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General News    H3'ed 2/18/11

Crackdown on Medicare Fraud Is Picking Up Steam

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Message Roger Shuler

Cross Posted at Legal Schnauzer

The U.S. government yesterday charged more than 100 health-care providers in a Medicare-fraud scheme  that exceeded $225 million in false billings.

Investigators unearthed fraudulent activity in nine cities, but they did not reach into Alabama. That's bad news. Attorney General Eric Holder said a national crackdown on health-care fraud is far from over, meaning Birmingham eventually could be targeted. That's good news.

Evidence suggests that our state has a serious problem with health-care fraud, some of it apparently tied to Rob Riley (photo above), son of former Governor Bob Riley, and his associates at the University of Alabama at Birmingham (UAB).

Health-care fraud already has surfaced as an issue in Alabama, but federal investigators seem to have only scratched the surface of a large-scale problem here. Earlier this year, seven hospitals paid a total of $6.3 million  to settle their part in a long-running whistleblower lawsuit regarding Medicare fraud. Two of the hospitals were in Alabama, and three other Alabama hospitals--including St. Vincent's and St. Vincent's East in Birmingham--were part of an earlier settlement in the same case.

The government now has collected $101 million in the "qui tam" lawsuit, which was originally filed in New York and has unearthed fraud at health-care facilities in at least six other states.

That case revolved around the medical-device field, and that is exactly where Rob Riley has placed his slippery tentacles. Riley is a lawyer by trade, but he seems to have a penchant for engaging in dubious business ventures. A whistleblower case filed in Birmingham alleges fraud against Performance Group LLC, a company owned in part by Riley. No substantive action has been taken in the case, largely because of some curious rulings by a federal judge with strong Republican roots, but that needs to change.

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I live in Birmingham, Alabama, and work in higher education. I became interested in justice-related issues after experiencing gross judicial corruption in Alabama state courts. This corruption has a strong political component. The corrupt judges are (more...)
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