A federal appeals court reinstated $ 85.1 million of a $ 347.9 million dividend against rehabilitation companies in a lawsuit brought by a whistleblower who charged with the False Claims Act for Medicare and Medicaid Claims.
2011 2011 Angela Ruckh, a registered nurse, filed a lawsuit against two skilled healthcare institutions, two related records that provided management services at these facilities and 51 other facilities in Florida and one affiliated company that provided rehabilitation services, prosecuted violations of the False Claims Act, and Florida False Claims Act According to Thursday's Decision Angela Ruckh v. Salus Rehabilitation LLC, dba La Vie Rehab, 207 Marshall Drive Operations, LLC dba Marshall Health and Rehabilitation Center, et al.
After a month-long trial, a jury in U.S. District Court in Tampa, Florida, found defendants responsible for filing 420 fraudulent Medicare claims and 26 fraudulent Medicaid claims and awarded $ 1
After applying statutory tripling and sanctions, the district court favored the Whistleblower, the United States and the State of Florida for $ 347.9 million.
However, the district court dismissed the jury's verdict as "not supported by the evidence" and granted the verdict to the judges as a matter of law.
A three-judge appeals court panel unanimously reinstated the $ 85.1 million Medicare award, but approved the dismissal of the Medicaid award.
"To draw all the conclusions in favor of the relative, which we must … we conclude that the evidence at trial allowed a reasonable jury to establish that the defendants committed Medi care-related fraud," said the decision.
It said that a jury "could reasonably end the defendants who are ramping up," which it defined as "the unauthorized, artificial timing of services to coincide with Medicare's regular assessment periods, thereby maximizing reimbursements. "
In claiming Medicare fraud, the panel confirmed that the Court of First Instance rejected the award. "The relator's only allegations of Medicaid fraud consist of defendants' failure to prepare and maintain comprehensive care plans for their residents," the decision said.
"Although we accept this accusation as true, we believe the failure to do so cannot establish Medicaid fraud as a matter of law," it said. The whistleblower "was required not only to prove that the defendants failed to comply with this requirement , without their failure to do so was substantial. "
The case was arrested for further litigation.
Ms. Ruckh's attorney, Derek T. Ho, a partner with Kellogg, Hansen, Todd, Figel & Frederick PLLC in Washington, said in a statement, "We are pleased that the jury's verdict was restored and we are grateful for our client's efforts and personal sacrifice to ensure that US taxpayers' money is not wasted due to fraudulent business practices."
A defense attorney in the case had no comment.
In May, a federal appeals court overturned a judgment in the Superior Court and considered that an adult care provider was entitled to coverage in connection with a lawsuit on false claims.