February 9, 2013
Dr. Hicham Elhorr of the Detroit area has been charged with Medicare fraud involving home health services and physician home visits. Dr. Elhorr is accused of being the mastermind behind a $40 million Medicare fraud scheme in which Medicare was fraudulently billed for services that were medically unnecessary or that were never actually provided.
The false claims were made through House Calls Physicians (HCP), which Dr. Elhorr owned and operated. Dr. Elhorr allegedly filed false claims with Medicare through HCP for home visits to patients who were never seen by a physician and for visits from physicians who were not licensed. Prosecutors also allege that Dr. Elhorr filed claims with Medicare for physician home visits that were purportedly rendered while Dr. Elhorr was out of the country, when patients were hospitalized and so not available to visit at home, or after the beneficiary had died.
Dr. Elhorr also allegedly referred Medicare beneficiaries for home health services that were medically unnecessary in exchange for kickbacks. According to the Justice Department, since January 2008, HCP billed Medicare for about $9.2 million and allegedly referred Medicare beneficiaries for home health services that produced about $30.8 million in Medicare reimbursements.
Federal authorities often rely on information from whistleblowers to identify and prosecute Medicare fraud. To encourage whistleblowers to come forward, the qui tam provisions of the False Claims Act permit whistleblowers to sue the wrongdoers on behalf of the government and to receive a portion of any money recovered in the lawsuit.
Whistleblowers should know their rights under the False Claims Act. Waters & Kraus‘ highly skilled attorneys have extensive experience working with whistleblowers and are ready to help guide you in this process. Contact us or call our whistleblower attorneys at 800.226.9880 to learn more about our practice and how we can assist.
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