Shands Hospitals will pay $26 million to settle a Medicaid/Medicare fraud case accusing it of admitting patients that didn’t require hospitalization to six of its facilities. A whistleblower claim submitted in 2008 claimed that the company overbilled Medicaid and Medicare with the admissions. The Medicare/Medicaid fraud lawsuit accuses Shands of…
The US Department of Justice and 55 hospitals have reached a $34M Medicare fraud settlement accusing 55 hospitals in 21 states of engaging in making false claims for kyphoplasty procedures. The allegations were brought under the False Claims Act by whistleblowers, who will receive about $5.5 million from the settlements…
The US Justice Department says that US Renal Care will pay $7.3 million to settle allegations that its Dialysis Corporation of America submitted false Medicare claims, billing more for Epogen, an anemia medication, than what it actually gave to dialysis patients. The accusations stem from a Qui Tam lawsuit filed…
Grace Healthcare LLC will pay $2.7M with interest to resolve fraud violations that it either knew of or caused their submission related to the Medicare and TennCare/Medicaid programs. The allegations were reported in a whistleblower lawsuit filed by one of the nursing home manager’s former employees, who will now receive…
Two men have filed a whistleblower case in what may be one of the largest incidents of Medicare fraud in the country’s history. The plaintiffs are Dr. Alon Vainer, a dialysis clinics medical director, and nurse Daniel Barbir. They contend that their employer, dialysis company DaVita Inc., overbilled Medicaid and…
A recently unsealed federal whistleblower lawsuit accuses Planned Parenthood Gulf Coast of turning in over 87,000 reimbursement claims to Medicaid that were either “false, fraudulent, or ineligible.” Abby K. Johnson, the plaintiff, is an ex-director at one of the defendant’s clinics. She says she had “system-wide” access to billing activities…
WellCare Health Plans Inc. has consented to pay $137.5 million to settle four whistleblower lawsuits filed against it over allegations of fraudulent Medicaid and Medicare claims. The health care provider is accused of falsely inflating the amount it claimed to have spent on medical care so it wouldn’t have return…
A $25 million settlement has been reached in the whistleblower lawsuit filed by a former nurse employee against Odyssey HealthCare Inc. Per her Qui Tam complaint, submitted in 2008, between 2006 and 2009 Odyssey enrolled and recertified patients who were non-terminal for hospice care, and billed for services that weren’t…
In his whistleblower fraud lawsuit, Michael Rehfeldt, a former Vitas Healthcare Corp. manager, accuses the hospice care chain of defrauding the US government. Vitas is a unit of Chemed Corp. Rehfeldt claims that Vitas and health insurers enrolled patients that weren’t fatally ill in Medicare. He is alleging fraudulent billing…