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Nov 22, 2019 by |

California and San Francisco Whistleblower Attorney: Illegal Physician Referrals and Medicare Fraud

ATTORNEY NEWSLETTER

Medicare Fraud From Illegal Referrals, Kickbacks, and False Charges

Stark Law and False Claims Act Suit

Whistleblower/qui tam cases brought under the federal False Claims Act (FCA) often involve false claims for reimbursement under Medicare and Medicaid. In addition to the FCA, the federal Stark Law prohibits physician referrals of a Medicare or Medicaid patient to a health services provider if the referring physician has a financial interest in that provider. The California whistleblower attorneys at Evans Law Firm, Inc. represent individuals with credible information of any type of fraud against the government, including healthcare fraud under the Stark Law and similar statutes.  If you have credible information for a whistleblower or qui tam case, call the whistleblower/qui tam attorneys at Evans Law Firm Inc. today at (415) 441-8669.

In a recent victory for whistleblowers the U.S. Court of Appeals for the Third Circuit revived whistleblower claims alleging a healthcare provider violated the FCA by billing Medicare for services referred by physicians in violation of the Stark Law.[1] U.S. ex rel. Bookwalter v. UPMC et al., No. 18-1693 (3d Cir. Sept. 17, 2019).  In addition to illegal referrals, the Court found the whistleblowers adequately plead allegations that the doctors acted as assistants on surgeries when they did not, stated they acted as teaching physicians when they did not, billed for parts of surgeries that never happened, and performed surgeries that were medically unnecessary or needlessly complex. The case has been remanded to the trial court and discovery is proceeding. 

Whistleblower/qui tam cases like Bookwalter are long and complex.  The rewards for whistleblowers can be substantial, however, and total as much as 15-30% of any amounts the government recovers.  Cases begin with original and credible information of false claims supported by hard evidence and documentation supporting the information.  Ingrid M. Evans and the other California whistleblower/qui tam attorneys at know what the kind of evidence the government looks for in these cases and know how best to structure, organize, and present your evidence and documentation through initial application or complaint, discovery and investigation, and trial and/or settlement negotiations.  

Contact Us

If you or a loved one has information regarding a whistleblower or qui tam case of false claims for Medicare and Medicaid reimbursement, violations of the Stark Law, other false claims or kickback schemes involving government contracts, or cases under the Internal Revenue Code for prosecution of tax avoidance schemes including offshore schemes, contact Ingrid M. Evans and the other California whistleblower attorneys at Evans Law Firm, Inc. at (415) 441-8669, or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>. Our attorneys have experience with large whistleblower cases, complex financial contract litigation, and large insurance companies. We can help guide your case through whistleblower false claims applications, discovery and investigation, a jury trial or toward an equitable settlement.  We also handle cases involving physical and financial elder abuse, nursing home abuse, whole life insurance and universal life insurance, and indexed, variable, and fixed annuities.

[1] Evans Law Firm, Inc. was not involved in the case in any way.

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