Because health care fraud in the Medicare and Medicaid programs is such a huge problem, this week our whistleblower lawyer blog writers (former federal prosecutors who are now whistleblower attorneys) begin a series of posts on “Lessons from Health Care Fraud in Medicare and Medicaid.” We will discuss how whistle…
In a whistleblower lawsuit settlement, the Loma Linda Behavioral Science Center agreed to pay more than $2 million to resolve allegations of overbilling. This False Claims Act whistleblower case was filed by a former employee of Healthcare Financial Advisors (HFA), a consulting firm that advises hospitals in preparing cost reports.…
Health care cases remain busy this week. The Justice Department on April 26 announced that it is joining whistleblowers in pursuing three qui tam lawsuits against HealthEssentials Solutions Inc. (HES) that allege false claims were submitted to Medicare. The cases involve allegations of upcoding — improperly using a diagnosis code…
We find it staggering to read about how blatant Medicare fraud can be, which often provokes a whistleblower to step forward. Today’s L.A. Times reports on a shameless scheme to defraud Medicare: Elderly and mentally ill patients allegedly were offered doughnuts, candy and other gifts to lure them into more…
According to a recent report issued by the Inspector General of the Department of Health and Human Services, State enforcement results regarding Medicaid fraud cases have been disappointing. Virtually every state in the country has a State Medicaid Fraud Control Unit whose principle job is to uncover and detect fraud…
We saw another significant whistleblower case against a drug company hit the news wire this week. The government announced that it was joining a qui tam lawsuit under the False Claims Act against the company Boehringer Ingelheim Roxane, Inc. The Complaint alleges overcharging on pharmaceutical products. In joining this lawsuit,…
I looked into the experiences that states have had with their own False Claims Acts, because almost every state is considering passing its own. I have tried to provide a brief summary that I hope is useful to you. To encourage states to enact their own False Claims statutes with…
The International Federation of Pharmaceutical Manufacturers and Associations revised its Code of Ethics on January 1 of this year for the first time in a decade. Under the newly revised Code of Ethics, members of the trade group which represents pharmaceutical companies worldwide may no longer provide “expensive gifts” or…
This is the final section of my article. It discusses the most significant recent qui tam cases under the False Claims Act (as of December 2006). B. Recent Significant Recoveries Under the False Claims Act: 1. Health Care Industry a. Tenet Healthcare Corporation: $900 million In June 2006, Justice Department…
This is part 4 of my article on the False Claims Act. This part discusses the huge increase in federal dollars recovered in the past few years: IV. Recent Recoveries and Other Developments In Qui Tam Litigation A. An Explosion of Federal Dollars Recovered Since 1986, Under the False Claims…