The former billing manager for MedStar Ambulance, Inc. will receive a $3.5 million whistleblower reward for reporting overbilling at the ambulance company. MedStar has agreed to pay $12.7 million to settle the whistleblower’s claims that it billed Medicare for unnecessary ambulance services. The whistleblower’s complaint alleged that the company billed Medicare for ambulance services that were not medically necessary, that were billed at higher levels of services than patients’ conditions required, and that were billed at higher levels of services than were actually provided. One of the schemes involved billing Medicare for routine trips to a doctor’s appointment or nursing home as if they were emergency runs in order to receive higher Medicare reimbursements. The whistleblower also reported that the company double-billed patients and Medicare, and that it billed Medicare when it should have billed hospitals or municipalities. The whistleblower brought his claims under the qui tam provisions of the False Claims Act. He filed a complaint “under seal” (i.e., in secret) in federal court and handed over all of his evidence to the U.S. Attorney. The government then used his evidence to conduct an investigation and pursue claims against the company. The False Claims Act provides that a whistleblower is entitled to a reward of between 15% and 30% of the amount the government actually recovers. In this case, the whistleblower will receive $3.5 million, or approximately 28% of the government’s recovery. If you have evidence of overbilling or false claims submitted to Medicare or Medicaid, then you should consult with an experienced whistleblower lawyer immediately to protect your rights. There are strict time limits and procedural requirements to preserve your claim. Call John Howley, Esq. at (212) 601-2728 to schedule a free and confidential consultation.
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Drayer Physical Therapy Institute, LLC has agreed to pay $7 million to settle allegations that it submitted false claims to Medicare, TRICARE, and Federal Employee Health Benefit Programs. Two former employees brought a whistleblower or qui tam lawsuit against the company under the False Claims Act. The whistleblowers alleged that the company provided services to multiple patients simultaneously, but then billed the government at the much higher rate for services provided by a physical therapist to one patient at a time. The False Claims Act allows individuals to file healthcare fraud lawsuits on behalf of the government and share in any recovery. In this case, the two whistleblowers will share 24% of the settlement payment, or approximately $1.7 million. This reward is based on the amount and quality of evidence the whistleblowers brought to the government, as well as their willingness to help the government during an investigation of their claims. As this case illustrates, whistleblowers are essential to the government’s efforts to crack down on multi-million dollar frauds. Without the help of whistleblowers, it is virtually impossible for the government to uncover this type of fraud. Only insiders know both what type of treatment the patients received and how that treatment was billed to the government. If you have evidence of false claims submitted to Medicare or Medicaid, then you should consult with an experienced whistleblower lawyer immediately. You will help stop fraud and waste in the healthcare system. You may also be entitled to legal protections and a substantial financial reward as a whistleblower. Do not delay. There are strict time limits and procedural requirements to claim a whistleblower reward. Call John Howley, Esq. at (212) 601-2728 today to schedule a free and confidential consultation with an experienced whistleblower lawyer. John Howley, Esq. The Howley Law Firm P.C. 350 Fifth Avenue, 59th Floor New York, New York 10118 (212) 601-2728 Renown Health has agreed to pay $9.5 million to settle allegations that it submitted false claims to Medicare for in-patient hospital services. According to a whistleblower complaint, the services should have been billed at much lower rates for out-patient or observation services.
The settlement resolves a qui tam or whistleblower lawsuit brought by a former employee under the False Claims Act. That law allows individuals with evidence of false claims to commence a lawsuit on behalf of the government and share in any recovery. The whistleblower in this case will receive a $1.7 million reward from the settlement. During her employment as Director of Clinical Compliance, the whistleblower noticed a number of technical billing discrepancies. One of the issues she noticed was the submission of claims to Medicare for in-patient care when it appeared that the patients had never been admitted to the hospital. After bringing her concerns to management without any success, the whistleblower brought her concerns to the government in the form of a qui tam lawsuit. Qui tam lawsuits are filed “under seal” (that is, in secret) to allow the government time to investigate before the defendant learns that it is a suspect in a Medicare fraud investigation. The government then decides whether to pursue the lawsuit on its own, or to allow the whistleblower, known as a “relator,” to pursue the lawsuit on its behalf. If the government pursues the lawsuit and wins, the relator is entitled to a reward of between 15% and 25% of the amount actually recovered. If the relator pursues the lawsuit on behalf of the government, then she is entitled to a reward of between 25% and 30% of the amount recovered plus her attorney’s fees and costs. If you have evidence of false claims submitted to Medicare or Medicaid, then you should consult with an experienced whistleblower lawyer immediately to protect your rights. You may be entitled to legal protections and a significant financial reward. There are, however, strict procedural requirements and time limits to qualify for a whistleblower reward. You should not delay. To schedule a free and confidential consultation with a whistleblower lawyer, call John Howley, Esq. at (212) 601-2728. |