Joel Hesch helps whistleblower receive nearly $5 million as a reward for reporting Medicare fraud by a long term acute care hospital chain (LTCH or LTACH fraud)

The government awarded a whistleblower a reward of $4.85 million for reporting a long term acute care hospital chain for allegedly admitting patients who did not meet the Medicare criteria for admission to a long term acute care hospital (LTCH or LTACH). The whistleblower is a former employee of the LTCH chain. She contacted Joel Hesch for help in reporting the LTCH Medicare fraud to the government and apply for a whistle blower reward. Her LTCH fraud allegations consisted of admitting patients who did not meet the Medicare criteria for admission to an LTCH and/or rehabilitation facility and fraudulently extending patient stays beyond what was medically necessary in order to obtain higher reimbursement than allowed for LTCH hospitals.

On behalf of the whistleblower, Mr. Hesch filed a qui tam complaint under the False Claims Act to claim a reward for reporting LTCH fraud against Medicare and other government healthcare programs. The False Claims Act pays whistleblower rewards of between 15% and 25% of the amount the government recovers based upon the whistleblower’s allegations. Mr. Hesch successfully convinced the government to issue subpoenas and interview dozens of witnesses to corroborate the whistleblower’s allegations of LTCH or LTACH Medicare fraud.

The Department of Justice reached a settlement agreement with the LTCH hospital chain and it agreed to pay $24,225,865 to settle allegations that it fraudulently billed Medicare and other healthcare programs by submitting claims for reimbursement for Medicare patients that did not meet the admission criteria for a LTCH or LTACH facility, and also for extending the stay of Medicare patients at LTCH hospitals beyond the time medically necessary.

The government agreed to pay the whistleblower an award or a reward of $4,845,173 for reporting the LTCH fraud by filing her qui tam complaint under the False Claims Act. To be eligible for a reward, a whistleblower must hire an attorney to file a qui tam complaint in court. Mr. Hesch followed all of the exacting government procedures to ensure the whistleblower would receive her award. Although the national average for a whistleblower is about 17% of the settlement amount, Mr. Hesch convinced the government to pay his client 20% of the settlement amount paid by the LTCH hospital to resolve the whistleblower’s allegations of LTCH fraud, which amounted to $4.85 million as a reward for reporting the fraud.

Joel Hesch applauds the courage of his whistleblower client for stepping forward and reporting LTCH or LTACH Medicare fraud. She is a hero.

Joel Hesch has helped many other whistleblowers receive rewards for reporting fraud against the government. In another LTCH fraud case, Mr. Hesch helped a whistleblower receive a $12 million reward for reporting fraud by another long term acute care hospital chain (LTCH or LTACH fraud). This case pushes the total judgments obtained by Joel Hesch for fraud against the government under the False Claims Act to over $1.7 billion, consisting of cases Joel worked on while working for the Department of Justice for 16 years in the whistleblower reward office and the last 10 years of representing whistleblowers who file for rewards.

Mr. Hesch also encourages you to contact him in confidence to find out if you have the right type of case of fraud against the government in which a monetary reward is available for reporting Medicare fraud or fraud against any other government program.

Click here for an article by Joel Hesch on “How to Report Long Term Acute Care Hospital Fraud (LTCH or LTACH fraud)”