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Archive for the 'Legal' Category

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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Posted By Marcella Auerbach Responces 0
Category Legal, False Claims Act, Health care Posted December 27th, 2006

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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Posted By Marcella Auerbach Responces 0
Category Legal, False Claims Act Posted December 6th, 2006

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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Posted By Marcella Auerbach Responces 0
Category Legal, False Claims Act, Health care, Medicare Posted December 5th, 2006

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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Posted By Marcella Auerbach Responces 0
Category Legal, False Claims Act, Health care, Medicare Posted December 4th, 2006

Whistleblower Suits Help Department of Justice Recover $3.1 Billion in FY 2006

A record $3.1 billion was recovered by the Justice Department in FY 2006 which ended on September 30. Prior to this year, the largest recovery was in FY 2003 for a total of $2.2 billion. The largest of FY 2006 recoveries included settlements against Tenet Healthcare Corporation and Boeing Company. “By any measure, it was a remarkable year…recoveries in health care fraud climbed more than a billion dollars over last year…,” said Peter D. Keisler, Assistant Attorney General of the Department of Justice?s Civil Division.

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Posted By Marcella Auerbach Responces 0
Category Legal, False Claims Act, Health care Posted November 30th, 2006

Kickbacks in Medical School? Take a Look at New Jersey’s State Medical School

Two doctors are being fired and the pay of at least eight others are being reduced in the wake of a federal monitor’s charges that the medical school has been paying kickbacks to cardiologists resulting in bilking Medicare and Medicaid out of tens of millions of dollars. The federal monitor said that the school’s top officials were complicit in the scheme and directly accused the interim university president, Bruce C. Vladeck of “trying to rebut, refute and bury” information. Vladeck released a letter responding to the report which included instructions to the dean of the medical school to fire or reduce the pay of 10 of the 18 physicians named in the monitor’s report. The kickback accusations are the latest in a line of accusations which caused investigators, after reading an article in a New Jersey legal publication which detailed a $2.2 million settlement by the school to a whistleblower, the former chief of the division of cardiology, who had warned the school that he feared these arrangements were probably illegal and to look further into the matter.
 

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Posted By Marcella Auerbach Responces 0
Category Legal, False Claims Act Posted November 21st, 2006

Double charges to Medicare Costs HealthSouth $4 Million

Conducting resulting in double charges to Medicare from 1994-2004 for the same prosthetic devices is costing HealthSouth (a nationwide rehabilitation company) millions of dollars. The allegations in this Federal False Claims Act case brought in Memphis, Tennessee, also included a scheme whereby HealthSouth would get braces and artificial limbs at no charge and then turn around and bill Medicare for the same devices.

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Posted By Kenneth Nolan Responces 0
Category Legal, False Claims Act, Medicare Posted November 7th, 2006

$48 Million to become $144 Million Verdict Against Amerigroup Corp. For False Claims

It may cost Amerigroup Corp, a company that specializes in health care for low-income patients $144 million in damages for discriminating against pregnant women. A federal jury returned a $48 million verdict, which will be tripled under state and federal False Claims Act laws. The whistleblower lawsuit alleged that while marketing its services in Illinois, Amerigroup avoided pregnant women and others likely to run up high doctor bills. State Attorney General Lisa Madigan called the company’s alleged discrimination “unconscionable.”

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Posted By Kenneth Nolan Responces 0
Category Legal, False Claims Act, Health care Posted November 3rd, 2006

No Mercy for Keystone Mercy Health Plan

Keystone Mercy Health Plan has agreed to pay $5 Million to Medicaid to settle allegations involving overpayments they filed to return to the Pennsylvania Department of Public Welfare. Lorraine Pittelli, a former Keystone Mercy claims-recovery examiner filed a whistleblower complaint and will receive $780,000 from the settlement .

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Posted By Marcella Auerbach Responces 1
Category Legal Posted October 30th, 2006

Are Unnecessary Heart Surgeries Being Performed?

A False Claims Act complaint has been filed against St. Edward Mercy Medical Center and heart surgeon alleging that unnecessary heart surgeries have been performed to defraud Medicare and other federal health care programs. The complaint , filed jointly by a former patient and a cardiologist, accuses the hospital of knowing that the defendant heart surgeon was performing unnecessary surgeries. For more information click here.

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Posted By Marcella Auerbach Responces 0
Category Legal, False Claims Act Posted October 16th, 2006

 

 

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Nolan & Auerbach, P.A. is a qui tam law firm whose practice is uniquely limited to healthcare fraud cases under the qui tam provisions of the False Claims Act. We know healthcare fraud because that's what we do! Toll free: 800-FRAUD 04