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Three examples of False Claims Act Violations in 2017

The government collected over $1.8 billion in Medicare and Medicaid fraud cases in 2017. The government collected these funds through a combination of criminal convictions and settlements. Medicare fraud settlements with the government accounted for over $27 million.

The collection efforts were primarily the work of Medicaid fraud control units. The Medicare fraud control units investigate hospitals and medical professionals accused of Medicare and Medicaid fraud. Three examples of investigations that led to prominent healthcare fraud cases in 2017 include:

  • Ambulance company worker gets jail time. The court convicted an ambulance company worker for a healthcare fraud crime. The court sentenced the worker to three years of prison time and required he pay $484,556.
  • Hospital settles for $18 million. Banner Health agreed to pay $18 million to settle a claim with the government. The government stated that hospitals within this system submitted unnecessary claims for treatment. The government states that the patients could have received a less costly option.
  • Respiratory service provider settles for $10 million. The government accused a company that provided oxygen devices of knowingly delivering these devices to patients without a medical need and billing for devices that were never delivered. The company agreed to pay $9.68 million to the government to settle the claim.

These examples include an individual, hospital and medical product provider. This list is a good reflection of the reality of healthcare fraud cases: anyone can face these allegations. Those who do face allegations of healthcare fraud are wise to take prompt, proactive action.

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