Although there is no perfect system that can prevent all types of criminal activity, the United States federal government has secured some huge victories in recent times prosecuting enormously large healthcare companies found to be committing fraud and taking advantage of patients for their own financial gain. Both Tenet Healthcare Inc., a multinational healthcare services conglomerate worth $18 billion, and Life Care Centers of America, the largest private nursing care company in the United States, have been caught red-handed this year defrauding the federal government and putting the needs of their patients second by deferring them to out-of-the-way healthcare centers and administering unnecessary services respectively.
Tenet Healthcare was found to be purposefully deferring pregnant patients to certain subsidiary facilities for profitable kickbacks, while also overcharging for unnecessary services. Life Care Centers of America was found to be overcharging for unnecessary services and keeping patients longer than necessary to squeeze more money out of patients and the federal government. As a result of these infractions, Tenet Healthcare has agreed to settle for $513 million and Life Care Centers of America has agreed to pay $145 million as a result of the lawsuits levied against them by state and federal prosecutors, awarding millions of dollars back to the government and taxpayers across the country.
The depth and scale of these fraudulent activities is alarming. In Tenet Healthcare’s case, it is the fourth major healthcare scandal they have faced since the early 1990s. In the case of Life Care Centers of America, their fraudulent activities were tracked between 2006 and 2013. In both cases, the criminal activities involved taking advantage of the patients that place their trust in their services for their own personal profit.
False Claims Act a saving grace in stopping healthcare companies
Both of these humongous fraud cases were brought to light thanks to the provisions of the False Claims Act, which encourages prosecutors from the state and federal levels to work together with civilian employees and patients to help weed out corruption and fraud in large healthcare companies. According to the Department of Justice, since 2009, over $31.6 billion has been recovered under the False Claims Act, and $19.2 billion of that comes directly from fraudulent healthcare charges, as was the case in both of these settlements.
The False Claims Act has a robust whistleblower protection component to its language, which empowers individuals to go public with information that could lead to the prosecution of companies taking advantage of patients or purposefully overcharging for unnecessary procedures and care. In the case against Life Care Centers of America, the case started after two former employees raised the alarm to the fraudulent activities.
Healthcare fraud is obviously a huge problem in this country. There is much trust placed in healthcare facilities that they will provide the proper amount of services and only bill the federal government for necessary services. However, these two cases prove that large healthcare corporations feel that they can either operate on the boundaries of the law or commit outright fraud, all to the benefit of their own profits and to the detriment of the people that they are supposed to be responsible for providing care to.
These cases prove that that large companies think they can be above the law. At Altman & Altman LLP, we believe nobody, no matter how large or profitable, is above the rules and regulations meant to protect patients and taxpayers. If you know of any illicit activities being performed by a healthcare facility, you are protected if you can provide proof of these activities. But you will also need help. That’s where the experienced legal team at Altman & Altman LLP can help. If you, or anyone you love, knows of illegal kickbacks or other illicit activity by profit-driven healthcare facility, call us today for a free consultation at 617-492-3000 or toll-free at 800-481-6199. We are available 24/7.