Hospital Medicare Upcoding Fraud Can Be The Basis of Large Whistleblower Reward Lawsuits: Medical Professionals Can Receive Large Rewards For Exposing Hospital Medicare Upcoding Fraud by Hospital Medicare Upcoding Fraud Whistleblower Reward Lawyer Jason S. Coomer

Hospital Medicare upcoding fraud can be the basis of large whistleblower reward lawsuits.  Hospital administrators, nurses, therapists, physician's assistants, and medical doctors can earn large financial rewards by properly exposing hospital Medicare upcoding fraud and other fraud schemes.  Health care professionals are strongly encouraged through large potential rewards to blow the whistle on hospital Medicare upcoding fraud and other forms of Medicare fraud.  If you are aware of a hospital committing Medicare upcoding fraud, feel free to contact Medicare Upcoding Fraud Whistleblower Reward Lawyer Jason Coomer via e-mail message or our submission form about a potential qui tam claim. 

Hospital Medicare Billing Fraud Whistleblower Lawsuits (Hospital Billing for Unnecessary Procedures,  Upcoding, Phantom Billing, and Unbundling Are All Forms of Hospital Medicare Billing Fraud That Can Be The Basis for Whistleblower Reward Lawsuits)

Hospital administrators that step forward and expose significant hospital Medicare fraud can claim large financial rewards and avoid potential criminal liability for allowing known fraud to continue.  If you are aware of Hospital Medicare Fraud, it is important to obtain evidence of the  upcoding, manipulation of outlier payments to Medicare, illegal kickbacks, charging for unnecessary services and procedures, charging for services not provided, double billing, bill padding, or other hospital Medicare fraud, then contact a hospital Medicare fraud lawyer that can assist you with a potential hospital Medicare fraud qui tam whistleblower lawsuit.

Assistant Administrator of Houston Hospital Indicted for Alleged Role in $116 Million Medicare Fraud Scheme

WASHINGTON – An assistant administrator of a Houston hospital was arrested today on charges related to his alleged participation in a $116 million Medicare fraud scheme involving false claims for mental health treatment, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).

An indictment filed in the Southern District of Texas and unsealed today charges Mohammed Khan, 62, of Houston, with one count of conspiracy to commit health care fraud, one count of conspiracy to pay and receive illegal health care kickbacks and five counts of paying or offering to pay health care kickbacks. Khan is expected to make his initial appearance in federal court today in Houston.

“The indictment against Mr. Kahn alleges that he used his position as a hospital assistant administrator to submit millions in false claims to the Medicare program,” said Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division. “According to the charges, he paid kickbacks to patient recruiters, owners of group homes and assisted living facilities, and beneficiaries so that he could fill his hospital with patients for whom he could bill the government for medically unnecessary services or services that were never provided. We will continue aggressively to pursue individuals who attempt to enrich themselves at the expense of the Medicare program.”

“The defendant charged in this indictment is accused of stealing precious Medicare resources by billing for services that were medically unnecessary or never provided," said Special Agent in Charge Stephen L. Morris of the FBI’s Houston Field Office. “Our health care fraud efforts have never been more collaborative and aggressive. We will continue to work with our law enforcement partners to protect patients and fight against health care fraud.”

According to the indictment, Khan, as the assistant administrator of a Houston hospital, allegedly operated a scheme to defraud Medicare beginning in 2008 and continuing until his arrest today. Khan allegedly caused the submission of false and fraudulent claims for partial hospitalization program (PHP) services to Medicare through the hospital. A PHP is a form of intensive outpatient treatment for severe mental illness.

The indictment alleges that Khan paid kickbacks to owners and operators of group care homes and assisted living facilities and to patient recruiters in exchange for delivering ineligible Medicare beneficiaries to the hospital’s PHPs. The indictment alleges that Khan also paid kickbacks to Medicare beneficiaries who attended the hospital’s PHPs. These kickbacks included cigarettes, food and coupons redeemable for items available at the hospital’s “country stores.” Khan and his co-conspirators submitted or caused to be submitted approximately $116 million in claims to Medicare for PHP services purportedly provided by the hospital to the recruited beneficiaries, when in fact, the PHP services were medically unnecessary or never provided.

Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,190 defendants who collectively have falsely billed the Medicare program for more than $3.2 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

The Government is Cracking Down on Medicare Fraud Upcoding Schemes and Other Forms of Medicare Fraud

Law enforcement authorities have been making great efforts to crack down on estimate that Medicare fraud costs taxpayers Billions of dollars each year.  The Health Care Fraud Prevention and Enforcement Action Team, The Joint DOJ-HHS Medicare Fraud Strike Force, and Medicare Fraud Strike Force are just a few law enforcement agencies that have been set up to crack down on Medicare fraud including Hospital Medicare Fraud, Pharmacy Medicare Fraud, and Medical Supply Medicare Fraud.

Stopmedicarefraud.gov is an extension of The Health Care Fraud Prevention and Enforcement Action Team (HEAT). HEAT is currently hard at work tracking down criminals that are stealing from Medicare in several cities across the United States including South Florida, Houston, Detroit and Los Angeles.  "In 2008, the multi-agency enforcement groups known as Medicare Fraud Strike Forces secured 588 criminal convictions; obtained 337 civil administrative actions against individuals and organizations who were committing Medicare fraud, and recovered more than a $1 billion in health care fraud monies under the False Claims Act.  To date, in fiscal year 2009, The Department of Justice has already recovered nearly a billion dollars in health care fraud monies and recorded 300 convictions." 

The 2010 budget for Health and Human Services contains additional funding for anti-fraud efforts over five years. It invests $311 million to strengthen program integrity in Medicare and Medicaid, with particular emphasis on greater oversight of Medicare Advantage and Medicare Prescription Drug programs. The Department of Justice estimates that $2.7 billion could be saved by improving oversight, and stopping fraud and abuse within the Medicare Advantage and Medicare prescription drug programs.

HEALTH CARE FRAUD CASE NETS RECOVERY OF $1.7 BILLION

HCA Inc. (formerly known as Columbia/HCA and HCA - The Healthcare Company) and HCA subsidiaries agreed to pay the United States over $1.7 Billion including $631 million in 2003 for civil penalties and damages arising from false claims the government alleged it submitted to Medicare and other federal health programs. In 2000, HCA subsidiaries pled guilty to substantial criminal conduct and paid more than $840 million in criminal fines, civil restitution and penalties.  HCA will paid an additional $250 million to resolve overpayment claims arising from certain of its cost reporting practices.  In total, the government will have recovered $1.7 billion from HCA.

This Qui Tam settlement resolved fraud allegations against HCA and HCA hospitals in nine False Claims Act qui tam or whistleblower lawsuits pending in federal court in the District of Columbia. Under the federal False Claims Act, private individuals may file suit on behalf of the United States and, if the case is successful, may recover a share of the proceeds for their efforts. Under the HCA settlement, the whistleblowers will receive a combined share of $151,591,500.00.

Hospital Medicare Upcoding Fraud Whistleblower Reward Lawyer Works With Medicare Upcoding Whistleblowers and other Medicare Upcoding Fraud Lawyers

As a Hospital Medicare Upcoding Fraud Lawyer, he works with other powerful qui tam Medicare Fraud Whistleblower lawyers that handle large Hospital Medicare Fraud cases.  He works with San Antonio Hospital Medicare Fraud Lawyers, Dallas Hospital Medicare Fraud Lawyers, Houston Hospital Medicare Fraud Lawyers, and other Texas Hospital Medicare Fraud Lawyers as well as with Hospital Medicare Fraud Lawyers throughout the nation to blow the whistle on Medicare fraud that hurts the United States. 

If you are aware of a hospital that is committing upcoding, manipulation of outlier payments to Medicare, illegal kickbacks, charging for unnecessary services and procedures, charging for services not provided, double billing, bill padding, or other hospital Medicare fraud, it is important to report it.  Further, if you are interested in becoming a qui tam whistelblower relator and potentially obtaining a portion of the money that is recovered and obtaining protections under the Federal False Claims Act, feel free to contact Hospital Medicare Upcoding Fraud Whistleblower Reward Lawyer, Jason Coomer.