November 27, 2013 — At times, the government uncovers False Claims Act violations in the health care field without help from insiders. Quite often, however, the government acts on a tip from a conscientious whistleblower working within the field. The False Claims Act’s qui tam language enables tipsters to fight fraud directly by filing a claim in federal court on behalf of the government. To reward informants who have the fortitude to do the right thing, the Act gives whistleblowers the right to share any proceeds from the suit.
Psychiatrist Billed Medicare for New York Home Visits While He Was in China
A psychiatrist working for the Department of Veterans Affairs (VA) in New York has pleaded guilty to Medicare fraud. Dr. Mikhail L. Presman is charged with submitting false claims to Medicare, seeking reimbursement for home medical treatment ostensibly provided to Medicare beneficiaries.
Presman was a full-time, salaried psychiatrist at the VA hospital in Brooklyn. Yet between January 2006 and May 2013, Presman found time to file around $4 million in claims for Medicare reimbursement for alleged home treatment provided to Medicare beneficiaries. In reality, Presman provided no treatment to many of the patients he allegedly treated. On 55 occasions, for example, Presman filed false claims to Medicare for home medical visits to patients who were in the hospital at the time of the purported home visits. Presman also submitted false claims to Medicare for New York City home medical visits allegedly occurring while Presman was in China.
Presman has consented to forfeit over $1.2 million in illegal gains. He is scheduled to be sentenced in February 2014 and could receive a ten-year prison sentence.
Blowing the Whistle on Fraudulent Medicare Claims
Insiders are not surprisingly the first to spot Medicare scams because they are often coerced into participating. That’s when many informants elect to notify the government in a False Claims Act lawsuit. Waters & Kraus has knowledgeable whistleblower lawyers in Texas, California and Maryland. We have heard our clients describe many times the awkward and often frightening position in which they’ve been asked to work. When you’re ready to collaborate on ending Medicare fraud, contact us by email or phone our False Claims Act attorneys at 855.784.0268 to talk about what we can do to make the process easier for you.