The United States announced this week that it has filed a complaint in partial intervention against Connections Community Support Programs (“Connections”) in the United States District Court for the District of Delaware. From at least January 2015 through October 2019, Connections purportedly submitted over 4,000 claims to Medicare in which it falsely certified that an individual holding an eligible qualification provided mental health services to Medicare beneficiaries when, in reality, a different Connections staff member who did not hold an eligible qualification provided the mental health service. The U.S. alleges that as a result of the false claims Connections submitted to Medicare and Medicaid, Connections was paid more than $4.5 million for mental health services for which it was not entitled to reimbursement. To read the full article, click here.
Can an employer be held liable under the False Claims Act (“FCA”) for retaliation if it takes an adverse action against a former employee? Until recently, only one federal appellate court had addressed the issue, holding that the FCA does not cover post-employment retaliation. However, the Sixth Circuit recently reached the opposite conclusion in United States ex rel. Felten v. William Beaumont Hospital. The court found that extending the FCA’s protections to former employees was “the more accurate reading” of the statute. Although Beaumont is binding precedent only in the Sixth Circuit, it is a useful reminder to employers that retaliation against former employee whistleblowers may potentially give rise to costly litigation and liability under the FCA. To read the full article from the National Law Review, click here.
A Florida man, Ivan Andre Scott, was sentenced this week to 10 years in prison for conspiracy to commit health care fraud with a scheme that resulted in the submission of approximately $3.3 million in fraudulent claims to Medicare for genetic testing. According to court documents, Scott allegedly targeted Medicare beneficiaries with telemarketing calls falsely stating that Medicare covered expensive cancer screening genetic testing, with each test costing as much as $6,000. After beneficiaries took the test, Scott allegedly paid unlawful bribes and kickbacks to telemedicine companies to obtain doctor’s orders authorizing the tests. To read the full DOJ press release, click here.
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