April 23, 2014 — The nation’s Medicare program is funded with federal tax dollars to help our seniors. Medicare fraud by unethical physical therapy clinics only drives up health care costs for taxpayers everywhere. The U.S. Justice Department counts on conscientious whistleblowers to spot Medicare fraud and work to stop it by filing a False Claims Act lawsuit. The statute’s qui tam provisions provide health care employees a way to do what’s right. Insiders who file suit for the government may be compensated with a significant share of any proceeds from the suit.
Fraudsters Used Florida Physical Therapy Clinics to File $28.3 Million in False Claims to Medicare
Roberto Fernandez Gonzalez (“Fernandez”), a former straw owner of a Florida rehabilitation facility, has received a 30-month prison sentence for his part in a $28.3 million health care fraud scheme. Fernandez was ordered to forfeit $446,738 and to make restitution in the identical amount.
Fernandez, an immigrant from Cuba with no training in health care, reportedly schemed with co-conspirators to make false claims to Medicare through a number of Florida physical therapy rehabilitation clinics and other businesses. Between 2005 and 2009, Fernandez and/or his co-conspirators submitted more than $28 million in phony Medicare claims, of which Medicare paid $14.4 million.
One of the facilities used was Rehab Dynamics Inc., located in Venice, Florida. After Fernandez’s co-conspirators acquired the clinic, they transferred ownership to Fernandez in a sham sale. In fact, Hernandez — who lacked the money to buy the clinic — was actually paid $20,000 to act as the clinic’s straw owner for three months in 2008. In that short time, Rehab Dynamics filed $1.6 million in false claims to Medicare for physical therapy services that had not been provided. The federal healthcare program paid $446,738 on the phony claims.
Clinic Insiders often the First Line of Defense against Medicare Fraud
Health care insiders with jobs in billing and accounting are usually among the first to root out False Claims Act violations. But most informants have no idea about how to file their own whistleblower lawsuit. With qui tam lawyers from coast to coast, Waters & Kraus guides tipsters through the process, protecting their rights. Contact us by email or call our False Claims Act lawyers at 855.784.0268 to learn more about collaborating to fight Medicare fraud.