False Claims Act Attorney Reports On University Hospital Fraud and Settlement

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We are attorneys that investigate False Claims Act cases nationwide, including in the states of Tennessee, Arkansas, Mississippi, Kentucky and elsewhere for Medicare fraud, tax fraud, contractor fraud and more against a range of employers including healthcare providers, medical device companies, defense contractors, and pharmaceutical companies. We stand ready to provide a free case evaluation to you; please call us today.

False Claims Act Lawyer Discusses Hospital Settlement

As attorneys that represent individuals that want to pursue claims of fraud on behalf of the United States Government, I found this particular case development interesting enough to post it on this website.

As a False Claims Act attorney, I wanted to advise the public that the previous owner of the University of Maryland St. Joseph Medical Center has agreed to pay the Federal Government $4.9 million dollars for overbilling the Medicaid and Medicare system by keeping patients in the hospital longer than needed.  This is a potentially wide-stretching issue across the country in that numerous hospitals and facilities may very well be requiring patients to similarly stay longer than needed.

Capa Kel’s initiatives which recently sold to the University of Maryland Medical System denied any wrongdoing and said in a statement that it wanted to avoid lengthening costly court proceedings.  As a False Claims Act lawyer, I have seen similar stretches by business across the country.  This is especially true considering when the same hospital system faces hundreds of lawsuits from patients who accused Dr. Mark Midei, once a star cardiologist at St. Joseph of placing stents in the arteries of patients who may not have needed them. It also previously paid the government $22 million dollars to settle a separate allegation involving a cardiology practice where Midei once worked and to repay Medicare payments received for stents he implanted.

The unnecessary hospital stays were discovered by a routine audit conducted by St. Joseph, which then alerted federal officials.  The admissions, which occurred from 2007 to 2009, were not tied to any one doctor or department.  There may very well be additional hospitals in the United States, including in states such as Tennessee, Mississippi, Arkansas, or Kentucky that are requiring patients to stay extended days in hospitals in order to maximize Medicare and/or Medicaid recoveries.  If you are aware of any such wrongdoing or suspicion of any other fraudulent activity, we invite you to contact us as soon as possible.

If you have evidence to support claims of fraud against a business or entity, please contact us as soon as possible.

THE SCOPE OF FRAUD

Amazingly, some estimates have suggested that approximately 10% of the entire annual United States budget is lost to companies or individuals who are defrauding the government. The United States Federal budget for 2010 was $3.456 billion, meaning around $345.6 million was wrongfully wasted on fraud.

The entities defrauding the government do so in a variety of ways: Medicare or Medicaid fraud whereby they bill the government for services which they never provided or overbill for services that were provided; SEC Trading; Tax Fraud; TARP Fraud; Military/Defense contract fraud; Pharmaceutical Manufacturing;contract fraud involving any number of large government spending programs; or other types public benefit fraud.

HELPING THE PUBLIC.

As a whistleblower attorney, we are interested in speaking with persons willing to make known the truth about company practices and are willing to file a qui tam or whistleblower action. One area in particular we are interested in discussing are lawsuits involving medical device companies where the company is alleged to have overcharged, engaged in kickback programs, and the like. We will nevertheless investigate claims in a variety of areas.

Workers and persons all across the country witness actions at their work that may be unlawful or even corrupt. Unfortunately, some employees and workers feel that they will be fired, terminated, harrassed or punished if they report an unlawful or corrupt action. These reporters, however, are protected by the law as a Whistleblower and can receive compensation because of the False Claims Act or the Medicaid False Claims Act. If you have reported actions that may be fraudulent, then you should talk to a Whistleblower or qui tam lawyer about your facts.

Whistleblowers help the government to get back billions of dollars each year with the help of the False Claims Act. In fact, fraudulent Medicaid claims are also caught by whistleblowers having the Medicaid False Claims Act on their side. If you report a false claim or fraudulent action to the government, then the government will give you, the whistleblower, a part of the money that gets recovered. This is because of qui tam requirements. Qui Tam means that a person files a lawsuit for the king and also for him or herself. The phrase is qui tam pro domino rege quam pro se ipso in hac parte sequitur, or, “he who sues for the king as well for himself.”

These requirements and lawsuits were made popular during the Civil War when many people were getting away with fraudulent actions against the government. In 1986, the False Claims Act was amended to raise the total compensation given to people who reported fraudulent actions, or whistleblowers. If a whistleblower works with a lawyer then it may be possible for them to get three times the amount the government would get in damages and also get additional compensation for general fines.

TYPES OF CASES

The most common situations that could form the basis of a Qui Tam action include:

  • Submitting a false or fraudulent record, bill or statement to the government in order to fraudulently obtain money such as reporting a medical service that was never performed for Medicare or Medicad;
  • Conspiring with a third party to submit or present have a false or fraudulent claim to the government;
  • Withholding property of the government with the intent to defraud or conceal the property from the government;
  • Fraudulently buying property of the government from someone not authorized to sell that property; and
  • Making a false statement to fraudulently avoid paying money to the government or to avoid delivering property to the government.

THE PROCESS

We will meet with you and thoroughly investigate your case.  As we mentioned, we will travel to see you, as we want to meet with you in person and review all documents you may have to support your case.  We will then investigate on our own and prepare a complaint for filing in federal court.  The case will be filed under seal, and served on the U.S. Attorney’s Office along with a Declaration of Evidence that is not filed but also served on the Government.

Once the case is filed, a United States Attorney investigates the lawsuit and underlying allegations of fraud for an initial period of 60 days. If after investigating the claim the U.S. Attorney believes the allegations of fraud are meritorious, the United States Government takes over the case and either enters into a settlement or continues the lawsuit against the wrongdoer. The Relator would then be entitled to a portion of the recovery despite the fact that the government has taken over the case.

The amount that the Relator would be entitled to receive would be approximately 15 percent to 25 percent of the decision. It is estimated that the government intervenes and takes over a case approximately 30 percent of the time.

FOR HELP, PLEASE CONTACT US.

We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us.

Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more.

For more information, please contact our team of whitsleblower and qui tam attorneys today.

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