March 19, 2013 — Finding that Illinois nursing home operator Momence Meadows submitted fraudulent bills to Medicaid and Medicare, a federal jury in Illinois has awarded $28 million to the government in a case filed under the federal False Claims Act and the Illinois Whistleblower Reward and Protection Act. According to Martindale, the jury found that the nursing home had billed the two healthcare programs for “worthless services” and that it falsely certified that it was in compliance with applicable laws and regulations.
Two former nurses collaborated with the government in the case, alleging that the nursing home mistreated residents and submitted fraudulent charges to Medicare and Medicaid. In addition, the two whistleblowers alleged that they had been wrongfully terminated after they told nursing home management about their concerns. Under the qui tam provisions of the False Claims Act, a whistleblower (the relator) is authorized to file suit on behalf of the American government and participate in any recovery. When the government collects the judgment in this case, the tipsters will be entitled to a sizable share of the award.
The two insiders alleged that Momence Meadows was so understaffed that residents there suffered from bedsores and scabies. To hide the facility’s substandard care, the nurses claimed, medical records were falsified and troubling documents were destroyed. The services, alleged the relators, were so deficient as to be worthless.
At the end of a trial lasting nine days, the jury agreed, finding that the nursing home had submitted more than 1,700 false claims to Medicaid and Medicare worth more than $3 million in damages. The jury went on to award the maximum penalty allowed under the False Claims Act — $11,000 per false claim. And it tripled the damages award. On top of that, the jury found that the nursing home had falsely claimed to be in compliance with applicable health care statutes and regulations, which finding supported another $19 million damage award, plus penalties. Lastly, the jury gave the two whistleblowers over $400,000 for their wrongful termination claims.
Medicare Fraud Uncovered by Insider Heath Care Professionals
Medicare and Medicaid fraud is often discovered by professionals inside the health care provider’s operation. Before coming forward, whistleblowers need to become informed about their own rights. The experienced lawyers at Waters & Kraus provide tipsters with the representation they need in the fight against Medicare fraud. Contact us or call our health care fraud attorneys at 800.226.9880 to learn more about our qui tam practice.