Twelve-Year Sentence for Medicaid Diaper Scam

Maria Paz Garza was the King Midas of incontinence supplies: she turned diapers into dollars—over two and a half million of them, according to the government’s indictment. She did it through a scheme that charged Texas Medicaid for diapers and other incontinence supplies that were never provided, or never …

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Far-Fetched Whistleblower Claim of the Month

The hospital industry is accustomed to far-fetched whistleblower claims: allegations that a hospital knowingly submitted false or fraudulent Medicare or Medicaid claims or fired a whistleblower for trying to prevent such activity.  But in terms of far-fetched claims decided in January, whistleblower Jana Endicott …

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2016 Nerve-of-a-Burglar Award

Competition for the 2016 Nerve-of-a-Burglar Award was fierce, with health care providers constantly coming up with new and different ways to scam Medicare and Medicaid.  Nevertheless, we have a clear winner: the Michigan physician charged with an array of fraudulent Medicaid schemes that included ordering …

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What’s In a Name? Or, the Importance of Emphasis

I.A. Khair of New Jersey ran an ambulance company called K&S Invalid Coach.  Presumably, “Invalid” was pronounced IN-va-lid, with the emphasis on the first syllable.  Maybe it should have been pronounced in-VAL-id, with the emphasis on the second syllable.  Why?  Because by running the company Khair …

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Flying Pigs and False Claims

On July 7 the Fourth Circuit invoked Flying Pigs to vacate a lower federal court judgment in a Medicaid false claim case, even though neither the lower court nor any of the parties asked it to. The case started in 2007, when the relators filed a qui tam action in Virginia state court against several medical …

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When Inside Knowledge Is a Handicap to a Whistleblower

Here’s a riddle: The whistleblower is a former employee of the defendant, with inside knowledge of the operations at the heart of his qui tam suit.  How can that inside knowledge be a handicap in pressing his claim?  A June 21 decision by a Massachusetts federal court provides an answer and an …

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