September 27, 2017

South Carolina hospital AnMed Health agreed to pay over $7 million to resolve allegations it violated the False Claims Act by knowingly disregarding the statutory conditions for submitting claims to the Medicare program for a variety of services, including radiation oncology services, emergency department services, and clinic services.  Specifically, the government alleged that AnMed Health billed for radiation oncology services for Medicare patients when a qualified practitioner was not immediately available to provide assistance and direction throughout the radiation procedure, as required by Medicare regulations.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former AnMed Health employee Linda Jainniney.  She will receive a whistleblower award of roughly $1.2 million from the proceeds of the government’s recovery.  DOJ (NDGA)

Tagged in: FCA Federal, Hospital Fraud, Improper Medical Personnel, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,