Medicare has for decades provided health insurance for millions of older Americans and others. When someone defrauds Medicare, they are stealing from seniors and all other taxpayers.
We read recently of owners of a nursing home who have agreed to a $1.25 million settlement of a lawsuit filed under the qui tam provisions of the False Claims Act. The whistleblower suit alleged that the nursing home operators had submitted false Medicare and Medicaid claims. The Department of Justice said the care at the Georgia home was “grossly substandard.”
The head of the Justice Department’s Civil Division said, “Nursing home operators who bill Medicare and Medicaid for providing their residents with grossly deficient services will be held accountable.”
According to the news report, the amount to be paid to the whistleblower in this case has not yet been determined.
The poor care at the Georgia facility resulted in a wide variety of health problems for residents, including malnutrition, pressure ulcers, dehydration and more, the lawsuit said.
The government and whistleblower said that the nursing home submitted claims to both Medicare and Medicaid for payment for “grossly substandard or worthless services.”
Some residents were not given prescribed medications and others were overmedicated. Management of the facility also diverted government funds to entities they controlled, leaving the nursing home without the money to pay for essentials such as heating, cooling, cleaning, pest control and adequate food.
This kind of abuse can be stopped, as the whistleblower in this case has proven. If you have witnessed Medicare or Medicaid fraud, you can discuss your legal options with an attorney experienced in False Claims Act litigation.