Medicare Fraud 101

Archive for November, 2008

Whistleblower Lawsuit Against New Jersey Hospital Results in $3.85 Million Payment for Medicare Fraud

Cooper University Hospital in New Jersey has agreed to pay $3.8 million to the federal government as the result of inflating its Medicare claims from 2001 to 2003.  Specifically the Department of Justice alleged that the hospital improperly increased its charges for inpatient and outpatient care to make it appear that the charges were greater than they actually were.  The whistleblower litigation was brought by Anthony Kite, an independent hospital consultant.  

This outlier fraud case involved supplemental payments Medicare makes when a patient exceeds a predetermined payment amount, also known as outlier payments.  Similar lawsuits have been brought against other New Jersey hospitals with equal success as the result of their engaging in Medicare fraud. 

To learn more click here or if you have False Claims Act case contact Nolan & Auerbach P.A.

$60 Million Settlement by CoxHealth (Lester E. Cox Medical Centers) for Healthcare Fraud

Improperly billed claims paid by Medicaid payments has resulted in a $60 million settlement by CoxHealth. This settlement resulted from allegations that beginning as far back as January 1996, CoxHealth allegedly entered into prohibited financial agreements that violated Medicare cost report requirements, Stark Laws and the Anti-Kickback Statute. John F. Wood, the U.S. Attorney for the Western District of Missouri who brought the case said, “Our priority is protecting the patients. These laws are intended to ensure that physicians make referrals to health care facilities based on the best interest of their patients without being induced by payments from hospitals competing for their business. These laws also protect the integrity of the government-funded health care benefit programs.” These laws are in place to make sure that patient care is not compromised and that the best interest of the patient is paramount.To read more about this case, click here. Contact Nolan & Auerbach P.A. for more information about healthcare fraud.