Medicare and Medicaid Fraud Cases

Medicare Kickback Scheme Trial Begins

January 30th, 2015

Ed Novak, the owner and CEO of Sacred Heart Hospital in Chicago is standing trial this week with two co-defendants for their schemes to cash in on Medicare and Medicaid payments.

The issues with Sacred Heart came to light almost two years ago when federal agents started investigating the hospital for an alleged kickback scheme, which included unnecessary and often fatal patient surgeries in the name of more Medicare payments.

Witnesses are expected to testify that kickbacks to get patients referred to the hospital were disguised as teaching fees, rental payments, and other expenses. Recorded conversations of Novak describing his scheme are expected to come into evidence.

However some of the more gruesome allegations that have hit the press have been excluded by court ruling from coming into evidence. These allegations include the hospital's surgeon being called the "butcher" and nurses spraying patients with bug repellent to keep flies away.

Novak faces eight counts of fraud, each of which could bring a five-year prison sentence.

Do you have evidence of Medicare fraud? Call the Law Office of James T. Ratner today at (845) 383-1728 for your confidential consultation with an experienced Medicare fraud attorney in New York. James Ratner represents clients nationwide.

Prison Time for Hollywood Hospital Executive for Medicare Fraud

January 26th, 2015

Christopher Gabel, the former chief operating office of the Hollywood Pavilion psychiatric hospital was sentenced to six years in prison this week and ordered to pay $39.3 million in restitution because of his role in a scheme to defraud Medicare of $67 million.

Medicare had paid out $40 million of the $67 million in fraudulent claims. Employees of Pavillion submitted claims for care that was not actually provided from April 2003 to September 2012. Employees filed fraudulent claims under the names of Medicare beneficiaries across the country by paying bribes to patient brokers. Three accomplices in the scheme have already been convicted at trial and are serving prison time.

Medicare fraud robs the American taxpayer and the government of funds reserved to help those in medical need. Whistleblowers play an integral role in disclosing this kind of corruption, and you can be rewarded for the money you help the government recover.

If you have in-depth knowledge of Medicare fraud, call the Law Office of James T. Ratner today at (845) 383-1728 for your confidential consultation with an experienced Medicare fraud attorney in New York. James Ratner represents Medicare whistleblower clients nationwide.

The Difficulties in Fixing Medicare Fraud

December 22nd, 2014

In a recent case, John and David Mkhitarian used exchange students to create nearly 70 fictional medical practices enrolled in Medicare. Over two years, they collected $3.3 million from Medicare. Although, they were eventually caught and are being sentenced to prison time, their case illustrates one of the huge vulnerabilities of the Medicare system.

New medical providers are not properly vetted. Providers that are deemed to be low risk for fraud are often not even visited by inspectors, as was the case here, because it's not required.

This is just one fault in the multi-million dollar system. Even when the doctors are real, they can bill for procedures that are not medically necessary. Medicare pays out millions that it shouldn't because of the way the system is set up to pay out, and it will take an act of Congress to change it. Even tighter screening of new providers is difficult because of the sheer volume taxing the system.

In reality, whistleblowers like you may be the best weapon we have against the rampant Medicare fraud in this country. If you have significant and detailed information about ongoing Medicare fraud, you can help put a stop to it and be rewarded for your efforts.

Please contact the Law Office of James T. Ratner today at (845) 383-1728 to arrange a free consultation with an experienced Medicare fraud attorney. James T. Ratner represents clients nationwide.

Doctor commits Medicare fraud to buy castle

October 6th, 2014

Since 1966, Medicare has helped America’s elderly, disabled, and those with certain specific conditions receive the medical care they need. But some health care providers look at Medicare and think of ways they can defraud taxpayers for their own financial gain. If you’ve witnessed this kind of deception, please contact our Medicare fraud attorney today at (845) 383-1728 to schedule your free consultation and learn your rights under the law.

According to The Detroit News, Dr. Farid Fata has been accused of intentionally misdiagnosing his patients with cancer as a way to illegally take millions of dollars from Medicare. Even worse? He planned to spend $3 million of his illicit “earnings” to finance a castle in Lebanon.

