July 5, 2013 — Heath care fraud is costly, and the U.S. Justice Department relies on information provided by whistleblowers to recover millions of dollars each year that would otherwise be lost to Medicaid and Medicare fraud. The qui tam provisions of the federal False Claims Act allow health care workers who uncover overbilling and misreporting to government agencies to file a lawsuit on behalf of the government. In exchange for coming forward, whistleblowers are awarded a share in the government’s eventual recovery. Employees of health care companies, including companies that provide durable medical equipment, are often in the best position to become an informant on unethical health care providers.
Houston Man Guilty of Charging Medicare for Devices that Were Not Medically Necessary
Houston resident Kenny Msiakii, owner operator of Louisiana-based durable medical equipment (DME) company Joy Supply and General Services, has been sentenced to serve 97 months in prison for his part in a $6.7 million Medicare fraud scheme, according to the Justice Department. He was also sentenced to three years of supervised release and was ordered to pay $2.5 million in restitution. Mr. Msiakii was found guilty on December 13, 2012 on eight counts of health care fraud.
Mr. Msiakii’s Shreveport-based company purportedly provided orthotics and other durable medical equipment (DME) to Medicare beneficiaries. In fact, the company filed claims for medical devices that were medically unnecessary and/or were never actually provided. Mr. Msiakii submitted approximately $6.7 million in claims to Medicare between November 2007 and September 2009, and he was paid approximately $3.6 million for the unnecessary DMEs as well as the ones that were never actually provided to Medicare beneficiaries.
Health Care Company Insiders Are the First Defense Against Fraud
False Claims Act violations often are exposed by company employees who notify the government of fraud—such as overbilling or fraudulent reporting to Medicare or Medicaid. Informants who are willing to collaborate with authorities should learn about their rights before taking action. The Medicare fraud lawyers with Waters & Kraus provide whistleblowers the legal counsel they need. Contact us by email or phone our False Claims Act attorneys at 855.784.0268 to find out more about our qui tam practice.