February 27, 2015 — The False Claims Act empowers health care insiders to file a
whistleblower lawsuit on the government’s behalf. Courageous whistleblowers help to protect the integrity of our federal healthcare programs, like Medicare or Medicaid, for those who need them. Under the Act, the United States may choose to intervene in the lawsuit and take primary control for litigating it. The statute provides for the government’s recovery of three times the actual damages plus civil penalties. For their willingness to notify the government, tipsters — also referred to as “relators” — are rewarded with a portion of the government’s recovery.
ResCare Iowa Allegedly Failed to Have Independent Physician Examine Patients to Ensure Necessity for Home Health Care Services
ResCare Iowa Inc. — a home health care provider in Iowa — has resolved False Claims Act allegations with the United States and the state of Iowa for $5.63 million. ResCare Iowa allegedly failed to follow the rules for seeking reimbursement from Medicare and Medicaid in violation of the federal False Claims Act. Because Iowa’s Medicaid program is funded jointly by the state and federal governments, Iowa will receive $2.32 million from the settlement and the federal government will receive the rest.
Before Medicare or Medicaid will reimburse home health care providers, an independent doctor must meet with each patient “face-to-face” to ensure that home health care services are medically required. In addition the physician must specify the type and amount of services to be performed by the home health care provider. From 2009 to 2014, however, ResCare Iowa
reportedlychose not to comply with these rules. As a result, the provider was not entitled to reimbursement from Medicare or Medicaid.
Contact Us to File a False Claims Act Lawsuit Targeting Abuse by Home Health Care Providers
While Waters & Kraus is not handling this particular False Claims Act case, we are representing whistleblowers in similar lawsuits. If you have comparable claims against a different medical provider,
contact us by email or call our qui tam attorneys at
800.266.9880 to learn more about our practice and how we can work together to notify the government about fraudulent abuses of government-funded programs.
Michael Armitage and Louisa Kirakosian, two of our qui tam attorneys in the firm’s Southern California office, protect tipsters throughout the whistleblower lawsuit process.
