March 15, 2013 — Relying on the federal False Claims Act, the Justice Department has recovered in excess of $10.2 billion in cases of health care fraud resolved since 2009. The anti-fraud statute is a very effective weapon for fighting fraud against the American taxpayers. The qui tam provisions of the Act permit a whistleblower (the relator) to file a claim on behalf of the U.S. government and share in the resulting recovery. The United States may choose whether to intervene in the lawsuit. When it does, the relator who collaborates with the government takes home a smaller percentage of the recovery, but gains the government’s assistance in the case. If the government declines to intervene, the informant goes it alone, but retains a greater portion of any proceeds.
Medicare Fraud Lawsuit Against Fairfax, Virginia Therapy Provider Settles for $700,000
The owners of Fairfax Nursing Center (FNC), a skilled nursing facility in Fairfax, Virginia, have consented to pay $700,000 to settle a False Claims Act lawsuit alleging that the facility submitted false claims to Medicare for rehabilitation therapy services that were not reimbursable. According to the Justice Department, FNC provided occupational, physical, and speech therapy services to more than 35 Medicare patients that the beneficiaries either didn’t need or that Medicare should not have paid for. From January 2007 to December 2010, FNC’s therapy services were duplicative, excessive or performed solely in order to bill Medicare for the treatment.
FNC’s alleged misconduct was originally brought to light in a whistleblower lawsuit brought by two former therapists with the provider and one previous contract therapist. The tipsters will receive, collectively, $122,500 as their share of the recovery under the False Claims Act.
Medicare Fraud Revealed by Insider Employees
As was true with FNC, many Medicare fraud schemes are uncovered by someone inside the health care provider’s operation. Before coming forward, whistleblowers need to learn about their own rights. The experienced lawyers at Waters & Kraus provide informants with the aggressive legal representation they deserve in the battle against health care fraud. Contact us or call our Medicare fraud attorneys at 855.784.0268 to learn more about how we can help government collaborators.