ATTORNEY NEWSLETTER
Cardiology Practice Allegedly Failed To File Required Reports
Former Employee Blew Whistle On The Violations
Case Settles For $500,000 And Whistleblower Rewarded
Anytime a healthcare provider submits a claim to the government for reimbursement under Medicare, Medicaid, or any other government-sponsored healthcare program, the provider must comply with all the regulations that pertain to that request. For example, the government requires certain reports or certifications with respect to the medical procedure supposedly performed. If the provider knowingly fails to supply those certifications or reports, or submits false ones, those acts may constate actionable fraud under the False Claims Act (FCA), 31 U.S.C. §§ 3729 et seq. If you have credible information of healthcare fraud against the government, call Ingrid M. Evans and the other whistleblower attorneys at Evans Law Firm, Inc. today at (415)441-8669 or toll free at (888)50EVANS 503-8267 and we can help.
False Or Incomplete Reporting
Fraud against the government’s Medicare and Medicare-related programs totals in the billions every year. Some of the cases are very large but many of the cases are relatively smaller but cumulatively add up. The Department of Justice recently announced a $500,000 settlement of an FCA whistleblower case[1] resolving allegations that a cardiology practice submitted claims for reimbursement to Medicare and Medicaid that required both performance of the itemized procedures and the generation of corresponding interpretive reports. The United States alleged that the practice submitted and received payment for these claims without generating the required interpretive reports. A former employee in the practice blew the whistle on the group’s alleged failure to document the procedures as required by law. As the U.S. Attorney working on the case states, “When providers cut corners by failing to ensure that procedures are adequately documents, it cheats both the patients and the government.”
Former Employee Rewarded
The former employee who initiated the suit will receive a share of the government’s recovery. Any whistleblower suit, or qui tam action as it is called under the False Claims Act, is commenced by an individual, known as a “relator,” filing a complaint under seal in the U.S. District Court, and providing a copy of the complaint and other evidence to the local U.S. Attorney. 31 U.S.C. § 3730(b). The United States then has an opportunity to investigate the claims. If the government declines to intervene in the action, the relator may continue to litigate on his or her won. 31 U.S.C. § 3730(c). In either case, the False Claims Act provides the whistleblowers with a share of the government’s ultimate recovery in any judgment or settlement. 31 U.S.C. § 3730(d).
Contact Us
If you are an employee, former employee, bookkeeper, consultant, or other insider with original information of fraudulent reporting or concealment with respect to claims under Medicare or Medicaid, contact Ingrid M. Evans and the other California whistleblower and false claims attorneys at Evans Law Firm at (415) 441-8669, or toll free at (888)50EVANS 503-8267 or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>. In addition to False Claims Act cases, Evans Law Firm also handles bank fraud whistleblower cases under the Financial Institutions Reform, Recovery, and Enforcement Act (FIRREA), commodities and futures trading cases under the Commodities Futures Trading Commission Whistleblower Program, securities fraud cases under the Securities and Exchange Commission Whistleblower Program and FINRA Whistleblower Office and offshore tax evasion and other tax fraud cases under the Internal Revenue Service Whistleblower Office.
[1] Evans Law Firm, Inc. was not involved in the case in any way.
