Upcoding

Court Hits Nursing Home Chain Consulate Health Care with $347 Million False Claims Act Fraud Judgment

Posted on by Simon Mikail
Category: Health Care Employee Rights, Whistleblower Protection
A recently announced judgment by a district court held a nursing home chain named Consulate Health Care liable for $347 million dollars in total judgment for 446 cited false claims of unlawfully upcoding Medicare claims for patient therapy services. The judgment was entered by Judge Merryday following a jury verdict ...

$5.3 Million Dollar Settlement after False Claims Act Whistleblower in Oncology Practice Reports Medicare Fraud

Posted on by Simon Mikail
Category: Health Care Employee Rights, Whistleblower Protection
Anyone could, and should, report fraudulent activity by his or her employer. In this case, it was a medical coder at an oncology practice. As result, the oncology medical group will settle with the government for $5.3 million dollars to bring to close allegations that it systematically falsely billed Medicare and Medic...

California’s Most Notable False Claims Act Whistleblower Cases of 2015

Posted on by Simon Mikail
Category: Employee Rights, Whistleblower Protection
In 2015, California accounted for approximately 25% of all healthcare related False Claim Act (FCA) cases.  From the ones unsealed, the average settlement amount recorded is approximately $6 million per case.  With increasing and more frequent monetary awards, relators are increasingly emboldened to continue reportin...