FIRST PERSON: Don’t Muzzle the Whistleblowers

RIPPING OFF THE U.S. government has reached epidemic proportions. The Department of Justice estimates that fraud costs the Medicare system alone between $30-$60 billion annually. But instead of fines and jail time, fraudsters are frequently rewarded with more government business. And if the U.S. Chamber of Commerce and its allies have their way, these fraudsters will gain enhanced legal protection. The U.S. Supreme Court recently heard oral arguments in a critical case testing the right of citizens to bring suit in the name of the United States in order to recover damages from corporations or individuals that have cheated the government. By taking up the case known as Schindler Elevator, the high court is looking into whether a private citizen can secure information from a Freedom of Information Act request and use that information to form the basis of a qui tam or False Claims Act whistleblower lawsuit…

Read the complete article here: https://www.law.com/corpcounsel/almID/1202489937878/

Home Healthcare Agency Settles Whistleblower Suit for $5.8m

Doctor’s Choice Home Care, Inc. and former executives have agreed to pay $5.8 million to settle allegations that the home health agency engaged in a variety of conduct in violation of the False Claims Act, including providing illegal remunerations or bonuses for referring physicians. Doctor’s Choice, which provides medical services to Medicare patients in their homes, was also accused of pressuring clinicians to increase the number of visits to Medicare patients to avoid triggering protocols that reduce Medicare payments for low-visit patients. This settlement specifically contends that Doctor’s Choice acted in violation of both the Stark Law and the Anti-kickback Statute of the False Claims Act.

The suit was brought by four whistleblowers, all former employees of Doctor’s Choice.

Read the full press release here: https://www.justice.gov/opa/pr/home-health-agency-and-former-owner-pay-58-million-settle-false-claims-act-allegations

How a Civil War law forced a local medical group to pay $5.3M

Highland woman sued Hudson Valley Hematology Oncology Associates under the False Claims Act

John Ferro | Poughkeepsie Journal

In 1863, at the height of the Civil War, Congress passed legislation to ensure suppliers to the Union Army were not cheating the government.

More than 150 years later, that legislation — the False Claims Act — and its amended derivatives enabled a local worker to challenge the billing practices of her former employer, Hudson Valley Hematology Oncology Associates, resulting in a $5.3 million settlement announced Friday by Preet Bharara, U.S. Attorney for New York’s Southern District.

The medical practice, which treats cancer and blood disorders and has offices in Poughkeepsie and Fishkill, admitted it illegally waived Medicare co-pays for patients and then added those amounts to its bills to the taxpayer-funded health insurance program.

It also admitted it entered billing codes indicating doctors had overseen or administered a procedure, when only a nurse had done so, thereby inflating the bills to Medicare and Medicaid.

Source: https://www.poughkeepsiejournal.com/story/news/local/2016/10/24/false-claims-act-fraud-medicare/92519838/

LATEST: U.S. District Court denied Motion to Dismiss a case against the Massachusetts General Hospital

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