The United States Department of Justice ("DOJ") has settled seven whistleblower lawsuits against Community Health Systems, Inc. ("CHS") for a total of over $98 million. One was brought by Dr. Thomas L. Mason, M.D., a board-certified emergency physician, who had filed a whistleblower case against CHS in the United States District Court for the...
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Category: Healthcare Fraud
Nurse’s reward $15 million for blowing whistle on health care fraud
A Monroeville nurse will get just over $15 million for blowing the whistle on fraud at a national home healthcare company where she once worked. That company Amedisys Inc., a home health company operating in 37 states, agreed to pay $150 million in a settlement announced today.
"Amedisys made...
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GSK marketing exec turns whistleblower says doctors bribed to boost sales
A former marketing exec for Britain's biggest drug company,Ā GlaxoSmithKline, alleges that the companyĀ bribed doctors in Poland using money that was meant to be spent on educating patients.TheĀ whistleblower Jarek wisniewiski, claims that money put aside to teach patients in Poland about an asthma...
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IBM and others see big profits in preventing financial and healthcare fraud
IBM has announced the creation of a fraud and financial crimes prevention business combining big data analytics, business acumen and data visualization.Ā The global market for financial fraud detection well exceeds $8 billion per year and that is growing quickly.
Hackers penetrated many major computer systems last year to the tune of millions.
Hospital pays Uncle Sam $8.5 million to settle kickback fraud case
Memorial Hospital in Ohio Pays Government $8.5 Million to Settle False Claims Act Allegations that it violated the False Claims Act, the Anti-Kickback Statute and the Stark Statute by engaging in improper financial relationships with referring physicians, the Justice Department announced today.
"Improper financial relationships between health care providers and their referral sources can undermine...
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Diagnostic Laboratories pays $19.4 million for kickbacks to skilled nursing facilities
Diagnostic Laboratories and Radiology will pay $19.4 million to the federal government and State of California for allegations it provided kickbacks to skilled nursing facilities.
The information was revealed by two former employees who became whistleblowers who also claim that they were fired from DLR after they reported the billing practices to the authorities.
In the...
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Medicare billing fraud schemes of skilled nursing facilities sapping the system
In 2010, the Office of Inspector General (OIG) conducted a study of billing by skilled nursing facilities (SNF) after the Medicare Payment Advisory Commission raised concerns about SNF's improperly billing for Ā therapy to obtain additional Medicare payments. In 2012, Medicare paid $32.2 billion for SNF services.
What the OIG found was that skilled nursing...
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Tenet Healthcare paid kickbacks to clinics referring undocumented Hispanic pregnant women says Uncle Sam
Tenant Healthcare and Health Management Associates paid hundreds of thousands of dollars to clinics to steer undocumented pregnant Hispanic women to their hospitals, then filed fraudulent Medicare claims for their care , according to an unsealed federal whistleblower complaint.
The suit was originally filed by Ralph D. Williams, former Chief Financial Officer (CFO) at HEalth...
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Drugmakers use nursing home residents to push off label uses of drugs to defraud Medicare
Drugmakers have found a way to make more money by defrauding Medicare by marketing the off label uses of drugs to nursing home patients. This large group of helpless, hapless people can do nothing to stop being used as guinea pigs.
One example is Par Pharmaceuticals which paid $45 million this year to settle federal...
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U.S. files False Claims Act complaint against largest for-profit hospice chain Vitas Healthcare
The United States Department of Justice has filed suit against Vitas Hospice Services LLC and Vitas Healthcare Corporation alleging they submitted false billings to Medicare for hospice services for ineligible patients. In addition, the government alleges the companies billed for services that were not actually provided and focused on maximizing reimbursement and disregarded the...
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