Category: Medicare

ATTORNEY NEWSLETTER In 2010, a whistleblower came forth with information showing Extendicare Health Services Inc., a nursing home chain, was defrauding Medicare and Medicaid by charging patients for below-average care. Now, the nursing home chain will be paying $38 million to settle the failure-of-care claims – the largest amount ever […]

ATTORNEY NEWSLETTER When people hear the term “whistleblower,” they might associate it with large financial rewards and exposing companies committing financial fraud. This isn’t wrong.  However, there is a side to whistleblowing that is just, if not even more important, than exposing financial fraud.  Especially in whistleblower lawsuits against hospitals […]

ATTORNEY NEWSLETTER In August, Community Health Systems, Inc. (CHS) and Community Health Systems Professional Services Corporation along with 119 of their hospitals settled seven False Claims Act lawsuits for $98 million. Whistleblowers from all around the country came forth with information regarding the inappropriate practices of CHS and its associated […]

ATTORNEY NEWSLETTER If you are a victim of non-payment of a primary payment or reimbursement by a primary plan employer or carrier, you can file a private action against them for damages. Not only do they have to pay, they have to pay twice that amount.  On August 28, 2014, […]

ATTORNEY NEWSLETTER Whistleblowers brought two False Claims Act lawsuits for Medicare fraud against UnitedHealth Group, Inc. the first in 2011 and the second in 2014. On August 28, 2014, the Department of Justice joined the two complaints against UnitedHealth. In both lawsuits, whistleblowers alleged that UnitedHealth billed Medicare for hospice […]

ATTORNEY NEWSLETTER It has been more than a year since the landmark Supreme Court ruling in United States v. Windsor. The effect of the decision on law and policy continues to evolve. Recently the Centers for Medicare and Medicaid Services (CMS) released a new guideline that pertains to same sex […]

ATTORNEY NEWSLETTER The manufacturer of the antifungal medication Mycamine has agreed to pay $7.3 million to settle a whistleblower lawsuit. The lawsuit was filed in 2010 by Frank Smith in a United States District court. The defendant in the case is Astellas Pharma US Inc. and allegations involve False Claims […]

ATTORNEY NEWSLETTER The federal government has joined a whistleblower lawsuit against two hospital operators. The hospital operators were accused of fraudulently billing Medicare and Medicaid. The healthcare industry has been the target of many false claims cases recently. Many of the whistleblower cases contain fraudulent billing allegations. Los Angeles whistleblower […]

ATTORNEY NEWSLETTER Three people were recently convicted by a federal jury on charges related to Medicare fraud.  The trial lasted 13 days and the defendants were found guilty of conspiracy to commit health care fraud, health care fraud, and conspiracy to pay and receive kickbacks involving the Medicare Program.  The […]

ATTORNEY NEWSLETTER A California based nursing home operator has agreed to pay a settlement related to two whistleblower lawsuits.  The settlement is reportedly worth $48 million dollars.  It was alleged that the nursing home operator submitted bills to Medicare for therapy sessions that were unnecessary or never took place.  Ensign […]