Taxpayers fund Medicare, and when a criminal chooses to defraud the health care system, he or she is really taking money from the pockets of everyday citizens. That’s why whistleblowers are so important: They look out for the interests of all of us, and they take the brave step to spotlight fraud when it happens.

Wheelchair Medicare Fraud – The Great American Crime

September 17th, 2014

Since 1999, Medicare has spent $8.2 billion on power wheelchairs and scooters for 2.7 million elderly people. But in truth, the government can’t even tell how many of those were scams and how many of those were necessary devices.

In its golden age, Medicare fraud for wheelchairs made scammers rich and defrauded taxpayers by using the unsuspecting elderly of our country in the scheme. Scammers would collect elderly individuals who were on Medicare from their homes and take them to a doctor, who was also in on the scam. He would find the same issues every time and document that each one needed a powered wheel chair.

By exploiting blind spots in the system, scammers can get away with millions of dollars that should go to help those in sick and in need. Instead, it lines the pockets of those people who take advantage of holes in the system, and the taxpayers foot the bill.

In 2013, Medicare alone paid out almost $50 billion in “improper payments.” These bills contained mistakes and should not have been paid. No one knows how much was lost to fraud or caused by innocent errors.

In a system ripe for being abused, whistleblowers are key to curbing fraudulent practices.

If you are able to provide documentation regarding Medicare fraud, please contact James T. Ratner or call (845) 383-1728 today for your case evaluation with an experienced Medicare fraud lawyer. All consultations are strictly confidential, and Mr. Ratner represents clients nationwide.

Court Rules that Billing Medicare for Poor Quality Care Is Not False Claim

September 12th, 2014

In a recent case involving an Illinois nursing home, the 7th U.S. Circuit Court of Appeals ruled that poor quality care did not constitute “worthless services” under the False Claims Act. The lower court had ruled for the two whistleblowers, nurses who had previously worked at the facility. The district court ordered the facility to pay over $9 million.

The appellate court ruled that for a service to be worthless under the False Claims Act it must be “so deficient that for all practical purposes, it is the equivalent of no performance at all.”

At trial the nurses had alleged that the nursing home submitted thousands of Medicare and Medicaid claims for substandard and noncompliant services, such as lack of infection and pest control. They alleged that one patient died because of a colostomy bag malfunction.

Although the care, or lack thereof, sounded egregious, the appellate court did not find that it rose to the level of worthless.

To get your False Claims Act case evaluated by an experienced attorney, please contact James T. Ratner or call (845) 383-1728 today. All consultations are strictly confidential, and Mr. Ratner represents clients nationwide.

Chiropractor Charged with Medicare Fraud

September 10th, 2014

In a recent case in Pennsylvania, a chiropractor named Bauer was charged with submitting thousands of false claims to Medicare.

In the case, the complaint alleges that the chiropractor's license was revoked in 2008 because of an inappropriate relationship with a patient. That revocation excluded him from Medicare. Bauer then continued to work in the management and administration of his primary care practice, submitting thousands of Medicare claims for reimbursement, totaling $3 million.

The government contends that Bauer submitted false claims to Medicare and improperly sought reimbursement for the services that he provided.

Do you have proof of Medicare fraud? Are you ready to blow the whistle? Please contact James T. Ratner or call (845) 383-1728 today to discuss your case with an experienced Medicare fraud attorney. All consultations are strictly confidential.

Medicare Data: Clues to Fraud

April 30th, 2014

The U.S. government released a large quantity of Medicare billing data this month, which could be useful to whistleblowers and their whistleblower attorneys who are documenting cases against health care providers and drug companies who have cheated the Medicare system with health care fraud.

One of the benefits of the release of data is encouraging more whistleblowers to come forward. Employees can now see if the practices of the doctors and labs that they work for are in line with other practices or if they are fraudulent. This could give whistleblowers the comparative they need to go forward.

Whistleblowers can be rewarded for their efforts. You can receive up to 30 percent of the amount recovered by the government.

If you have the ability to provide documentation about Medicare fraud, please contact James T. Ratner by calling (845) 383-1728 to discuss your case with an experienced Medicare fraud attorney. All consultations are strictly confidential.

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