Author Archives: Staff

During a raid conducted by federal authorities, sixteen people within the Los Angeles area were arrested for an $18 million Medicare fraud scheme. One of the doctors arrested worked at Manor Medical Imaging Clinic of Glendale, where he wrote prescriptions for anti-psychotic drugs that were billed to Medicare and Medi-Cal, but never sent to patients. If convicted, the sixteen individuals could face up to 30 years in federal prison.

Read more at: http://www.businessweek.com/ap/financialnews/D9QLANFG0.htm

The Centers for Medicare & Medicaid Services (CMS) has yet to impose a single moratorium on new Medicare providers and suppliers, an authority CMS officials were given by President Obama’s health care reform eight months ago. Concerned about CMS’ inaction,  Senators Chuck Grassley (R-Iowa) and Orrin Hatch (R-Utah) have written a letter to Heath & Human Services (HHS) Secretary Kathleen Sebelius. In the letter, they note that “[i]t is not reasonable to suggest that CMS needs more time to study whether there is need to impose a temporary moratoria … when ample evidence exists from the strike force activities to justify moratoria in these high fraud areas.”

 
Read more: http://www.fiercehealthcare.com/story/congress-urges-cms-fight-medicare-fraud-moratoriums/2011-10-27#ixzz1cMxxoWqc

In a recently unsealed lawsuit, whistleblower Gale Bryden accused Wyoming Medical Center of defrauding Medicare and Medicaid. The lawsuit claims that the hospital’s records clerks altered hospital records by changing patient admission status without physician orders, which resulted in increased reimbursements. Hospital attorney Dick Williams states, “We have denied from day one that there was any intent to improperly bill the government…. Or that there was a systematic direction from anyone to alter statuses or records.”

Read more: Whistleblower accuses hospital of fraud under false inpatient status – FierceHealthcare http://www.fiercehealthcare.com/story/whistleblower-accuses-hospital-fraud-under-false-inpatient-status/2011-10-26#ixzz1cMxhazxq

Former sales executive with Champion Industries, William Burch, has been sentenced to two years in federal prison for giving bogus evidence to federal prosecutors in a whistleblower investigation against Champion Industries. Burch forged a letter from competitor Honeywell to support the whistleblower suit he filed in 2008, which implied that Honeywell had notified Champion of a planned price increase in oil filters, before the information became public. Assistant U.S. Attorney Mary Crawley stated that the grand-jury investigation that resulted from the forged evidence provided by Burch cost the government more than $83,000 and “perverted the criminal investigative process.”

Read more at: http://www.philly.com/philly/news/132632393.html

Software company Oracle Corp. and Oracle America will pay $199.5 million plus interest to the General Services Administration. The settlement is expected to be the largest false claims settlement ever collected by the General Services Administration. The settlement falls under the whistleblower provisions of the False Claims Act, as the company failed to meet its contractual obligations regarding a 1998 agreement with GSA.

Read more at: http://washingtontechnology.com/articles/2011/10/07/oracle-settlement-gsa-false-claims-lawsuit.aspx