$520,000 False Claims Act settlement is second this week.
The state of Georgia is cracking down on Medicare and Medicaid fraud.
If there’s any doubt on that score, just look at the two False Claims Act settlements that came out this week – a $20 million settlement with the Medical Center of Central Georgia in Macon, and a $520,000 settlement with Irwin County Hospital in Ocilla.
Mike Bothwell of the Bothwell Law Group in Atlanta, who helped settle the second case in less than 20 months, notes that heath care fraud cases can be complex, but that the law provides real rewards for whistleblowers who step up with insider information that leads to recoveries and an end to fraud schemes.
In his Irwin County Hospital case, won with the help of co‐counsel Brandon Hornsby at the Hornsby Law Group in Atlanta, the whistleblowers walked away with a $130,000 award for helping stop the fraud, and as compensation for the retaliation that followed.
Federal and State False Claims Acts allow private citizens with insider knowledge of fraud, waste, and abuse to bring an action on behalf of the governments in order to stop the fraud. If the case is won, the government can recover over three times the amount defrauded, and successful whistleblowers can receive between 15 and 30 percent of the governments’ recovery.
“It’s all about incentivizing integrity,” says Bothwell. “Chiselers are always incentivized to cheat. The False Claims Act sets things right by providing a countervailing incentive to do the right thing.”
There’s no question the False Claims Act works. Last year, the U.S. government and the states recovered well over $6 billion thanks to whistleblower‐initiated cases.
Bothwell notes that a lot of False Claims Act cases involve health care – a situation likely to continue as the Affordable Care Act kicks in.
The Macon hospital settlement involved allegation of upcoding for more expensive inpatient services when the billing should have been for less costly outpatient or observation services.
In the Irwin County Hospital case, the allegations involved kickbacks for patient referrals and for billing for improperly performed imaging services.
Bothwell notes that it looks like a real fraud‐fighting partnership is forming between Georgia Attorney General Sam Olen’s Medicaid Fraud Control Unit, the U.S. Department of Justice, and Georgia whistleblowers and their attorneys.
“We’re seeing a real public/private partnership that is bringing a real dividend for the American people. That’s exactly how the law is supposed to work.” Mike Bothwell, Whistleblower Attorney
________________________________
About the Bothwell Law Group:
Since 1996, the Bothwell Law Group has earned a national reputation for successful representation of whistleblowers in federal and state courts across the United States, and is one of only a handful of firms exclusively representing whistleblowers. Bothwell Law Group’s cases have resulted in the recovery of more than $400 million for the United States treasury and in the payment of millions of dollars in whistleblower rewards. Inquiries may be directed to Mike Bothwell at (770) 643‐1606, email Mike@WhistleblowerLaw.com.
For more information about the firm, FCA settlements and FCA experience, see
www.whistleblowerlaw.com
Do you know what constitutes a qui tam Medicare lawsuit? Medicare is a government-funded healthcare plan. It provides eligible citizens with affordable healthcare options. The system relies on honest workers and a reliable healthcare system to make sure it operates smoothly. However, not all healthcare workers play by the rules. And, if they defraud Medicare, they should expect to get caught and pay the price.
Can you imagine the impact false claims by Medicare providers could have? Medicare is often the difference between a patient being able to receive health care and having to do without. In spite of the good it does for so many, there are those who attempt to game the system. That includes false claims by Medicare providers. How prevalent are these claims? It happens more often than most people realize. 
Private individuals use Medicare qui tam cases to show that a person or group has committed fraud against the government. The term “qui tam” is from a Latin phrase. It refers to someone who pursues legal action on behalf of the government as well as themselves. It originated in 13th century England, where it has since fallen into disuse. However, the United States still uses qui tam writs under the 
The benefits of being a Medicare whistleblower are tempting, but do they outweigh the risks? Most people want to do the right thing, but when they are under pressure to provide information, office staff, healthcare providers, doctors and others caught up in fraudulent schemes sometimes say they were afraid to speak out. For others, the lure of securing a major payout is their major motivation. Find out how to make a complaint to enjoy the most protection.
Medicare fraud attorneys help people fight back against health care providers and clinics that use and abuse the elderly. Bad billing practices don’t just put more money into a clinic’s pocket. They make it harder for people to get the medical coverage they need. 
Fraudulent insurance claims come in all varieties, and ultimately, it is the people who need the most who suffer more than anyone else. Substandard providers make money off the poor while delivering shoddy services. When a problem is widespread enough, policies change to limit services to keep unscrupulous medical providers from taking advantage of them. You can help preserve services and employment opportunities for those who are above-board by reporting fraudulent billing practices.