April 29, 2014 — The Medicare program is funded with federal tax dollars to serve our nations’ seniors. Medicare fraud by unprincipled health care workers and medical equipment suppliers only drives up health care costs for everyone. The U.S. Department of Justice counts on whistleblowers to notify the government about fraudulent health care schemes by filing a False Claims Act lawsuit. The qui tam provisions in the statute give insiders a way to do what’s right. Tipsters who bring a lawsuit on the government’s behalf may receive a significant share of any proceeds from the lawsuit.
Los Angeles Physician Assistant Signed Phony Prescriptions Used in Medicare Fraud Operation
A California physician assistant has pleaded guilty to Medicare fraud charges alleging that he signed phony prescriptions for power wheelchairs and other durable medical equipment (DME). While working for two medical clinics in the Los Angeles area, Erasmus Kotey signed medical documents, including prescriptions, for a variety of high-priced durable medical equipment, none of which was medically necessary. Kotey then schemed with others to sell the fraudulent prescriptions to DME supply companies. Phony prescriptions in hand, the DME supply companies in turn filed false claims for reimbursement to Medicare.
The Medicare fraud operation was ongoing between November 2007 and December 2008, first at a Los Angeles clinic located at 866 North Vermont Avenue and then at a Monterey Park clinic located at 943 South Atlantic Boulevard, Suite 218.
Kotey’s misconduct resulted in a total of $7 million in false Medicare claims, of which Medicare paid $3 million. The Justice Department reports that Kotey is scheduled to be sentenced in September 2014.
Insiders Notify the Government about Phony Prescriptions and False Claims
Health care insiders, particularly those working in the accounting sector, are usually the first to root out False Claims Act violations. But most informants are unsure about how to bring a whistleblower lawsuit. With qui tam lawyers in Los Angeles, where the incident reported here occurred, as well as Dallas and the Washington D.C. area, Waters & Kraus guides whistleblowers through the process, watching out for their interests. Contact us or call our experienced attorneys at 855.784.0268 to discuss collaborating to fight health care fraud.