Qui Tam 101

Archive for the 'Medicare' 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.

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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