Recently, health care fraud has been getting more attention throughout the country. Consequently, prosecutors have been putting more resources into pursuing these types of cases. As this focus increases, we will likely see an increase in the number of these cases brought, and more aggressive pursuit of large settlements from those accused of these crimes.
Such a large settlement recently occurred in a Florida Medicare fraud case. A Vero Beach doctor and his wife were accused of Medicare fraud by the Department of Justice. The lawsuit alleged that the couple defrauded Medicare through reporting false diagnoses. Specifically, they claimed that the couple would report more serious diagnoses for their patients than actually existed. These more serious diagnoses would allow them to receive more money from Medicare than they needed for patient care.
Rather than going to trial, the couple agreed to settle the lawsuit. The settlement amount was very large. A court has also frozen a large portion of the couple’s funds, in order to redirect the money to pay off the settlement.
As one can tell, the Department of Justice took a very strong interest in this case. They brought the initial claim, pursued a large settlement, and made efforts to freeze the funds needed to pay the settlement. This is indicative of the greater focus prosecutors have been placing on Medicare fraud, like the alleged billing scheme in this case. This will likely not be the last large settlement we see in these cases in Florida, as this increased focused seems unlikely to go away soon.
Source: HealthLeaders Media, “Florida Physician to Pay $22.6M to Settle Medicare Fraud Claims,” John Commins, 29 Nov 2010