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Posts Tagged ‘fraud’

(PRWEB) December 17, 2013

The Corporate Whistleblower Center says,There is little oversight for billing practices for procedures and treatments involving Medicare at many hospitals, or healthcare facilities in our opinion. Skilled nursing facilities and nursing homes can be cash cows for people who want to take advantage of the system. Because of this, opportunities for whistleblowers to come forward and be rewarded are very real, and we’d like to talk to anyone with well documented proof to call us anytime at 866-714-6466.

Penalties for Medicare fraudas well as the rewards for whistleblowerscan be astronomical. Recently, The Ensign Group, which operates skilled nursing facilities throughout the United States, agreed to pay $ 48 million to settle allegations that it submitted fraudulent claims to Medicare for services that were not medically necessary. According to the suit, from 1999 to 2011, allegedly six different skilled nursing facilities routinely submitted false claims to the government for services that included physical and speech therapy, even though they were not medically necessary for the patients. This was allegedly done to increase their Medicare reimbursement.

The two whistleblowers in this case will both receive a portion of the $ 48 million settlement.

Taking advantage of senior citizens and their conditions in order to bilk the government out of taxpayer dollars is not something that should be tolerated by anyone, says the Corporate Whistleblower Center. We are asking all insiders who have documented proof of ongoing Medicare fraud to contact us at 866-714-6466. We keep all calls confidential, and we will explain the whistleblower reward program and process to you, then help you get your case to the best whistleblower attorneys in the country. http://CorporateWhistleblowerCenter.Com

Simple rules for a whistleblower from the Corporate Whistleblower Center:

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An American fugitive convicted in a $ 1-million health-care fraud scheme in California was arrested Wednesday in Canada.

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Contemporary Issues in Healthcare Law and Ethics, Second Edition 2003 1567931987

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“There is something bad happening to our children in family courts today that is causing them more harm than drugs, more harm than crime and even more harm than child molestation”. – Judge Watson L. White, Superior Court Judge, Georgia “There is no system ever devised by mankind that is guaranteed to rip husband and wife or father, mother and child apart so bitterly than our present Family Court System.” – Judge Brian Lindsay, Retired Supreme Court Judge, New York Violations of Federal Law on Judicial Determinations: -Violation CFR Sec 1356.21(d): Documentation of Judicial Determinations (Must be supported by EXPLICIT evidence) (1) The judicial determinations regarding contrary to the welfare, reasonable efforts to prevent removal, and reasonable efforts to finalize the permanency plan in effect, including judicial determinations that reasonable efforts are not required, must be explicitly documented and must be made on a case-by-case basis and so stated in the court order. (2) Neither affidavits nor nunc pro tunc orders will be accepted as verification documentation in support of reasonable efforts and contrary to the welfare judicial determinations. (3) Court orders that reference State law to substantiate judicial determinations are NOT acceptable, even if State law provides that a removal must be based on a judicial determination that remaining in the home would be contrary to the child’s welfare or that removal can only be ordered after reasonable efforts have been
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Charlotte woman indicted for health care fraud
CHARLOTTE, N.C. — Federal authorities say a woman is charged in a scheme to defraud Medicaid of at least $ 650000. The U.S. Attorney's Office in Charlotte said Wednesday that 37-year-old Charlotte Elizabeth Garnes is charged with health care fraud …
Read more on Sacramento Bee

County health care agency names new administrators
Cyndie Cole, part of the county system since 1985, has already begun work as hospital administrator and deputy director of the Ventura County Health Care Agency. She leads the 223-bed medical center in Ventura as well as the 49-bed Santa Paula Hospital …
Read more on Ventura County Star

Health 'reform' law deja-vu (again)
A similar feeling grips the reader of “An act improving the quality of health care and reducing costs through increased transparency, efficiency and innovation,” the Bay State's new health care bill signed into law this month. The “center for health …
Read more on Boston Herald

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The pharmaceutical giant Glaxo SmithKline will pay billion in the largest healthcare fraud settlement in US history. The company covered up the drug risks and encouraged doctors to prescribe its products for uses they did not have approval for. From Washington, Al Jazeera’s Alan Fisher reports. Source, credit to Aljazeera- www.aljazeera.com FAIR USE NOTICE: This video has been posted to further advance our understanding of environmental, political, human rights, economic, Technological, democratic, scientific, and social justice issues which constitutes a “fair use” of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 USC Section 107 for research and educational purposes.
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From: www.youtube.com Please click Like on my FaceBook page here: www.facebook.com Subscribe to www.youtube.com July 02, 2012 – The pharmaceutical giant Glaxo SmithKline will pay billion in the largest healthcare fraud settlement in US history. The company covered up the drug risks and encouraged doctors to prescribe its products for uses they did not have approval for. From Washington, Al Jazeera’s Alan Fisherreports. FAIR USE NOTICE: This video may contain copyrighted material. Such material is made available for educational purposes only. This constitutes a ‘fair use’ of any such copyrighted material as provided for in Title 17 USC section 106A-117 of the US Copyright Law.

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Health Care Fraud and Abuse Laws Affecting Medicare and Medicaid: An Overview

Health Care Fraud and Abuse Laws Affecting Medicare and Medicaid: An Overview

A number of federal statutes aim to combat fraud and abuse in federally funded health care programs such as Medicare and Medicaid. Using these statutes, the federal government has been able to recover billions of dollars lost due to fraudulent activities. In March 2010, Congress enacted comprehensive health care reform legislation. One focus of this legislation, the Patient Protection and Affordable Care Act (PPACA) as amended, is improved health care fraud and abuse enforcement. PPACA, among other things, creates new health care fraud enforcement tools and expands upon the types of prohibited conduct. This report provides an overview of some of the more commonly used statutes used to fight health care fraud and abuse and discusses some of the changes made to these statutes by PPACA.

