false claims act | The Health Law Firm Blog

Hospice of the Comforter Inc., Faces Whistleblower Lawsuit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On September 6, 2012, the Department of Justice (DOJ) announced it will join in a whistleblower lawsuit alleging false Medicare billings against Hospice of the Comforter Inc., (HOTCI). The hospice is located in Altamonte Springs, a suburb of the Orlando area, and provides hospice services to local patients.

To read the entire whistleblower complaint filed, click here.

Allegations in the Lawsuit Against HOTCI.

According to the DOJ, the lawsuit was filed by the former vice president of finance for HOTCI. The case alleges HOTCI submitted false claims to Medicare for hospice care patients who were not terminally ill. The lawsuit also claims an executive at the hospice told employees to admit Medicare recipients for hospice care even before […]

By The Health Law Firm|2024-03-14T10:00:36-04:00June 1, 2018|Categories: Health Care Industry, In the Know, In the News, Medicare, Medicare Audit, The Health Law Firm Blog, Whistleblower|Tags: audit, defense attorneys, Department of Justice (DOJ), false claims act, FCA, Florida Medicare, fraud defense, fraud prevention, fraud schemes, government health programs, legal representation, medicare, Medicare fraud, Medicare overbilling, qui tam suits, whistleblower, whistleblower protection|1 Comment

Adventist Health System Settles Whistleblower Lawsuit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 18, 2013, Adventist Health System/Sunbelt Inc., the parent company of Orlando-based Florida Hospital, settled a whistleblower lawsuit, according to court documents. The whistleblower lawsuit, filed in 2010, stated that seven Adventist hospitals in Florida overbilled the federal government between 1995 and 2009, allegedly resulting in tens of millions of dollars in false claims, according to an article in the Orlando Sentinel and other sources.

Click here to read the Order of Dismissal.

Previous reports from the Orlando Sentinel stated that the lawsuit could have damages of more than $100 million, but the details of the settlement are not yet available.

Alleged Details in the Case Against Adventist Health System.

The lawsuit claims that seven Adventist hospitals in Florida allegedly used improper coding to […]

Whistleblower Lawsuit Alleging Medicare Fraud Against Blackstone Medical, Inc., Dismissed

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A whistleblower lawsuit against Blackstone Medical, Inc., alleging Medicare fraud against Parrish Medical Center, was dismissed by a U.S. District Judge in Tampa, Florida, on August 15, 2012. According to Orthopedics This Week, the case was unsealed on August 8, 2012, but dismissed without prejudice, all pending motions were denied as moot, and the clerk was directed to close the case, just one week after.

To see a copy of the order of dismissal, click here.

Whistleblower Originally Filed False Claims and Kickback Complaint.

According to the lawsuit, the whistleblower was asked to bid on a contract with the Parrish Medical Center in Florida, to provide intraoperative neurophysiological monitoring services. The whistleblower alleges he discovered that a […]

By The Health Law Firm|2024-03-14T10:00:37-04:00June 1, 2018|Categories: Medicare, Medicare Fraud, The Health Law Firm Blog, Whistleblower|Tags: audit, Blackstone Medical, defense lawyer, false claims act, FCA, fraud defense, fraud defense attorney, fraud prevention, fraud schemes, government health programs, legal representation, medicaid, medicare, Medicare overbilling, qui tam suits, whistleblower, whistleblower protection|2 Comments

Duke University Health System Pays $1 Million to Settle Allegations of False Claims in Whistleblower Lawsuit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On March 21, 2014, Duke University Health System in Raleigh, North Carolina, settled a whistleblower/qui tam lawsuit, according to the Department of Justice (DOJ). The lawsuit, filed in 2012, stated that the three-hospital academic medical center is alleged to have fraudulently inflated its Medicare bills by unbundling a number of cardiac services and billing for physician assistants’ (PAs) time illegally. Duke University Health System agreed to pay $1 million to resolve these allegations.

Click here to read the press release from the DOJ.

