According to a report by PNJ.com, Health Management Associates Inc. (HMA), a company that runs dozens of medical facilities across 15 states, is facing eight separate whistleblower lawsuits, including one recently filed by the United States Department of Justice.
The lawsuits claim that HMA exploited federal healthcare programs by allowing excessive inpatient admissions and paying doctors for referrals, says a Department of Justice news release.
The federal lawsuit targets former HMA CEO Gary Newsome, alleging that he demanded physicians to needlessly place patients in the emergency room when they should have been admitted into observation or even discharged. Doctors who complied with Newsome’s demands were allegedly awarded bonuses and other contractual benefits.
Kmart Corporation will pay a settlement amount of $2,550,000 to the United States federal government and 32 states, including Georgia, for allegedly having its national pharmacy centers make false prescription claims to government health insurance programs.
The Federal Bureau of Investigation (FBI), U.S. Attorney Barbara L. McQuade, and the Office of Inspector General of Health and Human Services all joined together to make the announcement of the case’s result.
According to a report by The Augusta Chronicle, on the night of October 3, former Enron Corp. executive and whistleblower Sherron Watkins spoke to a packed hall at Georgia Regents University about her role in uncovering one of the largest corporate scandals in American history.
The 2001 Enron scandal involved large-scale corporate fraud, the revelations of which dominated the national conversation and impacted the public’s trust in monolithic companies and corporations. Thousands of employees were laid off. Billions of dollars in investments went down the drain. Top company executives were tried and sent to prison.
Watkins started working for Enron in 1993. Soon after the scandal erupted, she resigned as vice president of corporate development.
According to a report by islandpacket.com, a federal whistleblower lawsuit alleges that several Atlanta-based hospitals operated by Tenet Healthcare Corp. and Health Management Associates engaged in an elaborate Medicaid fraud scheme. The state of Georgia has filed a coinciding lawsuit.
The suits allege that the hospital companies paid prenatal-care clinics ran by Hispanic Medical Management (HMA) to provide prenatal care to expectant, undocumented Hispanic women. Afterward, the clinics referred the patients to their hospitals for delivery and other newborn care services at Medicaid’s expense.
Under federal and state laws, hospitals cannot have patients referred to them if their procedures are covered by federal healthcare programs such as Medicaid. Although undocumented people are generally not eligible for Medicaid, they do receive coverage for emergency conditions, one of which is childbirth. Hospitals are reimbursed for the care they provide in these situations.
According to a report on wsoctv.com, Scott Wickersham of Whisteblower 9 was asked by a viewer to investigate a charity that had been distributing pink bags all over south Charlotte asking for donations of clothes and electronics. He found the charity to be legitimate on all technicalities, but their Better Business Bureau (BBB) rating was severely wanting. More specifically, the charity organization, Nspire Outreach, had an F rating.
Wickersham came upon warning signs besides the F rating that made him question the legitimacy of the charity organization. The pink bags the company used in Charlotte to gather donations had a different organization’s name printed on them. After hauling in $7 million in 2006, the company became a church organization, thus freeing them from listing financial documents.
The former director of public safety for Social Circle has filed a claim because he believes he was wrongfully fired after reporting violations to city officials. According to a news report on Firehouse.com, the Georgia man reported that local firefighters falsified training records and submitted fraudulent time records. He believes that his contract was not renewed because he reported these concerns. The city has fired back by saying that the former director did not engage in activity that is protected under the Whistleblower Act. It now must be determined if the former director faced wrongful reprisal for reporting his concerns about the alleged violations.
The Georgia Whistleblower Act (O.C.G.A. 45-1-4) was enacted in 1993 to eliminate fraud, abuse, and waste in state programs, and to protect the individuals who report these violations. Under the law, any public employee who acts as a “whistleblower” by reporting a potential violation shall be free from reprisal or discipline from his employer.
A new study shows that $5.1 billion of taxpayer money was spent by our government to fund care at nursing homes that failed to meet basic federal requirements. The Associated Press reports that one out of every three patients who required care at a skilled nursing facility ended up in a place that did not meet federal standards of care.
When someone requires daily help from a therapist or nurse, they can pursue financial support for their needs from Medicare. This new study from the Department of Health and Human Services clearly shows that many vulnerable elderly patients are not receiving the basic care they need. Facilities that are receiving funding from Medicare or Medicaid need to write up care plans that are specifically tailored for each resident. Unfortunately, many facilities are finding ways to get funding for procedures and services they are not even providing. Others are requiring patients to go through therapy that is not needed just so that the facility can continue to receive funding.
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