July 15, 2013 — The Justice Department depends on insiders to fight fraud. The use of informants is the best way to get to the root of fraud that robs the government of millions each year in health care fraud. To encourage tipsters to step forward, the qui tam provisions of the False Claims Act authorize health care workers and other whistleblowers to file suit on behalf of the government. Whistleblowers are then entitled to a share in any settlement or judgment the government obtains through the lawsuit.
Washington Health Care Center Settles Allegations of Overbilling Medicare
Tacoma, Washington-based Sound Inpatient Physicians Inc. will pay a total of $14.5 million to settle charges that the health care firm overbilled Medicare and other federal health care programs, according to the Justice Department. Sound Physicians provides hospitalists and other doctors to hospitals and other medical centers. The company employs over 700 hospitalists and post-acute physicians. These medical professionals provide services at 70 hospitals and a network of post-acute facilities spread across 22 states.
Sound Inpatient Physicians allegedly submitted inflated claims to Medicare and other federal programs between 2004 and 2012. The claims were made on behalf of hospitalist employees and billed for higher levels of care than were documented in patient medical records.
These allegations were brought to light in a whistleblower lawsuit filed by former employee Craig Thomas. Mr. Thomas will receive $2.7 million of the $14.5 million settlement for his role in exposing Sound Inpatient Physicians’ False Claims Act violations.
Health Care Insiders Are the First and Best Defense Against Fraud
Insiders like Mr. Thomas offer the best chance the government has to spot fraud. Tipsters and informants need to understand their rights, though, before coming forward to collaborate with the government. The Medicare fraud attorneys at Waters & Kraus provide whistleblowers skilled legal counsel. Learn from our experience. Contact us by email or phone our False Claims Act attorneys at 855.784.0268 to discover more about our qui tam practice.