February 15, 2019

Do I Have a Qui Tam or False Claims Act Case? Dear Lord, Beyond Belief!

Medicare fraud leading to qui tam litigation by whistleblowers is a growing scenario.

The following report of health care fraud really stretches the boundaries of fraudulent behavior and the belief that the government can self-regulate it’s programs to detect such activity. As reported by Associate Press writer Shayha Mohajer on August 10, 2011, two pastors in the now-defunct Los Angeles church, Arms of Grace Christen Center, abused their congregation’s trust by using the parishioners’ personal information to defraud Medicare out of 14.2 million dollars.

The pastors used their parishioners’ personal information to establish several fraudulent medical supply businesses. These businesses billed Medicare for power wheelchairs and other expensive medical devices and equipment. The two pastors and their co-conspirators used fraudulent prescriptions and other illegally obtained documents to bill Medicare for the medical equipment, which was never needed nor provided to customers.

At the end of the two week trial, Christopher Iruke, one of the pastors, was found guilty of one count of conspiracy and seventeen counts of health care fraud. His wife Connie Ikpoh and another employee were found guilty of of one count of conspiracy and four counts of health care fraud.

Mr. Iruke’s attorney stated that his client didn’t know the prescriptions were fraudulent. Even if this is true, it does not address what Mr. Iruke thought of using his parishioners’ personal information to set up the medical supply business in the first place. Did he not realize this was illegal? Did he not stop to think, or even pray about the consequences of using this information to set up these businesses? He did not have any moral or ethical objections when entering this scheme? Really? What were they thinking?

This news story emphasizes that once again it is not the much-maligned beneficiaries – the elderly and poor – of the government-sponsored health care programs that are driving these programs into financial ruin. Rather it is the providers of health care supplies, services, and pharmaceuticals that are taking advantage of a poorly self-audited government program, which allows these persons to bilk the government out of millions of dollars each year. Perhaps the recent changes the federal government has made over the last year to better detect and stop this type of fraud, as discussed in previous posts, will lessen the opportunity for this type of fraudulent behavior.

Do YOU think that you may have a False Claims Act case on your hands? Are you perhaps a “whistleblower” who knows about corruption at your workplace? Berg & Androphy is here to help you. Learn more about Qui Tam and False Claims Act law cases by visiting this Overview page today.  Please contact us here if you have questions or wish to speak to one of our attorneys about your situation.