Tagged Articles

Medicare 312 articles

Whistleblower Sues Arizona Cancer Center For Alleged Medicare Fraud

A whistleblower complaint alleging an Arizona cancer treatment company cheated Medicare and other federal health care programs out of millions of dollars is moving ahead after a federal judge rejected the defendant’s motion to dismiss the case. The Republic/Arizona Central reports that the whistleblower suit alleges the Arizona Center for Cancer Care and its principals engaged in schemes to double-bill the government, overcharge for testing and treatments, and bill for medical services that patients didn’t need. The lawsuit claims these practices helped AZCCC improperly collect more than $8 million since 2011. Based in the Phoenix metro area, AZCCC operates 35 ... Read More

Whistleblower Helps U.S. Recover $33.2 Million From Alere Inc.

Massachusetts medical device maker Alere Inc. will pay the United States $33.2 million to settle a whistleblower lawsuit that alleged the company knowingly sold unreliable testing devices to hospitals. The U.S. Attorney’s Office for the District of Maryland said that from 2006 to 2012, Alere sold its “Triage” cardiac testing devices to hospitals even when it knew that the devices provided unreliable results. Alere’s Triage devices are frequently used in emergency departments for the quick diagnosis of acute coronary syndrome, heart failure, drug overdose, and other serious conditions. The whistleblower lawsuit, filed by former Alere senior quality analyst Amanda Wu, ... Read More

$1 Billion Whistleblower Case Against Hospice Provider Unsealed

A whistleblower lawsuit against one of the nation’s largest hospice care providers was unsealed last week after the federal government declined to intervene. The lawsuit, filed in 2010 against HCR ManorCare by a former regional director of operations under whistleblower provisions of the False Claims Act, alleges the company engaged in a “corporate-wide pattern of conduct that has resulted in the submission of thousands of false claims” and payments of “millions of dollars” to Medicare for patients who were not terminally ill. When a terminally ill Medicare patient enters hospice care, Medicare stops covering traditional medical care designed to improve ... Read More

Whistleblower Case Recovers $1.65 Million From Vermont Hospital

A whistleblower complaint filed against a Vermont hospital by one of its former administrators has ended in a $1.65 million settlement. Brattleboro Memorial Hospital agreed to pay the U.S. and the State of Vermont the sum to resolve allegations that it knowingly submitted or caused the submission of false claims to the Medicare and Medicaid programs. Amy Beth Main filed the lawsuit on behalf of the U.S. and Vermont under the whistleblower provisions of the federal and Vermont False Claims Acts. Plaintiff’s counsel told the Brattleboro Reformer that Ms. Main, an administrator in Brattleboro Memorial’s financial services department, “protested internally” ... Read More

Court Reinstates LHC Home Health Nurse’s Whistleblower Case

A nurse who filed a whistleblower retaliation lawsuit against her employer even though she wasn’t demoted, harassed or terminated, can move forward with her case, a federal appeals court ruled. Sue Smith, a former nursing director for Louisiana-based home health care agency LHC Group Inc., filed the whistleblower retaliation lawsuit after she allegedly became aware of a scheme to defraud Medicare and Medicaid. Ms. Smith worked at LHC’s home health office in Lexington, Kentucky. According to Business Insurance, Ms. Smith claims employees of the home health office routinely sidestepped federal rules and admitted patients into care without the clinical evaluation ... Read More

Health Care Fraud Convictions Get Palm Beach Physician 3 Years

A Palm Beach, Florida physician who was convicted of profiting from a scheme of health care fraud that cheated Medicare and other federal health care programs out of millions of dollars was sentenced to three years in prison and a $200,000 fine. Dr. Gary Marder, a prominent osteopathic physician and well-known South Florida philanthropist, previously paid about $6 million to settle a related civil suit brought by a whistleblower under the False Claims Act. It was that case that federal investigators looked into and chose to press criminal charges against Dr. Marder. According to the Palm Beach Post, U.S. District ... Read More

Whistleblower Physician Sues D.C. Hospital For Medicare Fraud, Retaliation

An acclaimed Washington D.C. doctor has filed a federal whistleblower complaint against United Medical Center and its management company Veritas of Washington LLC alleging he lost his job in retaliation for standing up to practices that he says compromised patient health and safety and cheated the Medicare and Medicaid programs. Dr. Julian Craig accepted a position as the Chief Medical Officer for United Medical Center, Washington D.C.’s only public hospital, in 2015. He remained there until Nov. 18, 2017, when he was fired after testifying before the D.C. City Council about “the hospital’s improper admission practices, malfeasance affecting patient health ... Read More

Las Vegas Doctor Arrested For Illegal Opioid Distribution

A Las Vegas pain management physician was arrested Tuesday, Feb. 13, and charged with 29 counts of unlawful distribution of a potent opioid drug and health care fraud. The U.S. Justice Department (DOJ) said it leveled the charges against Dr. Steven A. Holper, 66. Seven of the 29 charges allege the doctor prescribed the opioid Subsys (fentanyl sublingual spray), outside his professional practice to people who had no medical need for the drug. According to the DOJ, Dr. Holper “routinely prescribed Subsys for his patients without cancer.” The remaining charges involve Dr. Holper’s alleged false statements to Medicare and private health ... Read More

Whistleblower Lawsuit Ends in $16 Million Judgment Against Delaware MRI Operator

A whistleblower’s False Claims Act lawsuit against a Delaware MRI provider and its owner has resulted in a default judgment of more than $16 million. The U.S. Attorney’s Office for the District of Delaware said a Delaware federal court ruled on Jan. 29 that Orthopaedic and Neuro Imaging LLC (ONI) must pay $16,223,091, with the company’s owner, Richard Pfarr, personally liable for $6.12 million of that amount. Robin White, a former ONI employee, filed the whistleblower lawsuit on behalf of the U.S. government after she found that the company was submitting claims to Medicare for magnetic resonance imaging (MRI) scans ... Read More

Whistleblower Alleges Wichita Hospitals Cheated Medicare, Endangered Patients

A whistleblower lawsuit filed by a cardiologist under the False Claims Act (FCA) against a group of Wichita, Kansas hospitals and physicians was unsealed last week, revealing allegations that the defendants performed costly medical tests and procedures that weren’t medically necessary and subjected Medicare patients to undue risk. According to the Associated Press, the court unsealed the whistleblower lawsuit after the U.S Department of Justice declined to intervene in the case. Statements made by federal authorities, however, indicate that the lawsuit will likely proceed without the government’s participation. “The government’s decision to decline should not be construed as a statement ... Read More