Title XI of the Social Security Act contains Medicare and Medicaid program-related anti-fraud provisions, which impose civil penalties, criminal penalties, as well as exclusions from federal health care programs on persons who engage in certain types of misconduct. PPACA amends these administrative sanctions and authorizes the imposition of several new civil monetary penalties and exclusions.

Under the federal anti-kickback statute, it is a felony for a person to knowingly and willfully offer, pay, solicit, or receive anything of value (i.e., “remuneration”) in return for a referral or to induce generation of business reimbursable under a federal health care program.The statute prohibits both the offer or payment of remuneration for patient referrals, as well as the offer or payment of anything of value in return for purchasing, leasing, ordering, or arranging for, or recommending the purchase, lease, or ordering of any item or service that is reimbursable by a federal health care program. PPACA revises the evidentiary standard under the anti-kickback statute and eliminates the requirement of actual knowledge of, or specific intent to commit a violation of the statute. This amendment may make it easier for the government to prove its case.

The Stark law and its implementing regulations prohibit physician self-referrals for certain health services that may be paid for by Medicare or Medicaid. Under the Stark law, if (1) a physician (or an immediate family member of a physician) has a “financial relationship” with an entity, the physician may not make a referral to the entity for the furnishing of these health services for which payment may be made under Medicare or Medicaid, and (2) the entity may not bill the federal health care program or any individual or entity for services furnished pursuant to a prohibited referral. PPACA limits certain exceptions to the Stark law.

The federal False Claims Act (FCA) imposes civil liability on persons who knowingly submit a false or fraudulent claim or engage in various types of misconduct involving federal government money or property. Health care program false claims often arise in billing, including billing for services not rendered, billing for unnecessary medical services, double billing for the same service or equipment, or billing for services at a higher rate than provided (“upcoding”). Civil actions may be brought in federal district court under the FCA by the Attorney General or by a person known as a relator (i.e., a “whistleblower”), for the person and for the U.S. Government, in what is termed a qui tam action. PPACA appears to make it easier for certain relators to bring qui tam actions, thus potentially allowing some FCA actions to proceed that would have been dismissed under prior law.

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CNBC’s Scott Cohn reports on the billions of dollars lost each year by Medicare and Medicaid fraud.

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(PRWEB) January 25, 2012

The Corporate Whistle Blower Center is urging professionals, executives, or managers in healthcare, in medical products, medical devices, or pharmaceuticals to step forward if they have substantial proof their company, or a company they know about is cheating, or defrauding the government out of millions of dollars in Medicare, or Medicaid fraud. The group says, “In the hospital business it could be a ER doctor, a CNO, or a CMO, who has proof their hospital is admitting ER patients, who should have been sent home, just to make a lot more money off of Medicare, or Medicaid. In the nursing home business it could be over medicating patients, to cover up the fact the nursing home is so short staffed, they do not have enough staff to provide the mandatory time per day to meet Medicare, or Medicaid requirements. In the medical device industry, an example could be surgeons in collusion with a medical device company’s representatives, that are selling extremely expensive titanium hip replacements to 90 year olds with dementia, when the patient could have received a hip replacement at a fraction of the cost, or when it comes to pharmaceutical companies the sky is the limit, when it comes to scams to over bill, or defraud the taxpayers.” http://CorporateWhistleBlowerCenter.Com

The Corporate Whistle Blower says, “We are in the business of helping whistleblowers advance their claims, with the goal being a huge reward, provided the wrongdoing is in the millions of dollars, and the whistleblower possesses significant proof, that makes it all easy to prove. Significant proof is not-I think they are doing this. Significant proof is being able to prove it with records, documents, or other witnesses.” The Corporate Whistle Blower Center treats all whistleblower calls with very strict rules. There is absolute confidentiality over things that are said. Based on the quality of the information, and the fact set quality, the Corporate Whistle Blower Center may try to help a whistleblower develop, or package their information, and based on the quality of the information the group will suggest what US law firms may be best suited to advance a claim. No other group in the world offers services like these. For more information whistleblowers, who possess significant, provable information are encouraged to contact the Corporate Whistle Blower Center anytime at 866-714-6466, or they can contact the group via their web site at http://CorporateWhistleBlowerCenter.Com

Simple rules for a whistleblower from the Corporate Whistle Blower Center:


Do not go to the government first, if you are a major whistleblower. The Corporate Whistle Blower Center says, “Major whistleblowers frequently go to the federal government thinking they will help. Its a huge mistake. Frequently government officials could care less, or they are incompetent.”
Do not go to the news media with your whistleblower information. Public revelation of a whistleblower’s information could destroy any prospect for a reward.
Do not try to force a government contractor, or corporation to come clean to the government about their wrongdoing. The Corporate Whistle Blower Center says, “Fraud is so rampant among federal contractors, that any suggestion of exposure might result in an instant job termination, or harassment of the whistleblower. We say, come to us first, tell us what type of information you have, and if we think its sufficient, we will help find the right law firms, to assist in advancing your information.”

Any type of insider, or employee, who possesses significant proof of their employer, or a government contractor fleecing the federal government is encouraged to contact to Corporate Whistle Blower Center anytime at 866-714-6466, or they can contact the group via their web site at http://CorporateWhistleBlowerCenter.com

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