Healthcare scam spanning more than a decade in West Virginia results in fifty million dollars restitution

Healthcare scam spanning more than a decade in West Virginia results in fifty million dollars restitution

An admission of guilt of making forged claims was made by Wheeling Hospital Inc. It was a hospital for severe care located in Wheeling of West Virginia. It had the knowledge that these claims were based on actions that violated the Physician Self-Referral Law. Also, they violated the Anti-Kickback Statute. It has agreed to pay fifty million dollars to the government for compensation.

The Physician Self-Referral Law states that the physician is not allowed to refer to his patients the medical services that get paid through Medicaid or those institutions that are connected with the doctor or his family financially.  The Anti-KickBack Statute states that it is illegal to pay to cause referral of services or products of Medicaid, Medicare, or other such government-supported programs. These laws have been put in place to make sure that decisions of medical nature are not driven by selfish financial motives. They make sure that medical decisions serve the welfare of the patients.

Jeffrey Bossert Clark commented on how monetary incentives in the association of hospitals and patients can disbalance the service provisions of health. He was the Acting Assistant Attorney General. He was from the Department of Justice’s Civil Division. He assured that his office was committed to eradicating such illegal practices that compromised the integrity of doctors in their services.

Furthermore, Bill Powell also commented that his office was dedicated to making sure that medical professionals follow all the rules in the area of his office. He was the US Attorney of the Northern District of West Virginia. He expressed hopes that the settlement of the case would lead to clearing of all previous fake claims of Wheeling Hospital so that it would go on providing the complete spectrum of services to people in the area.

Scott W. Brady stated how people getting services from federal-funded programs have faith in the programs and believe that these programs will always take the best path for their health welfare. He was the US Attorney of the Western District of Virginia. He assured that his office would always insist on checking anyone going against the interest of the patients for their personal gains.

Maureen R. Dixon also commented on how inappropriate incentives can negatively affect the medical decisions of health workers and cause breakage in the faith that people have in the healthcare system. She was from the Department of Health and Human Services Office of Inspector General. She was the Special Agent In-charge. Further, she assured that her office would always make sure that selfish people who work only for personal benefits at the cost of others’ health would be held accountable.

The whole conspiracy lasted almost thirteen years, starting in 2007. So Wheeling Hospital was charged with paying unlawful incentives to doctors for referrals.

Louis Longo was the one who brought the case into the light of the law. He was the Executive Vice President of the hospital. In 2017, he filed a complaint regarding the unlawful actions in the hospital. There is a provision in the False Claims Act that provides incentives for those people who such cases to the government’s knowledge. These incentives consist of receiving a portion of the settlement amount of the case. Even though the first-filed complaint was private, such cases can be taken over by the government. Longo was to receive ten million dollars from the settlement.

The government’s interest in the case shows its dedication to battling healthcare fraud. The False Claims Act is a very important tool in winning this battle. To report or provide any information about any illegal actions or wasteful activities, one can contact the Department of Health and Human Services. The contact number is 800-HHS-TIPS( 800-447-8477).

The Justice Department’s Civil Division was the main government office that managed this case. The U.S. Attorney’s Offices for the Northern District of West Virginia and Western District of Pennsylvania were also involved in the investigation of the case. The Department of Health and Human Services Office of the Inspector General was also a contributor to the investigation. The Federal Bureau of Investigation was a major help in the inspection and analysis of the information regarding the case.

However, the final verdict regarding the case remained to be decided. So the amounts of restitution determined are only allegations.

Fraud cases usually comprise a complex web of many people and institutions. Drawing up the best path to choose and help win through such situations requires special knowledge. Those who are in such fixes should look for genuine legal assistance. The Healthcare Fraud Group is here to help those tangled in such circumstances. We give comprehensive assistance through simple communication along with the combination of academics as well as experienced background. We ensure your case is represented in the most effective way in the court of law. Please feel free to contact us at 888-402-4054 for free consultations.

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