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Christus Health Settles Medicare Fraud Suit

Christus Health Settles Medicare Fraud Suit

 

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A $1 million Medicare fraud settlement payment has been made by Christus Health, a Houston based hospital system. Whistleblower Mark Razin, who is a Healthcare Financial Advisors

employee, worked with Christus on cost reports that maximized Medicare reimbursement. Specifically the charges stated failure to report overpayments and billing ineligible costs. From 1988 through 2001 the medical chain that operates 40 hospitals and facilities in eight states committed violations such as wrongful billing to Medicare for advertising, marketing and administrative costs resulting in a qui tam lawsuit.

This qui tam or whistleblower lawsuit was filed in 1998 in the federal district court of Los Angeles against not only Christus but many other former clients of Healthcare Financial Advisors as well. Certus acquired the firm in 1998. The lawsuit had been “under seal” and not known to the public until recently, when a federal district court judge in Los Angeles unsealed the case. As a result of Razin’s daring qui tam allegations the government has recovered $62.9 million.

Other fraudulent behavior on the part of Christus that lead to a qui tam suit included the reopening of previous years’ cost reports to make adjustments and resubmit them to increase their Medicare reimbursements. This was done on the advice of Healthcare Financial Advisors. Razin decided to take a stand and become a whistleblower back in 1998 ending these actions.
Razin was represented by the San Francisco based firm Phillips & Cohen LLP, specialists in qui tam suits, who have gained some $6.89 billion is civil settlements. Stated Mary A. Inman, an attorney with the firm, “Healthcare providers must disclose to Medicare any overpayments that result from reimbursement errors. The Medicare system depends on the honesty of hospitals and other healthcare providers. They shouldn’t be trying to game the system.” She went on to praise the government attorneys involved, “I particularly want to acknowledge the work of Assistant U.S. Attorney Shana T. Mintz and Jeff McVicker of the U.S. Attorney’s Office in Los Angeles. Their skill and diligence helped taxpayers recover Medicare funds that otherwise would have been lost to fraud.”

These qui tam whistleblower suits appear to be the only thing stopping the loss of possibly billions in taxpayers money to Medicare fraud.

Sources:

http://www.prnewswire.com/news-releases/christus-health-systems-pays-nearly-1-million-to-settle-medicare-fraud-charges-by-whistleblower-104430473.html

http://www.beckershospitalreview.com/hospital-financial-and-business-news/christus-health-in-houston-to-pay-1m-settlement-in-medicare-fraud-lawsuit.html

 
 
 

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