May 1, 2013 — The Department of Justice relies on the federal False Claims Act to fight Medicare and Medicaid fraud and to return millions of dollars to American taxpayers each year. Under the qui tam provisions of the False Claims Act, health care workers and other private individuals who learn about fraudulent schemes against federal healthcare programs are authorized to sue the wrongdoers and keep a portion of any monies collected. Health care provider employees are generally in an ideal position to learn about fraud when it occurs and to notify the government.
$17.1 Million Health Care Fraud Case Included False Claims and Kickbacks
The owner of a Louisiana home health care agency and its director of nursing have been convicted in a $17.1 million conspiracy to defraud Medicare, the Justice Department has announced. The evidence at trial demonstrated the following.
Louis T. Age, Jr. owned South Louisiana Home Health Care Inc., which from 2005 to 2011, submitted $17.1 million in false claims to Medicare for home health care services. Age ran the operation with Verna Age, his ex-wife and the outfit’s director of nursing. The pair concocted a kickback scheme that worked like this: Recruiters were paid to bring in Medicare beneficiaries to receive unnecessary home health care. Doctors were paid to refer the Medicare patients to Age’s company to receive the unnecessary services. Verna Age, a registered nurse, falsified patient records and directed her employees to create phony certification evaluations so it would appear as though the Medicare recruits really needed care.
This was not just a huband and wife team, but a family operation. Louis Age’s daughter, Ayanna Age Alverez, also participated in the scam. Alvarez was trained by her father and stepmother to perform a variety of functions, including:
- Paying kickbacks to recruiters who brought in Medicare beneficiaries
- Paying kickbacks to physicians willing to sign phony home health certifications
- Falsifying patient records
Sentencing has not yet been scheduled in the case.
Health Care Workers Best Tipsters in Medicare/False Claims Act Cases
False Claims Act violations surrounding kickbacks and falsified medical records, like this one, are reported most frequently by concerned insiders. Sometimes a courageous health care practitioner will come forward. Other times, the government is notified by accounting personnel. Informants willing to collaborate with the government should learn all that they can about their rights before taking action. With whistleblower lawyers across the country, Waters & Kraus offers tipsters the experienced legal representation they deserve. Contact us or call our Medicare fraud attorneys at 855.784.0268 to learn how we can help you.