Nolan Auerbach & White are experienced Medicare Fraud Lawyers helping courageous whistleblowers.
In 2014, Medicare Part B paid $7.0 billion for 451 million lab tests provided to its beneficiaries. For the top 25 lab tests in 2014:
Excessive fluorescence in situ hybridization (“FISH”) testing in the absence of unambiguous clinical value AND the associated payment of kickbacks by clinical laboratory providers to physicians involved in direct patient care established clear evidence of Medicare fraud.
In December 2015 the Department of Justice announced a nearly $20 million recovery against a Florida provider group specializing in cancer diagnoses and treatment. The government’s allegations stated that 21st Century Oncology LLC submitted claims to Medicare and Tricare for FISH tests that were not medically necessary and, furthermore, that kickbacks (bonuses) were offered to referring urologists for inducing referrals and for the testing of patients. To the extent that the two conditions above accompanied the test ordering, the government alleged the testing violated the federal Anti-Kickback Statute.
Kathleen Hawkins, RN MSN, had been employed by Defendant, Catholic Healthcare West (CHW) for approximately 6 years when she decided she had had enough of trying to change the hospital system from within.
CHW, a California not-for-profit corporation that operated hospitals in California, Arizona, and Nevada, was at the time the eighth largest hospital system in the nation and the largest not-for-profit hospital provider in California.
Joe Strom contacted us in 2005. We were very grateful that he did. We immediately formed an all-star legal team and a process to stop a very harmful pharmaceutical marketing strategy. It was this process we set into motion that ultimately returned hundreds of millions of dollars to the U.S. Treasury, and a portion of that, very well-deserved, into Joe’s bank account.
Joe told us a very troubling story about the off-label promotion of a pharmaceutical drug for patients who already suffered from chronic heart failure.
Bruce Moilan was a seasoned hospital systems expert by the time he contacted our Firm. At the time he decided to file his qui tam lawsuit, he was employed by South Texas Health System as a System Director for Materials Management. In this position, he oversaw $24 million in annual purchases of supplies and equipment and helped determine budget, reduction and cost analysis throughout the contract bidding and negotiations process. His job was to insure proper implementation for purchasing, receiving and management of inventory, for McAllen Hospitals, L.P.