The Department of Justice reported last week that the Fairfax Nursing Center and its owners would pay $700,000 for knowingly submitting false claims to Medicare between January 2007 and December 2010. The Medicare fraud revolved around submitting claims for treatment that was not medically necessary or were otherwise not provided for as part of Medicare coverage.
The overbilling of Medicare is a known problem the government responded to in 2009 when it announced the creation of the Health Care Fraud Prevention and Enforcement Action Team (HEAT). Since that time the Justice Department has recovered more than $11.3 billion under the Federal False Claims act and more than $7.7 billion of that has come specifically from Medicare Whistleblowers.
Chris Paulos, an attorney with the Levin, Papantonio law firm, says, “Fraud occurs in many forms and often the only way that it is exposed is when insiders, aware of the fraud, come forward. In days gone by, when a whistleblower would step forward and say something, they found they had little support and were often dismissed. Now, thanks to the provisions of the Federal False Claims act, whistleblower claims have teeth.”