According to court records, the nurse signed false medical documentation for his employers, a group of home health care agencies. Each home health agency used the false medical records to bill Medicare for home health care services that were never actually rendered.
The home health care agencies accused of participating in the Medicare fraud are Physicians Choice Home Health Care LLC, First Care Home Health Care LLC, Quantum Home Care Inc., and Moonlite Home Care Inc.
Medicare paid the home health companies a total of $13.8 million in false claims. Of that amount, Medicare paid approximately $450,988 for skilled nursing claims based on falsified patient records signed by this particular nurse. Nine other individuals have pleaded guilty and await sentencing. Six more are waiting for trials on the home health fraud charges against them.
This is yet another sad story of employees who went along with their employer’s submission of false claims to Medicare. Instead of receiving a reward for reporting the fraud, these employees will spend years in prison and pay hundreds of thousands of dollars to the government in restitution.
Nurses, physical therapists, billing and accounting staff, and other healthcare employees are at serious risk if they know that their employer is submitting false claims to Medicare or Medicaid. If you think that you will never get caught, or that you are too low on the organization chart to matter, you should think again.
The government goes after everyone who has any involvement in health care fraud. And it has very powerful tools to detect false and fraudulent claims, including sophisticated computer programs to detect suspicious billing patterns. The government also has thousands of investigators and auditors who are constantly looking for evidence of Medicare and Medicaid fraud. They try to find everyone who had any role in the fraud.
You do have options. You can choose to do nothing and wait until the FBI shows up to interrogate you. Or you can consult with an experienced False Claims Act lawyer now to protect your rights. Those rights may include a large reward for helping the government stop Medicare and Medicaid fraud. Under the False Claims Act, a whistleblower who helps the government recover money paid on false claims is entitled to between 15% and 30% of the amount recovered.
If you are aware of false documents or fraudulent claims involving Medicaid, Medicare, or another federal government healthcare program, then you should consult with an experienced False Claims Act attorney immediately to protect your rights. To schedule a free and confidential consultation by telephone or in person, call my office today at (917) 652-6504 or click here to communicate with me via email.
John Howley, Esq.
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