Medi-Cal May Have Paid Millions In Phony Drug Treatment Claims

September 24, 2014 — Many states, including California, have False Claims Acts that mirror the federal statute and prohibit medical providers from billing Medicare or any other government healthcare program for services that patients do not need. Under the qui tam provisions of the state and federal statutes, health care insiders are encouraged to collaborate with the government about false claims by filing a whistleblower lawsuit. Informants may receive a substantial portion of the government’s recovery.

State Audit Reveals That California Medicaid Program Potentially Paid Millions In False Claims For Reimbursement By Drug Rehabilitation Programs

A statewide audit has revealed that California’s Medi-Cal program may have paid out more than $93 million in fraudulent claims to substance abuse clinics across the state. The audit covered claims made to the state’s Medicaid Drug Treatment program between July 2008 and December 2013.
The latest audit follows a 2013 investigation by CNN and the Center for Investigative Reporting that reported on substance abuse clinics in Los Angeles County that filed false claims with Medi-Cal for patients who were dead, in prison or didn’t use the clinics for some other reason.
Much of the fraudulent billing reportedly was centered in Los Angeles County. The audit uncovered 323 instances in which California reimbursed clinics for treatment of Los Angeles County patients who were deceased at the time of the purported services.
Medi-Cal also reimbursed clinics that may not have been authorized providers under the program. Over 65% of reimbursements to potentially unauthorized clinics went to drug rehabilitation clinics in Los Angeles County.

False Claims Act Lawsuits Redress Abuse

While Waters & Kraus is not yet handling any of these particular cases involving overbilling of the California Medicaid program, we are representing whistleblowers in similar lawsuits. If you have comparable claims against a medical provider, contact us by email or call our qui tam attorneys at 855.784.0268 to learn more about our practice and how we can work together to collaborate with the government to stop fraud and abuse. Our qui tam lawyers, like Michael Armitage and Gary Paul in the firm’s California office, are committed to advancing and protecting informants’ interests in whistleblower lawsuits.

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