Duke University Health System Accused of Submitting False Claims to Federal Health Care Programs.

According to the complaint, the lawsuit was originally filed by a former health care bill coder and quality-control auditor for Duke’s revenue-cycle subsidiary, Duke Patient Revenue Management […]

By The Health Law Firm|2024-03-14T10:00:56-04:00June 1, 2018|Categories: False Claims Act, The Health Law Firm Blog, Whistleblower|Tags: billing for bundled claims, defense attorney, defense lawyer, Department of Justice (DOJ), Duke University Health System, false claims act, FCA, Florida Medicare, fraud defense, fraud prevention, fraud schemes, government health programs, health care fraud, health law firm, legal representation, medicaid, medicare, Medicare billing, Medicare fraud, North Caroline health care fraud, PA, physician assistant, physician assistant billing, qui tam, qui tam attorney, qui tam lawsuit, qui tam lawyer, the health law firm, TRICARE, unbundling, whistleblower, whistleblower lawsuit, whistleblower lawyer, whistleblower protection|Comments Off

Qui Tam Cases: If You Are Thinking About Blowing the Whistle, Follow These Tips

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

At The Health Law Firm, we have represented many clients that were involved in qui tam cases brought because of false claims under the Medicare False Claims Act (FCA). We have defended health facilities and health professionals, but we have also brought whistle blower cases against health facilities and health professionals, representing the whistle blower. If you are thinking about blowing the whistle on any type of fraud or unlawful conduct by your current or former employer, there are important facts that you should know.

Filing a qui tam (whistle blower) case can be complicated, complex, and time consuming. It’s important to seek experienced legal counsel to guide you through the difficult process. It is crucial that a whistle blower’s attorney have a good working […]

Florida’s Medicaid Program Receives Settlement Payment from Pharmaceutical Company

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Florida Attorney General’s (AG) Medicaid Fraud Control Unit (MFCU), 46 other states and the federal government reached a $48 million agreement with pharmaceutical company Healthpoint Ltd., on February 25, 2013. According to the Florida AG, the settlement is in response to allegations of misrepresenting the regulatory status of an ointment used to treat skin conditions and submitting false Medicaid claims. Florida’s Medicaid program will receive almost $900,000 of the settlement.

Click here to see the press release from the AG’s office.

Pharmaceutical Company Allegedly Submitted False Claims to Medicaid.

According to the Department of Justice (DOJ), Healthpoint launched the ointment for the treatment of nursing home patients with bed sores. The settlement resolves allegations that Healthpoint marketed the ointment, Xenaderm, without the approval of the […]

By The Health Law Firm|2024-03-14T10:01:39-04:00May 15, 2018|Categories: Legal Defense for Pharmacists, Pharmacist, Pharmacy, Pharmacy Law, Whistleblower|Tags: Department of Justice (DOJ), false claims, false claims act, Federal Food Drug and Cosmetic Act, Florida defense attorney, Florida defense lawyer, Florida health care law, florida health law, Florida Medicaid fraud, Food and Drug Administration (FDA), Healthpoint, Healthpoint Ltd., medicaid, Medicaid fraud, medicaid fraud control unit, nursing homes, Office of Attorney General (AG), overpayment, pharmaceutical company, pharmaceutical drugs, quit tam, whistleblower|Comments Off

New Mexico’s Largest Mental Health Providers Accused of Defrauding Medicaid Out of $36 Million

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

For months now, 15 New Mexico behavioral health agencies have been the subject of a Medicaid fraud investigation. The state’s largest mental health providers had their Medicaid funding frozen by the New Mexico Human Services Department (HSD) due to credible allegations of fraud, according to KUNM News. The behavioral health agencies are accused of collectively defrauding Medicaid of $36 million over three years. The findings in an audit conducted in 2012, by OptumHealth, the contractor that handles Medicaid payments for New Mexico’s behavioral health system, alarmed state officials to the point that they hired Public Consulting Group (PCG), a firm that specializes in Medicaid fraud, to conduct another audit in June 2013.

