• About John Howley
JOHN HOWLEY, ESQ.
  • About John Howley

Six-Figure Whistleblower Reward for Former Coding Manager

3/12/2013

0 Comments

 
Picture
A former revenue manager and coding compliance officer for a radiology practice will receive a whistleblower reward of between $345,000 and $575,000 for helping the government uncover double billing of Medicare and Medicaid by his former employer and one of its clients.

The whistleblower went to the government with evidence that Children’s Physician Services of South Texas had billed and received payment for professional services provided by a radiology practice and, without disclosing the payments, directed the radiology practice to bill and receive payment for the same professional services.

Here’s how the fraud worked.  Technicians working for Children’s Physician Services took genetic ultrasounds of patients and sent the resulting images to Radiology Associates for reading and interpretation by a physician.

Children’s Physician Services then billed Medicare and Medicaid for both the taking of the ultrasound and the reading and interpretation of the ultrasound image.  When Radiology Associates billed for its professional services, that resulted in double billing of Medicare and Medicaid for the reading and interpretation of the ultrasound image.

At some point, the government alleged, Radiology Associates learned of the double billing but continued to bill Medicare and Medicaid anyway.

A former coding manager at Radiology Associates ended the fraud – which involved thousands of ultrasound images over a five-year period – by commencing a qui tam or whistleblower lawsuit under the False Claims Act.  The lawsuit was filed “under seal” and disclosed only to local prosecutors.  The prosecutors then conducted an investigation and decided to join in the lawsuit.

Children’s Physician Services and Radiology Associates agreed to settle the lawsuit by paying a total of $2.3 million.  Under the False Claims Act, the former coding manager will receive between 15% and 25% of that amount as his whistleblower reward, for a total reward of between $345,000 and $575,000.

If you are aware of false claims submitted to Medicare or Medicaid, then you should consult with an experienced whistleblower attorney to find out if you may be entitled to a whistleblower reward and legal protections.

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 via email.

John Howley, Esq.



The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation.  I invite you to contact our law offices and welcome your calls, letters and electronic mail.  Contacting us does not create an attorney-client relationship.  Please do not send any confidential information to us until such time as an attorney-client relationship has been established.  I practice law and offer legal services only in jurisdictions where I am properly authorized to do so.  I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules.
0 Comments

Your comment will be posted after it is approved.


Leave a Reply.

    Picture
    John Howley, Esq.
    350 Fifth Avenue 59FL
    New York, NY 10118
    (212) 601-2728

    Employment Law

    Healthcare Fraud

    Whistleblower Rewards
Get an Experienced Advocate On Your Side​
John Howley is available to consult with potential clients by telephone, video-conference, or in person.  All consultations are by appointment.  To schedule a consultation, call our offices today at (212) 601-2728.
Click to Call


​Follow John Howley, Esq.

Follow John Howley, Esq. on social media for the latest legal news and updates.



​John Howley, Esq. | 1345 6th Ave 2nd floor | New York, NY 10105 | (212) 601-2728
​
​Copyright (c) 2012-2023 by John Howley, Esq.  This web site is for educational purposes only,  It does not provide legal advice, nor does it solicit clients seeking legal advice or representation.  To the extent it may be considered attorney advertising, readers are cautioned that prior results do not guarantee a similar outcome.
  • About John Howley