It happens all the time. A physical therapist is asked to authorize more therapy than the patient really needs. An EMT who transports patients in ambulances to dialysis treatment is asked not to indicate on the trip report that the patient was in a wheelchair or able to walk. A visiting nurse is asked to submit time sheets for more time than was actually spent with the patient.
The employer uses these documents to submit millions of dollars in false claims to Medicare. When they get caught – and at some point they always get caught – the employer pays back the money, and the employees go to prison.
In a recent case, a registered nurse pleaded guilty to home health fraud after government investigators discovered that she had signed false documents for a home health care company.
The nurse admitted that she created nursing visit notes to justify home health care services that the patients did not really require. She also admitted that she signed nursing visit notes for home visits, when the visits were actually made by other individuals who were not licensed.
The employer used these types of false records from this nurse and others to submit $24 million in false claims to Medicare for home health care services.
The nurse now faces up to ten years in prison and a fine of up to a $250,000.
If the nurse had contacted an experienced whistleblower attorney, she could have protected herself and earned a substantial reward. Under the federal False Claims Act, individuals who help the government stop Medicare fraud are entitled to a whistleblower reward of between 15% and 30% of the amount the government recovers.
For example, if this nurse had helped the government collect $24 million from the home health care company, she would have been entitled to a whistleblower reward of between $3.6 million and $7.2 million. Instead, she is facing the possibility of a very long prison sentence.
Do not go to prison for your employer’s fraud. If you are aware that your employer is creating false documents, then you should consult with an experienced whistleblower attorney immediately. You may be entitled to legal protections and a substantial reward under the False Claims Act.
To arrange a free and confidential consultation with an experienced whistleblower attorney, call John Howley, Esq. at (212) 601-2728 or click here to reach our office by email.
John Howley, Esq.
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