Hospital for medically unnecessary treatment. Some of the patients came from assisted living facilities owned and operated by several of the owners of Larkin Community Hospital.

Peter D. Keisler, Assistant Attorney General for the Department of Justice Civil Division stated, “The Department of Justice is committed to vigorously litigating cases about conduct that undermines the integrity of the Medicare and Medicaid programs. We will not tolerate health care providers who pay kickbacks or perform medically unnecessary treatments on elderly beneficiaries in order to generate Medicare and Medicaid payments.”

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Cost Report Fraud Allegations Cost Baptist Medical and Integris Health $12.2 Million

A former contractor of Integris blew the whistle on Integris Health, Inc., alleging that it was submitting inflated claims to Medicare. The complaint stated that Integris sought payment from Medicare for post and non-transplant related costs that Integris knew were not reimbursable under the Medicare program. In addition,the Complaint alleged that Integris claimed Medicare reimbursement for liver and heart organ acquisition costs related to transplant patients who were not Medicare beneficiaries. The whistleblower will receive $2.3 million as a share of the recovery under the False Claims Act. Integris Baptist Medical Center, a not-for-profit health organization, is located in Oklahoma City, Oklahoma and operates the largest Medicare certified Heart, Liver and Kidney transplant program in the state of Texas. Integris Health, Inc. is the parent corporation for Integris Baptist Medical Center.

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