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The federal government continues to follow through on its commitment to vigorously pursue those individuals and businesses that defraud the government and taxpayers – efforts have been shown to yield positive results in recovering government funds. As this Boston Globe article points out, fraud investigators recover nearly $8 for every $1 they spend to pursue alleged wrongdoers. Given that about 20 percent of the federal budget — $732 billion in 2012 — goes to federal healthcare programs, and that fraud and abuse cost the taxpayers between $22 billion and $102 billion each year, it makes good fiscal sense (not to mention moral and ethical sense) to aggressively go after those who commit healthcare fraud.

Just last week, the government intervened a False Claims Act lawsuit against Tenet Healthcare Corp. (Tenet) and Health Management Associates (HMA) – two of the largest owner/operators of hospitals in the country – alleging that the hospitals paid illegal kickbacks to obstetric clinics that provide services to primarily undocumented Hispanic women in exchange for referrals of those patients for labor and delivery at the hospitals and billed state Medicaid programs for services provided to the referred patients.

The government continues to pursue and obtain significant settlements in False Claims Act cases, as well. Medical device manufacturer EndoGastric Solutions Inc. recently agreed to pay up to $5.25 million to resolve allegations that it violated the False Claims Act by making illegal kickbacks and misleading health care providers about how to bill federal health care programs for a procedure using one of its devices.

Although fraud and abuse cost the country billions of dollars each year, the illegal activity often goes unreported. Patients may not notice when they government is billed for services that they didn’t receive and self-interest often prevents third-party billing companies from reporting instances of fraud. For this reason, whistleblowers are critical to preventing fraud and holding those who commit fraud accountable. Because they are such a critical component to the fight against fraud and abuse, whistleblowers receive a share of the government’s financial recovery from any False Claims Act lawsuits.

The whistleblower attorneys at Goldberg Kohn are committed to fighting fraud against the government and protecting the rights of whistleblowers. Please contact us at (312) 863-7222 if you would like to learn more about healthcare fraud or would like to schedule a free, confidential appointment with one of our nationally recognized whistleblower attorneys.