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Sep 21, 2021 by |

Los Angeles Whistleblower Attorney: Rehab Company Pays $2 Million To Resolve Allegations Of Billing Medicare For Unnecessary Or Unreasonable Services

ATTORNEY NEWSLETTER

Former Rehab Director Of Company Blows Whistle 

Company Allegedly Billed For Unnecessary “Ultra High” Therapy

Complaint Alleged Eight Years Of Fraudulent Practices

Healthcare fraud costs the government billions every year.  Private individuals play a great role in getting some of that money back for the government.   Under the False Claims Act (FCA), 31 U.S.C. §§ 3729 et seq., individuals are authorized to bring actions on behalf of the government, known as “qui tams.” The individuals bringing the cases are referred to as “relators.” 31 U.S.C. § 3730(b).  Individuals with knowledge of the fraud can be rewarded for bringing suit if the government recovers against the offending companies. 31 U.S.C. § 3730(d).  Often the fraud is against government programs like Medicare and Medicaid.  If you have credible information of Medicare or Medicaid (known in California as Medi-Cal) fraud in Los Angeles or elsewhere in California, call us today at (415)441-8669 and we can help. Our toll-free number is 1-888-50EVANS (888-503-8267).

Alleged Fraud By Rehabilitation Therapy Provider

In a recent settlement announced by the U.S. Attorney for the Central District of California,[1] a provider of rehabilitation for the elderly has agreed to pay $2 million to resolve allegations that it violated the False Claims Act by causing the submission of claims to Medicare for rehabilitation therapy services that were not reasonable or necessary. The settlement resolves allegations that, from January 1, 2006, through October 10, 2014, the company knowingly submitted or caused the submission of false claims for medically unreasonable and unnecessary “Ultra High” levels of rehabilitation therapy for Medicare Part A residents at 11 Skilled Nursing Facilities.  The government contended that the defendant pressured therapists to increase the amount of therapy provided to patients to the “Ultra High” level without regard to patients’ individualized needs. “The claims that patients required ultra-high levels of care appear to be driven solely by a desire to send ultra-high bills to Medicare,” said Acting U.S. Attorney Tracy L. Wilkison for the Central District of California. “This case is further proof that the government will vigorously pursue those who attempt to cheat the taxpayer-funded system that pays for medical care for millions of Americans, sometimes with the help of whistleblowers who shine a light on fraud.”

Claims For Wrongful Termination

Employees, agents, directors, executives, officers, and others are protected from employer retaliation for bringing false claims qui tam cases. 31 U.S.C. § 3730(h).  Despite this legal protection, employers continue to retaliate against whistleblowers.  If you are fired because you brought any fraud to light, however, you may be entitled to sue your employer in court  and seek double back pay (with interest), reinstatement, reasonable attorneys’ fees, and reimbursement for certain costs in connection with the litigation. 31 U.S.C. § 3730(h)(2). Evans Law Firm, Inc. can represent you in any action for retaliation as well as represent you in your underlying whistleblower application.

Contact Us

If you have credible information of government contractor fraud against Medicare or Medi-Cal call Ingrid M. Evans at (415) 441-8669, or toll-free at 1-888-50EVANS (888-503-8267) or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>.  In addition to FCA and CFCA whistleblower cases, Ingrid and Evans Law Firm, Inc. also handle bank fraud whistleblower cases under FIRREA/FIAFEA, commodity trading and securities fraud under the Commodities Futures Trading Commission Whistleblower Program and the Securities and Exchange Commission Whistleblower Program, and tax fraud under the Internal Revenue Service Whistleblower Program. 

[1] Evans Law Firm, Inc. was not involved in the cases in any way. The qui tam case is captioned United States ex rel. Pennetti v. Interface Rehab, et al., No. CV-14-4133 (C.D. Cal.).

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