November 26, 2013 — Each year, the U.S. Department of Justice counts on tips from conscientious whistleblowers to recoup millions in tax dollars that could otherwise be lost to fraudsters engaged in Medicare scams. The qui tam language incorporated in the False Claims Act gives inside employees the tools they need to help protect us all from fraud in the health care industry. In return for bringing a claim on the government’s behalf, informants retain part of any recovery from the lawsuit.
Alleged $12 Million Health Care Fraud Scam Involved Fabricated Patient Records
An Illinois man has been arrested for his role in an alleged $12 million Medicare fraud scheme. According to the Justice Department, Rick E. Brown and two others took part in a health care fraud scam involving Medicall Physicians Group Ltd., located in Schaumburg, Illinois. Between January 2007 and December 2011, Medicall allegedly submitted $12 million in false claims. Medicare paid Medicall over $4.5 million for the allegedly phony home health care services that were never provided.
The government charges that Brown conspired with Roger A. Lucero and Mary C. Talaga to defraud Medicare. Brown and Lucero owned and operated Medicall. Brown allegedly directed company employees to bill Medicare for patient care and other services that Medicall never provided. Lucero allegedly fabricated patient records to try to hide the fraudulent billings. And Talaga allegedly submitted Medicall’s false claims to Medicare, despite the fact that she knew the claims for reimbursement were based on phony records.
Health Care Workers on the Front Lines in Fight Against Medicare Fraud
False Claims Act violations involving bogus Medicare claims like those in this Illinois case often involve health care employees who are forced to take part under the threat of losing their jobs. Rather than participate in an illegal health care scam, however, many health care industry workers decide to collaborate with the Justice Department instead. The qui tam lawyers with Waters & Kraus provide knowledgeable and sensitive legal representation for the brave informants who are willing to do the right thing. Contact us by email or call our False Claims Act attorneys at 855.784.0268 to find out more about bringing a whistleblower lawsuit.