Orthopaedic and Neuro Imaging LLC (ONI) and its owner were accused of submitting some $6,125,947.13 in false claims to Medicare. A default judgment has been issued against them. Generally, a default judgment is entered when defendants fail to defend themselves in court.
A former office manager for a Tennessee pain clinic filed a qui tam lawsuit under the federal False Claims Act accusing her former employer of falsely billing Medicare and TennCare for unnecessary painkillers, upcoding claims, and billing Medicare for improper nurse practitioner services. The federal government and the State of Tennessee brought suit and have just settled with a chiropractor, a nurse practitioner and several now-closed pain clinics. As a result of the whistleblower's actions, she will receive more than $246,500 -- a share in the total settlements.
San Diego-based Scripps Health, a health care system, has agreed to settle False Claims Act allegations for $1.5 million. According to the Department of Justice, Scripps Health violated the Act by billing Medicare and TRICARE for physical therapy services performed by un-enrolled therapists. A former employee blew the whistle on the unlawful billings against the two federal health programs, and she will receive a $225,000 reward in return for her service.
A whistleblower has filed suit against a chain of Massachusetts mental health care centers, claiming the company defrauded the state and federal governments of $130 million. The accusation is that the company allowed "unlicensed, unqualified, and unsupervised employees" to treat patients. Doing so would be in clear violation of Medicaid regulations and requirements, the suit says.