Friday, July 29, 2005

Fired Florida Radiologist Accuses Ex-Boss of Medicare Billing Fraud

A prominent Boca Raton, Fla., radiologist has been accused of large-scale Medicare fraud in a whistleblower suit filed by a physician he once employed, according to a story published today in law.com.

The lawsuit, filed in federal court in West Palm Beach, Fla., accuses Dr. Fred L. Steinberg of bilking Medicare using a complex billing scheme that overcharged the government on a variety of imaging procedures. The lawsuit, which was unsealed last month, does not specify the amount of the alleged fraud.

Dr. David A. Clayman claims in the 2002 lawsuit that Steinberg, his former boss, fired him when he complained about Steinberg’s billing practices. The lawsuit brought under the federal False Claims Act was filed, as the law requires, on behalf of the federal government and was sealed while investigators looked into the allegations. Read the complete account here.

Mount Vernon Hospital $2.65 Million Settlement Agreement

A New York hospital today agreed to pay $2.65 million to settle charges that over a seven-year period it operated an unlicensed alcoholism treatment facility which took in several million dollars in Medicaid payments and kicked back approximately $60,000 per month to a firm that “brokered” the patients referred to it, according to attorneys Timothy J. McInnis and David A. Koenigsberg, who represent the whistleblower who brought the healthcare fraud allegations to the Government.

According to a news release in prforlaw.com, The Mount Vernon Hospital ("MVH") also agreed to enter into a Corporate Integrity Agreement with the U.S. Department of Health and Human Services, according to a Settlement Agreement among the Government, MVH and the whistleblower.

The Agreement, approved today by U.S. District Judge Kimba M. Wood, dismisses a federal civil Complaint unsealed by the U.S. Attorney’s Office for the Southern District of New York, which formally joined the whistleblower suit against MVH, according to McInnis, a former federal prosecutor now in private practice who concentrates in qui tam whistleblower cases brought under the federal False Claims Act ("FCA"). Read the full account here.

Tuesday, July 26, 2005

Humanscale Corp to Pay US $9 Million to Settle Fraud Allegation

Humanscale Corporation (formerly Softview Computer Products), a company that provides furniture and office products to the federal government, has agreed to pay the United States $9 million to resolve allegations that the company overcharged the government, the Justice Department has announced in a press release.

The government alleged that the New York firm failed to disclose current, accurate and complete discount and pricing information to the General Services Administration (GSA) contract negotiators and failed to comply with the price reduction clauses for three of its GSA Multiple Award Schedule contracts resulting in the overcharging of the government.

“The settlement today with Humanscale shows the Department’s determination to sue and collect damages under the False Claims Act when it’s determined that government contractors knowingly or recklessly overcharge the government,” said Peter D. Keisler, Assistant Attorney General for the Civil Division, in a statement issued June 30, 2005.

The settlement, which covers overcharges that occurred between April 1, 1998 and December 31, 2004, also resolves charges originally brought against Humanscale Corporation by a former employee, Gerald Rademacher.  Under the settlement, Mr. Rademacher will receive $1,575,000 for bringing the matter to the attention of the government.  Under the qui tam or whistleblower provisions of the False Claims Act, a private party can file an action on behalf of the United States and receive a portion of the settlement if the government takes over the case and prosecutes it successfully. 

Stopping Medicaid Fraud -- A Letter to the Editor

The following Letter to the Editor appeared in today’s editions of The New York Times.

To the Editor:

Re “As Medicaid Balloons, Watchdog Force Shrinks” (front page, July 19):

The federal False Claims Act authorizes a private citizen with inside knowledge of fraud in government programs to file a lawsuit in the name of the government and to receive a share of the recovery. At least 15 states, including California, Florida and Texas, have enacted such laws. A similar law applying to New York City takes effect next month.

According to a study published by Taxpayers Against Fraud, health care fraud recoveries under the federal False Claims Act from 1998 to 2003 represent a $13 return to the American people on every $1 invested in health care fraud investigation and prosecution.

We strongly endorse the efforts of New York’s attorney general, Eliot Spitzer, to enact a false claims law in New York State.

Neil V. Getnick
Lesley Ann Skillen
New York, July 21, 2005
The writers are lawyers who represented a whistle-blower in a $251 million Medicaid fraud recovery. Mr. Getnick is chairman of the board of Taxpayers Against Fraud.

Monday, July 25, 2005

Florida Sues Drug Companies in Medicaid Scam

Florida Attorney General Charlie Crist has filed suit against three pharmaceutical manufacturers for defrauding the state’s Medicaid program in a scheme that cost taxpayers $25 million.

According to a story in consumeraffairs.com, the lawsuit alleges that the companies wrongfully inflated prices in a way that let pharmacies receive excessive reimbursement for filling prescriptions for Medicaid patients who bought generic drugs for depression, schizophrenia, seizures, angina and other serious illnesses. Read the full account here.

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