December 26, 2013 — The U.S. Justice Department depends on tips from whistleblowers to help the government recover millions of dollars annually that might be lost to unscrupulous Medicare scams. The qui tam language in the False Claims Act gives health care employees a powerful weapon for fighting fraud in their industry. In exchange for filing a claim on the government’s behalf, insiders retain a portion of any proceeds from a whistleblower lawsuit. Health care workers are ideally situated to notify the government about unethical Medicare and Medicaid fraud scams because they are usually the first to see the operation in practice.
Radiation Oncology Provider Resolves False Claims Act Lawsuit Alleging Medicare Fraud
Vantage Oncology LLC (Vantage) has settled a whistleblower lawsuit with the government for over $2.08 million. Vantage runs radiation oncology centers in cities throughout several states, including Streator and Spring Valley, Illinois. The False Claims Act lawsuit, brought by former Vantage employee Suleiman Refaei, alleged that, between 2007 and 2012, Vantage submitted false Medicare claims for radiation oncology services conducted in Illinois.
According to the U.S. Justice Department, Vantage overbilled and double billed Medicare for some services, billed for oncology treatment given to patients without the physician supervision Medicare requires and submitted claims for radiation services to Medicare that did not include supporting documentation.
Suleiman Refaei, the tipster who was formerly employed by Vantage, will receive $354,450 under the qui tam provisions of the False Claims Act.
Conscientious Health Care Insiders Key to Ending Medicare Fraud
False Claims Act violations involving overbillings to Medicare are uncovered most often as they were in this case, by health care employees. Informants who are considering collaborating with the Justice Department should learn all they can about the process before moving forward. The qui tam lawyers with Waters & Kraus offer brave whistleblowers the legal representation they deserve. Contact us or phone our False Claims Act attorneys at 855.784.0268 to find out more about our health care fraud practice.