Wednesday, January 30, 2008

Ohio whistleblower gets $175K in fraud case against doctor

Antoinette Menapace has been awarded $175,000 for blowing the whistle on her boss, Dr. Mohammed Aiti.  Menapace worked as a medical billing coder from February to November 2004, and noticed that Dr. Aiti would order expensive medical tests for patients who did not need them.  Aiti would then bill Medicaid and Medicare.

Aiti was arrested in August 2006.  On January 10, he was found guilty of fraud and ordered to serve 37 months in prison, pay a $150,000 fine and restitution in the amount of $1.9 million. 

As whistleblower, Menapace was allowed a portion of the proceeds.

Click here to read Matthew Rink’s article in the IndeOnline.com about Whistleblower in fraud case against doctor gets $175k.

Saturday, January 26, 2008

U.S. Joins Whistleblower Suit Against NJ Hospitals

The US Department of Justice has joined a lawsuit that accuses three New Jersey hospitals of fraudulently inflating bills submitted to Medicare.  The suits were filed in 2002 by three realtors.  Peter Salvatori and Sara Iverson filed a lawsuit against Robert Wood Johnson Hospital and Barnert Hospital.  James T. Monahan filed a suit against Bayonne Medical Center.

Insufficient reimbursement rates for Medicare is a major problem for hospitals in New Jersey.  At least five of New Jersey’s acute care hospitals have filed for bankruptcy in the past two years, including Barnert Hospital and Bayonne Medical Center. 

Click here to read Jacqueline Palank’s article on http://www.forbes.com about U.S. Joins Whistleblower Suit Against Bankrupt Hospitals.

Thursday, January 24, 2008

Bechtel Infrastructure Corp. and PB Americas Settle Big Dig Lawsuit

A joint venture between Bechtel Infrastructure Corp. and PB Americas Inc. and certain design consultants have agreed to pay the United States and the Commonwealth of Massachusetts a total of $458 million to settle allegations that PB Americas violated federal and state criminal and civil laws by failing to provide adequate construction management and quality assurance services to the Central Artery Tunnel, known as one of the Big Dig, in Boston.

According to the terms of the global resolution, Bechtel and PB Americas will pay over $23 million to the United States to settle federal False Claims Act allegations, over $40 million to the Commonwealth of Massachusetts to settle False Claims Act allegation, and over $335 million to a state warranty fund for future repairs to the Central Artery Tunnel.

The agreement resolves claims made in a qui tam action filed against Bechtel Corp. and PB Americas in the United States District Court for the District of Massachusetts.  Under the agreement, the whistleblower will receive a share of the federal and state recoveries in the amount of $150,000.

Click here to read the press release about Bechtel Infrastructure and PB Americas Settle Qui Tam Lawsuit.

Tuesday, January 08, 2008

New Jersey False Claims Act Approved by State Senate

The New Jersey False Claims Act sponsored by state Senators John H. Adler and Joseph F. Vitale was unanimously approved in the senate today by a vote of 37-0.  Senator Vitale, D-Middlesex, spoke of the need to protect state citizens against abuse and fraud within Medicaid and other State claims programs.  “Medicaid and other claims programs are designed to serve as a safety net for those New Jerseyans who need them,” he said.  “However, when those programs are subject to fraud and abuse, our ability to help with those legitimate claims is diminished.”

Like other state False Claims Acts, the bill allows private individuals in New Jersey to bring an action against any person who knowingly causes the State to pay a false claim.  If the person is found guilty in court, they would face civil penalties between $5,000 and $10,000 for each verified count of a false claim.  Additionally, the court could impose up to three-times the cost of any losses the public entity would have sustained because of the false claim.

There is also a whistleblower incentive in the bill.  If false claims are proven in court, the whistleblower is entitled to 15% - 30% of the proceeds.

The bill now heads to the Assembly before going to the Governor to be signed into law.

Click here to read Jason Butkowski’s article on PolitickerNJ.com about Adler-Vitale ‘New Jersey False Claims Act’ Approved by Senate.

Four Texas Clinics Focus of Fraud Investigation

Four clinics in El Paso, Texas are under investigation for Medicare fraud.  Rebecca Gonzalez, a former employee of Fresenius Medical Care of North America, filed the lawsuit.  In it she alleged that the supervising physician, Dr. Alfonso Chavez, allowed an employee, Ramiro Debora, to treat patients as if he were a doctor.  Debora is neither a physician nor a physician’s assistant. 

The clinics bill Medicare for prescriptions and treatment of dialysis patients.  Gonzales also alleges that the company retaliated against her when she refused in writing to aid the clinic in concealing fraud from Medicare auditors.

Click here to read David Crowder’s article in the El Paso Times about Operator of four area clinics focus of fraud investigation.

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