July 9, 2018

NY-based Health Quest Systems, Inc. (Health Quest), and its subsidiary hospital Putnam Health Center (Putnam) entered a $14.7 million settlement with DOJ and a $895,427 settlement with New York based on their submission of inflated and otherwise impermissible claims for payment to Medicare and Medicaid.  Specifically, the defendants billed Medicare for undocumented E&M services, billed for home-health services without supporting medical records, and billed for orthopedic surgeons who referred patients in violation of the Physician Self-Referral Law, also known as the Stark Law.  Three former Health Quest employees, who filed suit under the qui tam provisions of the False Claims Act, will receive a share of the recovery, including a reward of nearly $2 million to one of the relators.  DOJ; USAO NDNY

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Healthcare Fraud, Hospital Fraud, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,