Arrest in COVID-19 Medicare Fraud Case

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The Department of Justice announced today the arrest of a Georgia woman on allegations of Medicare fraud related to coronavirus tests.

According to the DoJ press release, the woman was charged with violations of the Anti-Kickback Statute (AKS) and for submitting false claims to Medicare.  The allegations state that she was attempting to receive kickbacks for referring Medicare patients for genetic screening tests and COVID-19 tests.

It is a violation of the AKS to receive a kickback—whether monetary or an in kind kickback—for referring Medicare patients to medical providers.  Additionally, AKS violations likely violate the False Claims Act (FCA), which makes it illegal to submit false claims to the government for payment.  Medicare and Medicaid expressly condition payment on providers certifying compliance with various federal laws, including the AKS.  Therefore, any submission for payment to Medicare that was in violation of the AKS is also a false claim under the FCA.

Importantly, the FCA allows whistleblowers who uncover fraud against the government to bring a civil action in the name of the government and share in any recovery.

If you have uncovered fraud against the government, contact the whistleblower attorneys at Miller Law Group today for a free consultation.

The charges discussed above are based on allegations only.  There has been no determination of guilt.

Additional Resources: 

Medicare and Medicaid Fraud: The Reverse False Claim and the 60-Day Rule

Department of Justice Continues to Work with Whistleblowers During COVID-19 Pandemic

Whistleblower: Government Plans to Focus on Nursing Home Fraud in 2020