Medicare, Medicaid, TRICARE and other government health programs often provide suppliers, clinics and healthcare facilities with reimbursements for a wide range of services. Healthcare fraud may occur anywhere throughout the spectrum of healthcare services, including allegations involving medical device suppliers, medical practitioners and treatment providers.
The federal government recently settled a False Claims Act lawsuit with that alleged two substance treatment clinics and the owners of the facilities on the East Coast doubled-billed Medicaid for services associated with methadone treatment. The lawsuit also alleged that some services were never performed, although the clinics sought reimbursement from government programs.
The lawsuit alleged that the treatment providers provided patients counseling services as a part of a methadone maintenance program. The clinics billed Medicare for those counseling services at a “bundled” rate, according to the United States Attorney’s Office for the District of Connecticut. However, the clinics then sought additional reimbursement for psychotherapy services the clinics said they had provided to the same patients. The government says that the additional psychotherapy services were not provided.
The owners of the clinics were included as defendants in the healthcare fraud lawsuit. In settling the allegations, the clinics and the owners of the substance abuse treatment facilities do not admit committing fraud. Lawsuits filed under the False Claims Act provide the federal government with an avenue to recover taxpayer money that was wrongly paid to providers or contractors related to government contracts or healthcare programs.
The False Claims Act allows private individuals who are aware of fraudulent billing practices to act as additional eyes for the government. Individuals may file a whistleblower lawsuit on behalf of the government to obtain justice and recover taxpayer money that has been fraudulently obtained. Whistleblowers are entitled to recover a percentage of any money that is recovered through settlement or verdict as a “finder’s fee.” An experienced qui tam, whistleblower claims lawyer can explain the process and guide whistleblowers through the process.