Qui Tam 101 » Lawsuit

Whistleblower Exposes What Could be Massive Medi-Cal Fraud Scheme

Nolan and Auerbach — Sat, 21 Mar 2009 16:09:18 +0000

The State of California has joined a qui tam action against seven private laboratories to recover hundreds of millions of dollars in false claims submitted to the state’s Medi-Cal program for the poor, according to a March 20 press release by the California Office of Attorney General.

The lawsuit contends that the medical labs systematically overcharged the Medi-Cal program during the past 15 years. The defendants, including Quest Diagnostics and Laboratory Corporation of America, allegedly engaged in illegal kickbacks and overcharging the state by up to 400% for blood, urine and other lab tests. It is estimated that damages could amount to hundreds of millions of dollars.

Filed under California’s False Claims Act, the qui tam lawsuit asks for relief in the amount of triple the amount of California’s damages, civil penalties of $10,000 for each false claim; and recovery of costs, attorneys’ fees and expenses.

This is one of the largest, if not the largest, single state qui tam intervention against multiple laboratories, in history.

To read the full press release, go to: http://ag.ca.gov/newsalerts/release.php?id=1705&. For more about qui tam law and Healthcare Fraud, contact Nolan and Auerbach, PA.

U.S. Joins Suit Against Renal Care Group Alleging False Billings to Medicare for Home Care Renal Dialysis

Nolan and Auerbach — Tue, 28 Aug 2007 14:54:45 +0000

Last month, the United States intervened in a qui tam lawsuit accusing Renal Care Group Inc. (RCG) and Renal Care Group Supply Company (RCGSC) of fraudulently billing Medicare. The suit alleges that RCG and RCGSC fraudulently billed for supplies and equipment provided to End Stage Renal Disease (ESRD) patients who received dialysis treatments at home. Both companies are owned by Fresenius Medical Care Holdings Inc. which was also named in the lawsuit.

Feds Sue Nursing Home Company

Nolan and Auerbach — Mon, 25 Jun 2007 16:29:56 +0000

Cathedral Rock Corporation of Ft. Worth, Texas, which operates five nursing homes in St. Louis, Missouri has to now defend itself against a medicaid fraud lawsuit brought by federal authorities for violations of the False Claims Act. The lawsuit was brought by two whistleblower nurses who complained that patients were being neglected and that the facilities provided “worthless” health care.

To read more on this story click here.

Inflated Cost Reports Cost California Hospital Over $2 Million to Settle False Claims Act Allegations

Nolan and Auerbach — Mon, 30 Apr 2007 14:57:28 +0000

On April 20, 2007, the Loma Linda Behavioral Medicine Center paid the United States government in excess of $2 million to settle allegations of overbilling from 1992-1996. The settlementis the result of a lawsuit filed by a whistleblower under the False Claims Act. The lawsuit was originally filed in 1998 by a former employee of Healthcare Financial Advisors (HFA), a consulting firm that assists hospitals in preparing cost reports that are submitted to insurers. The lawsuit alleged that Healthcare Financial Advisors prepared for clients two costs reports; one which was inflated and sent to Medicare and another one designed for internal use only, that accurately reflected the amount of reimbursement the hospital should have received from Medicare. It should be noted that seven defendants thus far have settled the HFA whistleblower lawsuit, paying approximately $55 million to the government. (Jackson Memorial Hospital in Miami, Florida more than $14 million; St. Elizabeth Regional Medical Center in Lincoln, Nebraska more than $4 million, Lovelace Health System, a wholly owned subsidiary of Cigna Corp. based in Albuquerque, New Mexico, paid $24.5 million in 2002; St. Joseph’s Hospital in Houston, Texas, paid the government $1.5 million in 2002; Eisenhower Medical Center, located in Rancho Mirage, Calif., paid $8 million in 2005 and HealthSouth Bakersfield Rehabilitation Hospital in Bakersfield, Calif., paid $740,000 in 2005).

To read more click here and here or to learn more on cost report fraud click on this link.

$48 Million to become $144 Million Verdict Against Amerigroup Corp. For False Claims

Nolan and Auerbach — Fri, 03 Nov 2006 16:52:37 +0000

It may cost Amerigroup Corp, a company that specializes in health care for low-income patients $144 million in damages for discriminating against pregnant women. A federal jury returned a $48 million verdict, which will be tripled under state and federal False Claims Act laws. The whistleblower lawsuit alleged that while marketing its services in Illinois, Amerigroup avoided pregnant women and others likely to run up high doctor bills. State Attorney General Lisa Madigan called the company’s alleged discrimination “unconscionable.”

Visit Nolan Law Firm for more information on the False Claims Act.

For more information about this article click here.

Kellogg, Brown & Root Involved in a Super Fraud?

Nolan and Auerbach — Fri, 22 Sep 2006 15:10:42 +0000

Millions of dollars were charged to the federal government according to a federal whistleblower for a military Super Bowl party that never was…at least not for the troops. According to the lawsuit, Kellogg, Brown & Root used the money for its own football party. The goodies included giant tubs of chicken wings and tacos, a widescreen TV and cheese sticks.

For more information click here.