South Carolina and Nason Medical Settle Medicare Fraud Allegations for $1 Million
A Charleston-area medical center and the state of South Carolina have settled a federal whistleblower lawsuit claiming that the hospital committed Medicaid and Medicare fraud. The settlement is $1 million.
US Attorney Bill Nettles and Nason Medical, along with the urgent care center’s two owners Dr. Baron S. Nason and Robert T. Hamilton, have settled Medicare fraud allegations brought forth in a whistleblower lawsuit for $1 million.
The US and the whistleblower lawsuit contended that Nason Medical submitted false claims to Medicare, Medicaid, and TRICARE for services that were provided by physicians’ assistants, but were billed as though performed by physicians, which meant the hospital received more money for less skilled labor. Nason Medical also reportedly submitted false claims for medically unnecessary laboratory tests, including potentially harmful CT scans; claims for radiological services when the radiologist did not hold a current South Carolina license; and submitted claims for Tetanus Immunoglobulin, when the urgent care facility actually provided the Tetanus Toxoid vaccine, which is less expensive.
“Being a health care provider in Federal health care programs such as Medicare and Medicaid is a privilege, not a right. When health care providers order medically unnecessary procedures such as CT scans and submit other improper claims just to boost profits, they threaten both the health of their patients and the financial integrity of the Medicare and Medicaid programs,” said Derrick L. Jackson, Special Agent in Charge at the U.S. Department of Health and Human Services, Office of Inspector General (OIG). “In an effort to ensure Nason Medical’s egregious billing history is not its future, the company agreed to a rigorous 5-year Corporate Integrity Agreement (CIA) we crafted to hold them accountable.”
“Health care fraud is a very high priority in this office. We have shifted our office resources by trebling the number of attorneys dedicated to address civil fraud cases. This case is particularly egregious because it involves allegations of profiting by exposing patients to unnecessary radiation in the CT scans,” Nettles said.
Under the False Claims Act, employees may not be terminated or let go if they complain to the company about fraudulent billing practices, including potential Medicaid and Medicare fraud, or insurance fraud. One of the two whistleblowers in the Nason Medical case claimed that he was fired for reporting and trying to stop the health care company’s fraudulent billing practices.
The $1 million settlement repays the federal government for much of the Medicare fraud, but the company said in the settlement agreement that it will admit no wrongdoing.
Whistleblower Protections and Medicare Fraud Claims
“Qui Tam” are the first words of a Latin clause referring to the plaintiff as “one who sues as much for the state as for himself or herself.”
It is a provision of the Federal Civil False Claims Act that allows a private citizen to file a suit, in the name of the U.S. Government, charging fraud by government contractors and other entities that receive or use government funds. Bolstered by amendments passed by Congress in 1986, the law has armed private citizens who have independent and direct knowledge of fraud, whether financial institution fraud or Medicare fraud, with a weapon to prosecute government contractors and others who are defrauding the Government.
Common whistleblower actions include:
- Medicare fraud,
- defense contractor fraud, and
- other kinds of fraud against state or federal government
The Strom Law Firm Can Help Protect Medicare Fraud Whistleblowers with the False Claims Act
If you are personally aware of a fraud that has been committed by your current or former employer, a competitor or otherwise, from tax evasion to Medicare fraud, contact the South Carolina Qui Tam attorneys at the Strom Law Firm today for a no cost consultation to discuss the facts of your case and whether filing a qui tam may be appropriate. We understand the complexity of the False Claims Act, and can help you with your case. We offer free, confidential consultations so contact us for help today. 803.252.4800