April 1, 2013 — Relying on the federal False Claims Act, the U.S. Department of Justice has recouped in excess of $10 billion in fraudulent health care investigations over the last several years. The anti-fraud statute’s qui tam provisions authorize tipsters to file a lawsuit on behalf of the American government and then share in any recovery. If the government decides to participate in the lawsuit by intervening, the government collaborator takes home a smaller percentage of the recovery. When the United States declines to intervene, the whistleblower may receive a larger portion of any proceeds from the suit.
Houston Doctor Conspired with Home Health Care Companies to Defraud Medicare
A Houston physician has been sentenced to more than five years in prison for conspiring to commit health care fraud by creating phony plans of care for Medicare patients, some of whom he never even treated. For his role in a $17.3 million health care fraud scheme, Ben Harris Echols has also been ordered to pay restitution in the amount of $2,918,830, the Justice Department has announced.
During a four day jury trial in December, the evidence showed that the doctor signed plans of care for Medicare patients to allow two home health care companies, Houston Compassionate Care and Family Healthcare Group Inc., to submit false billings to Medicare. Echols signed plans of care for some Medicare patients about whom he had no knowledge and were not even under his care. Sometimes, Echols signed the documents despite the fact that other physicians were shown to be the attending doctors on the plans of care. Houston Compassionate Care and Family Healthcare Group Inc. used the phony plans of care to submit $17.3 million in fraudulent bills to Medicare for home health services. The two home health companies took in $5.5 million from Medicare for patients whose plans of care were signed by Echols.
Insider Health Care Professionals Notify United States of Medicare Fraud
False Claims Act violations involving falsified records are often reported by insider employees who recognize the illegality of creating phony medical records. Before notifying the government, conscientious tipsters need to know their own rights. The lawyers at Waters & Kraus offer informants the aggressive legal representation they need in the battle against health care fraud. Contact us or call our whistleblower attorneys at 800.226.9880 to learn more about our health care fraud practice.