Jul 27

The Hesch Firm Wins $8 Million Settlement for Whistleblower and U.S. Government in Medicare Fraud Case

The Hesch Firm, LLC is pleased to announce that an $8 million Medicare fraud settlement was finalized today in a False Claims Act Case involving Medicare fraud allegedly committed by a Georgia-based hospital and its Louisiana-based management company. In June of 2009, The Hesch Firm’s filed a qui tam action on behalf of its client, Mrs. Tucker, to claim a whistleblower reward for reporting LTAC fraud (also known as LTCH hospital fraud). The  Medicare hospital fraud case was filed in the United States District Court for the Southern District of Texas alleging that the Defendants billed Medicare for numerous fraudulent activities.

The whistleblower case was filed on behalf of the United States acting through the United States Department of Justice and on behalf of the Office of Inspector General of the Department of Health and Human Services. The Defendants in the case included a long-term, acute care hospital (LTAC) located in Georgia.

Having been involved in fighting fraud against the government for the past 22 years, first as a Department of Justice prosecutor and more recently representing whistleblowers, it is extremely gratifying to see justice served. The Hesch Firm is thrilled to have served a role helping Darlene Tucker pursue a fraud claim on behalf of the government and, ultimately, reach a settlement for our client and the United States.

The qui tam False Claims Act whistleblower complaint filed by The Hesch Firm on behalf of Ms. Tucker alleged that the Defendants participated in the following fraudulent conduct:

1. Knowingly extended patient stays at long term care hospitals (LTCH) beyond the time considered to be medically necessary in order to increase reimbursement amounts for the patients from federally funded healthcare programs;

2. Knowingly extended patient stays at the long term care hospitals (LTCH) beyond the time considered to be medically necessary in an effort to increase the average length of stay for all patients in order to maintain the facility’s classification as an LTCH and the higher reimbursement level;

3. Knowingly admitted patients who did not qualify for LTCH admission; and

4. Knowingly delayed the performance of patient procedures in order to increase billings.

While the settlement agreement specifies that it is neither an admission of liability by the Defendants nor a concession by the Government that its claims are not well-founded, the Defendants agreed to pay to the United States $8 million. The government awarded the Relator 26% of the settlement amount as the whistleblower reward for stepping forward and reporting alleged fraud against Medicare (LTCH fraud or LTAC hospital fraud), which amounted to more than $2 million as a whistleblower award.

The Hesch Firm has or is currently representing several other whistleblowers reporting long term care hospital fraud  (LTCH fraud or LTAC hospital fraud). If you know of LTCH or LTAC hospital fraud and want to know how to report it or how to find out if you might be eligible for a whistleblower reward, myself and the team of attorneys working with me would be delighted to help stamp out LTCH or LTAC hospital fraud against Medicare and consider becoming your attorney in claiming a whistleblower reward.

 

  1. Anonymous 1 Aug 2013 | reply

    Thank you for this article. That’s all I can say. You most definitely have made this blog into something special. You clearly know what you are doing, you’ve covered so many bases.Thanks!

  2. anonymous 7 Aug 2013 | reply

    Congratulations and thanks to you and Ms. Tucker for your efforts.

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