From time to time a development in health law confirms the adage that truth is stranger than fiction. That’s why we hand out the You-Can’t-Make-this-Up Award for real life developments that seem to defy the imagination. This month’s award goes to the Centers for Medicare & Medicaid Services’ October …
How to Get a 2,333% ROI?
September 22, 2017 Leave a Comment
Three affiliated home health companies in Tennessee agreed to pay $1.8 million to settle False Claims Act (FCA) liability. That’s a lot of money, but it’s only about four percent of the $42 million in potential liability that, according to BNA, federal prosecutors say the homes faced for false Medicaid …
Twelve-Year Sentence for Medicaid Diaper Scam
June 16, 2017 Leave a Comment
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 …
Far-Fetched Whistleblower Claim of the Month
February 6, 2017 Leave a Comment
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 …
2016 Nerve-of-a-Burglar Award
January 10, 2017 Leave a Comment
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 …
What’s In a Name? Or, the Importance of Emphasis
August 17, 2016 Leave a Comment
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 …