December 6, 2013 — The U.S. Department of Justice counts on unique information from tipsters to recoup millions in tax dollars every year that might otherwise go to fraudsters involved in Medicare scams. The qui tam provisions in the False Claims Act give insiders the tools they need to assist in protecting us all from fraudulent practices in the health care industry. In return for filing a claim on behalf of the government, tipsters retain part of any proceeds from the lawsuit.
Medical Equipment Supply Company “Marketer” Paid Doctors for Prescriptions
Two have been indicted for their alleged roles in a $3 million Medicare fraud operation in Louisiana. Tracy Brown is a New Orleans resident who owned Psalms 23-DME, a Louisiana medical equipment supply company. Sandra Parkman Thompson, now incarcerated in Texas, was a marketer whose job with Psalms 23-DME was to scout out doctors willing to issue bogus prescriptions the company could use in its scam. According to the United States Department of Justice, Psalms 23-DME filed false claims with Medicare for over $3 million for orthotic equipment, power wheelchairs and chair accessories prescribed for Medicare beneficiaries who had no need or desire for the equipment.
Thompson worked as a “marketer” who scouted out doctors amenable to writing out prescriptions for durable medical equipment for Medicare beneficiaries, even though the patients did not need these items. Thompson allegedly relied upon two physicians, in particular — Drs. Michael Hunter and Anthony Jase — to write falsified prescriptions for equipment that was medically unnecessary. Another doctor allegedly gave the falsified prescriptions directly to Brown, without going through Thompson. Brown allegedly paid the doctor around $250 per prescription.
At times, Psalms 23-DME billed Medicare for equipment that was never given to a Medicare beneficiary. Other times, Brown submitted false claims to Medicare for the most expensive durable medical equipment available through Medicare and then supplied the Medicare beneficiaries with equipment that was much less expensive, and would not even have been reimbursable by Medicare.
Brown allegedly paid Thompson for every prescription she produced for Psalms 23-DME, even when the equipment prescribed was unnecessary. Thompson and the other prescription-scouts allegedly received $500 for a wheelchair prescription and somewhere between $200 and $250 for prescriptions of unnecessary orthotic equipment, such as leg braces.
Drs. Hunter and Jase have already pleaded guilty to health care fraud. If Brown and Thompson are convicted of the health care fraud charges against them, they could face as much as five to ten years in prison for each count.
Health Care Employees on the Front Lines Fighting Medicare Fraud
False Claims Act violations involving phony Medicare claims like those in this Louisiana case often impose on honest health care employees who are intimidated and threatened with the loss of their jobs. Rather than become part of an illegal health care scam, however, many workers in the health care industry decide to notify the Justice Department instead. The qui tam attorneys with Waters & Kraus offer knowledgeable and sensitive legal counsel for the courageous informants who are willing to collaborate with the government. Contact us by email or phone our False Claims Act attorneys at 855.784.0268 to find out more about filing a whistleblower lawsuit.