Is a medical provider cheating U.S. taxpayers by charging for services, equipment or drugs that it is not providing to patients? You can file a lawsuit as a whistleblower under the False Claims Act to stop the fraud. Successful whistleblowers not only save money for taxpayers, they also earn 15% to 30% of what the United States gets back because of the lawsuit they filed.Do you know about a medical provider or DME company that is charging Medicare or Medicaid for services, equipment or drugs, even though it is not actually providing them to patients? You can turn to The Wallace Law Firm, LLC for help. Our Atlanta medical fraud attorney has tackled a large volume of whistleblower cases involving billing for medical services that the doctors did not provide. Lee Wallace is an experienced lawyer who has been recognized by clients and her peers alike for her exceptional services.
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Help the Government Stop Fraud
While some medical fraud is subtle, some just isn’t. There is nothing subtle about a medical provider that bills for services or medication it does not provide or a DME company that charges Medicare for equipment it never sends to the patient.
The Government is very interested in False Claims Act lawsuits filed by whistleblowers who know that a nursing home, hospital, DME company, doctor or other medical provider is billing for medical services, pharmaceuticals or equipment that it simply is not providing.
Examples of False Claims Act lawsuits against companies for billing for services they never provided:
- Services: Angie Cederoth, an accounts payable rep in the billing department of an alcohol and drug addiction facility, became a whistleblower. As a result of the False Claims Act lawsuit she filed, the owner of the Tennessee facility, CRC Health Corp., paid $9.25 million to the Government, and the Government paid the whistleblower, Cederoth, $1.5 million for helping taxpayers get their money back.
Cederoth had been an employee at New Life Lodge in Dickson County, Tennessee, which was owned by CRC. New Life Lodge was supposed to be providing treatment to adult and adolescent patients who needed help with drug and alcohol addiction, but in her FCA lawsuit, Cederoth said that her employer was billing Tennessee Medicaid (TennCare) for treatment it was not actually providing.
- Pharmaceutical drugs: The Government settled a False Claims Act lawsuit with a Kansas medical facility that provided cancer treatments and the doctor who owned the facility. According to DOJ, Hope Cancer Institute and owner Dr. Raj Sadasivan falsely claimed the facility was providing drugs and services to beneficiaries of Medicare, Medicaid and the Federal Employee Health Benefits Program.
The Government got its recovery thanks to an FCA lawsuit filed by three whistleblowers who were former employees of Hope Cancer Institute. The employees said that the cancer center was billing Medicare and Medicaid for high dosages of drugs for cancer patients, but in fact it was really giving the patients lower doses of the drugs than it claimed. The result was that Hope Cancer billed for more drugs than it ever actually provided to patients. The Special Agent in Charge of the investigation called it “greed-fueled fraud.”
- Equipment and medical supplies: The Office of Inspector General (OIG) has its own list of Most Wanted Fugitives. High on the list is Etienne Allonce, whose wife Helene Michel has been captured and jailed. The two owned a DME called Medical Solutions Management, Inc., which operated in Long Island, Brooklyn and Queens. The two owners and their employees talked their way into nursing homes by pretending to be sub-contractors. They looked up patient charts in order to find patients who needed wound treatment. Using the specific patient information they had located, they billed Medicare and Medicaid for wound care supplies for patients who really did have wounds. They raked in millions of dollars in Medicare and Medicaid payments — in her sentencing, the wife was ordered to pay restitution of $4.4 million — but never supplied the wound care supplies to patients.
Don’t stand by while doctors or DME companies or medical transport companies pretend to provide services they never actually supply. You can make a difference and stop fraud by reporting fraudulent providers.
Talk to our attorney today to learn more about the merits of your case.