Unlicensed Medical Provider Fraud

If you know of a medical office that is letting unlicensed people treat patients, operate medical equipment or interpret lab tests, you know that the practice is cheating its patients and may even be putting them at risk. By filing a False Claims Act lawsuit as a whistleblower, you can help the Government recover the money it should never have paid to these charlatans, and even more importantly, you can protect patients.

Under the law, you will receive 15% to 30% of what you help the Government collect.

Seek the legal services of our seasoned Atlanta medical fraud lawyer at The Wallace Law Firm, LLC. We can represent your case and help you stop fraud. Lee Wallace, our lead attorney, has recovered millions of dollars for clients and is well-respected by other lawyers. She has been named to the list of Georgia Super Lawyers® and Top 100 Trial Attorneys by her peers.

We do not charge you to discuss your case with us. Call today.

Medical Providers Must Be Licensed

Medicare and Medicaid, as well as state medical licensing boards have set out rules about who can treat patients and perform other medical procedures. For obvious reasons, Medicare and Medicaid will not reimburse companies when they allow unqualified or unlicensed people to treat patients.

If you know of a laboratory or a medical provider that is filing claims for services performed by people who are not properly licensed, you may be able to file a False Claims Act law case to notify the Government about what is happening.

Examples of False Claims Act cases where medical providers used unlicensed personnel:

  • GreatCare Home Health Agency of Los Angeles paid the Government $14.9 million to resolve a whistleblower’s allegations. The whistleblower, who had been the receptionist at the home health agency, said that GreatCare had paid kickbacks in order to convince physicians to refer patients. She also reported that the company was billing Medicare and Medicaid for work “performed by unlicensed personnel.” The owner and operator of the home health agency pled guilty to criminal charges that they had engaged in a scheme to defraud Medicare and Medicaid.
  • In 2014, a different home health agency, Americare Certified Special Services, Inc., of New York, self-disclosed that it had demanded reimbursement for services by an R.N., even though the R.N. had not actually rendered the services. It also disclosed that it had submitted claims for services by people who did not have a home health aide certificate. Americare agreed to pay the Government $44,593.41 under the Civil Monetary Penalties Law.
  • The owner of a Texas rehab and wellness clinic was jailed in the wake of accusations that his clinic billed Medicare and Medicaid for physical therapy and psychological services that were not provided by properly-licensed personnel. According to the Government, the clinic not only used unlicensed personnel, it also left them unsupervised. Despite the lack of oversight, the clinic billed as if physicians had directly supervised the work. The clinic even went so far as to fake the medical documentation by using a copy of a real physician’s signature.
  • A Tennessee Substance Abuse Treatment Facility Agree[d] to Resolve False Claims Act Allegations for $9.25 Million. The owner of New Life Lodge, which treated Medicaid patients who were being seen for drug and alcohol addiction, was accused of letting therapists who had not been properly licensed provide the substance abuse therapy.

File a Suit with Our Atlanta Medical Fraud Attorney

By filing a lawsuit as a qui tam “relator” (the legal term for a whistleblower under the FCA), you can help stop the fraud and protect patients. The Government thinks that getting information about fraud is so important that it will give the relator a percentage of the amount he helps the Government get back.

To find out more about FCA lawsuits involving unlicensed people providing medical care to patients, contact The Wallace Law Firm today.

Talk to a whistleblower lawyer at our firm. Call (888) 581-9132.