Sub-standard Care Certainly Triggers Fca Case

By Author: Jaun Paul
Total Articles: 53
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There are so many instances when False Claims Act (FCA) cases in health care center hinge on the fact that claims were submitted to Medicare or Medicaid when no actual care was provided at all.


Substandard care can easily trigger a FCA case, more specifically in residential health care setting like psychiatric treatment facilities and long-term care facilities.


Here's an example: The DOJ recently intervened in a FCA lawsuit involving three companies doing business as Keystone Marion Youth Center in Marion, VA. The Center, says the DOJ, bags Medicaid funds to provide psychiatric counseling and treatment for boys ages 11-17.


Who were the whistleblowers? The therapists who used to work at the facility are the qui tam relators or ‘whistleblowers' in the case. As per their allegations, the Center provided ...
... sub-standard care and submitted false claims to Medicaid.


The DOJ release acknowledges Virginia's Medicaid Fraud Control Unit and others for their early involvement in the case.


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