These behavioral health agencies […]

By The Health Law Firm|2024-03-14T10:01:50-04:00May 15, 2018|Categories: Medicaid audit, Medicaid fraud, Mental Health Counselor, Mental Health Counselor Law|Tags: Attorney General (AG), behavioral health agencies, defense attorney, defense lawyer, Department of Justice (DOJ), false billing, false claims, false claims act, legal representation, medicaid, medicaid audit, Medicaid false claims, medicare, medicare audit, Medicare false claims, Medicare fraud, mental health providers, Public Consulting Group (PCG), qui tam, qui tam lawsuits, settlement agreement, the health law firm, whistleblower, whistleblower attorney, whistleblower lawyer, whistleblower protection|Comments Off

Key West Pharmacy Blows Whistle on Medicaid Fraud and Comes Out on Top

By Danielle M. Murray, J.D.

On September 27, 2012, Public Citizen, a watchdog group, reported whistleblowers have initiated $6.6 billion in penalties against drug manufacturers in 2012. Most of these penalties are for fraudulently overcharging government programs. The report names a small Key West, Florida, pharmacy as one of the top whistleblowers in the country. The pharmacy noticed and reported that drug manufacturers were charging highly inflated prices to Medicaid.

To read the entire report on from Public Citizen, click here.

Whistleblowing Can Pay Off Big.

The study shows that the government collected billions of dollars, just in 2012, as a result of whistleblower efforts.

For whistleblowers such as the Key West pharmacy, helping the government fight fraud has its rewards. According to the Miami Herald, the government collected an estimated $1.3 to $2.5 billion […]

By The Health Law Firm|2024-03-14T10:01:06-04:00May 15, 2018|Categories: Legal Defense for Pharmacists, Pharmacist, Pharmacy, Pharmacy Law, Whistleblower|Tags: audit, defense attorney, false claims act, FCA, Florida defense attorney, government health programs, legal defense, legal representation, medicaid, medicaid audit, Medicaid defense attorney, Medicaid fraud, Medicaid fraud defense attorney, Medicaid overbilling, Medicaid scheme, qui tam suits, whistleblower, whistleblower protection|Comments Off

Qui Tam Cases: If You Are Thinking About Blowing the Whistle, Follow These Tips

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

At The Health Law Firm, we have represented many clients that were involved in qui tam cases brought because of false claims under the Medicare False Claims Act (FCA). We have defended health facilities and health professionals, but we have also brought whistle blower cases against health facilities and health professionals, representing the whistle blower. If you are thinking about blowing the whistle on any type of fraud or unlawful conduct by your current or former employer, there are important facts that you should know.

Filing a qui tam (whistle blower) case can be complicated, complex, and time consuming. It’s important to seek experienced legal counsel to guide you through the difficult process. It is crucial that […]

Specialty Pharmacy Settles Lawsuit Over Illegal Kickbacks

By Lance O. Leider, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Department of Justice (DOJ) announced on December 27, 2012, that a specialty pharmacy, based in San Diego, California, has agreed to pay a $11.4 million settlement. That payment is to resolve allegations that the company used kickbacks to persuade doctors to write prescription for its products. The allegations came from a whistleblower lawsuit filed by a former employee.

Click here to read the press release from the DOJ.

Expensive Kickbacks Used on Doctors.

An article in Modern Healthcare states that the specialty pharmacy allegedly used tickets to sporting events, concerts, plays, spa outings, golf games and ski trips to bribe doctors to write prescriptions for its products. The company […]

By The Health Law Firm|2024-03-14T10:01:09-04:00May 15, 2018|Categories: Legal Defense for Pharmacists, Pharmacist, Pharmacy, Pharmacy Law, Whistleblower|Tags: Anti-kickback statue, Department of Justice (DOJ), false claims act, health care fraud, health care scheme, kickback scheme, legal representation, pharmaceutical company, qui tam suits, specialty pharmaceutical company, whistleblower, whistleblower attorney, whistleblower lawyers, whistleblower protection|Comments Off