If you become aware of a physician or hospital improperly billing Medicare or Medicaid, you should consult with an attorney to understand your rights as a whistleblower before you proceed.
Philadelphia, PA (PRWEB) May 30, 2014
Young Law Group has opened an investigation into the practices of hospital cardiology departments following the announcement of another settlement by a hospital accused of violating the False Claims Act when its physicians performed medically unnecessary heart procedures, including coronary stents and diagnostic catheterizations. Other hospitals may have similarly billed Medicare and Medicaid programs for unnecessary cardiology diagnostics or medical procedures. Additionally, these hospitals may have paid physicians in excess of fair market value in violation of the Stark Law or entered into a sham consulting agreement as a form of illegal kickback to improperly compensate a physician for referrals.
Individuals with evidence of health care fraud in a medical practice or hospital can discuss their information with the attorneys of Young Law Group by confidential phone call to 1-800-590-4116.
By October 2013, at least 11 hospitals had settled allegations that they billed federal health care programs. *
In January, Saint Joseph Health System paid $16.5 million to resolve allegations that it submitted false claims to Medicare and the Kentucky Medicaid program. The settlement also covered allegations that it violated the Stark Law and Anti-Kickback Statute by entering into sham employment agreements to induce doctors at Cumberland Clinic to refer patients to the hospital operated by Saint Joseph. Three cardiologists reported the misconduct to the government and received $2.4 million to share from the settlement. The lawsuit was captioned United States ex rel. Jones, Hollingsworth and Rukavina v. Saint Joseph Health System et al., no. 6:11-cv-00081-GFVT (E.D.Ky.).
On May 28th, the Department of Justice announced a $40.9 million settlement with Ashland Hospital Corp. d/b/a King’s Daughters Medical Center. ** Physicians at the hospital were accused of performing unnecessary procedures and falsifying medical records to justify the procedures. The settlement also resolved allegations that certain cardiologist salaries were in excess of fair market value, violating the Stark Law.
The Stark law prohibits physicians from referring Medicare patients to a hospital where they have a financial relationship unless it is subject to a permitted exception. In order to meet the exception for self-referrals in a bona fide employment situation, remuneration for the physician’s services must be consistent with fair market value and commercially reasonable even in the absence of referrals. The Justice Department, when announcing the Ashland Hospital settlement, reiterated its commitment to ensuring treatment decisions are not motivated by financial gain.
Under the False Claims Act, eligible whistleblowers who report fraud against Medicare or Medicaid by a health care provider to the U.S. government may be entitled to between 15 and 30 percent of the amount recovered for the government based on their information.
“Whistleblowers who report misconduct help the United States to recover billions of taxpayer dollars every year that would otherwise be lost to companies engaged in fraud,” declared Eric L. Young, Esq., Managing Partner of Young Law Group. “If you become aware of a physician or hospital improperly billing Medicare or Medicaid, you should consult with an attorney to understand your rights as a whistleblower before you proceed.”
About Young Law Group, P.C.
Young Law Group represents whistleblowers reporting health care fraud to the U.S. Government via qui tam lawsuits permitted by the False Claims Act. Young Law Group also represents individuals reporting securities fraud to the SEC/CFTC programs and tax evasion to the IRS.
Eric L. Young, Esq., Managing Partner of Young Law Group, represented the first whistleblower awarded compensation by the IRS under the mandatory reward program created following the Tax Relief and Health Care Act of 2006. Young has also served as an expert witness in areas of U.S. whistleblower law and represented clients in some of the largest qui tam recoveries, including United States ex. rel. Lucia Paccione v. Cephalon Inc., E.D.P.A., 03-CV-6268.
Learn more about Eric Young, Esq., and Young Law Group at http://young-lawgroup.com
For a free, confidential case evaluation and discussion about whistleblower laws and rights, please call Eric Young, Esq., at 1-800-590-4116.
Attorney Advertising: Young Law Group, P.C., is a private law office located at 123 S. Broad St., Ste 1920, Philadelphia, PA 19109 with attorneys licensed to practice in Pennsylvania. The firm will associate with local counsel in other jurisdictions when necessary. Young Law Group may not be able to represent residents of all states.
For attribution purposes:
** http://www.justice.gov/opa/pr/2014/May/14-civ-567.html
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