A Medicare and Medicaid fraud case against Phoenix-based healthcare provider NextCare has ended in a $10 million settlement.  The alleged fraud included overbilling and unnecessary respiratory tests, allergy tests and tests for the H1N1 flu virus. A former employee of NextCare, Lorin Cohen, will receive $1.6 million for her whistleblower role in the case.

Source: Arizona Republic

It appears that this settlement originated from a whistleblower case filed by the former employee under the federal False Claims Act. The False Claims Act allows individuals to file suit against a company that has defrauded the federal government and to retain some of the money recovered from the company, usually 15-25%.  This case appears to present a typical example as it involves allegations that the company overbilled and/or wrongly billed Medicare and Medicaid for medical tests and procedures that were not necessary.  

Lexington, Kentucky Medicare fraud and whistleblower lawyer Robert Abell represents whistleblowers in Medicare fraud suits; contact him at 859-254-7076.

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