LEGAL NURSE CONSULTING NEWS: THE MEDICARE STRIKE FORCE'S ATTACK

The Medicare Strike Force was established in 2007 as part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT). This multi-agency team of federal, state, and local investigators was developed to shut down large-scale Medicare schemes operating throughout the country and safeguard taxpayer dollars. Their aggressive fight against health care fraud is operating in 9 districts throughout the U.S. They announced last month their expansion to two additional cities. Advanced Legal Nurse Consultants and Certified Legal Nurse Investigators are trained to spot Medicare fraud. More than 1,000 individuals have been charged with falsely billing the Medicare program for more than $2.3 billion. These individuals include doctors, nurses, health care company owners and executives, who are accused of various healthcare fraud-related crimes. Some of the crimes included conspiracy to defraud the Medicare program, violations of anti-kickback statutes, criminal false claims, money laundering and aggravated identity theft.

In March 2011, a Las Vegas woman pled guilty to falsely representing and owning a fraudulent medical supply company that billed Medicare for more than 3.5 million. Medicare reimbursed her company with approximately $1.7 million. Jummal Joy Ibrahim admitted between January 2006 and September 2009 she allowed her brother to use her identity to start Contempo Medical Supplies. Ibrahim claimed she did not know anything about the business and never intended to have any role in the operations or share its profits, according to the documents.

In Houston a few days earlier, Sunny Robinson was convicted of 19 counts of healthcare fraud and anti-kickback violations for the fraudulent claims to Medicare and Medicaid. His profit on these claims accumulated to the amount of $4.3 million.

These are just a few examples of the indictments going on involving the Medicare Strike Force. Due to the courageous whistleblowers coming forward on these cases, more of these cases are being reported. As a whistleblower, you may be entitled to a whistleblower reward of 15-25% due the provisions in the False Claims Act. If the government is not involved in the case, the whistleblower can pursue the case, resulting in a reward of 25-30%. To evaluate the strength of the complaint, contact a qui tam attorney.

In just two years, the Medicare Strike Force has quadrupled the number of anti-fraud teams and recovered a record of $4 billion on behalf of taxpayers. For more information on how to become a Certified Legal Nurse Investigator (CLNI), please call 866-933-2562.

References: www.hhs.gov, www.whistlebower.labovick.com, www.massdevice.com, www.healthcarefinancenews.com