• Lawsuit: Halifax Health submitted thousands of false Medicare, Medicaid claims


    ORLANDO, Fla.,None - In a multi-million-dollar Medicare fraud case, the Department of Justice claims Halifax Health submitted thousands of false Medicare and Medicaid claims.

    The Department of Justice's lawsuit was filed last week in Orlando's federal court.

    This all started with a whistle-blower lawsuit that was filed in 2009 by a former Halifax Medical Center employee. He claimed the hospital over-billed Medicare by millions of dollars.

    The lawsuit also accused doctors of taking kickbacks.   

    According to court documents, that money came from Halifax in the form of bonus and incentive pay.

    The federal government said if it had known about the hospital's compensation plan, it never would have paid the claims.

    Over the past decade, Halifax Health has made millions of dollars treating Medicare and Medicaid patients. But a complaint filed by the federal government on Friday claimed a great deal of that money ended up in doctors paychecks in the form of profit-sharing incentives and illegal kickbacks.

    "If that type of thing is going on, it makes you question where the loyalty of the doctors' is. Is it with the patient or is it all about the money?" former patient of Halifax Medical Center Roderick Mayes said.

    Mayes was born at Halifax Medical Center. As an adult, he's been treated by Halifax Health and he is insured by Medicaid. Now, the treatment of patients just like Mayes is falling under scrutiny.

    Federal law prohibits hospitals from submitting Medicare and Medicaid claims from referrals made by physicians who have a financial relationship with the hospital.

    U.S. attorneys allege that's what happened at Halifax and they've joined a whistle-blower's lawsuit.

    "My client tried to do everything that she could as a very principled and longtime employee to bring these problems to the attention of management. She got nowhere with that," said plaintiff attorney Marlan Wilbanks.

    According to court records, between 2007 and 2008, Halifax neurosurgeons received bonuses ranging between two and six times their annual salaries. Oncologists also received incentive pay.

    Halifax Health declined an  interview with WFTV about the federal lawsuit, but said, "This action by the government does not change our firm belief that there has been no intentional misrepresentation or illegal activity on the part of Halifax Health and we will continue to vigorously defend our position."

    Attorneys on both sides said they are collecting evidence to support their positions and there have been no attorney interviews of doctors.

    The federal government said it's seeking three times what was paid out to Halifax, and there could be additional penalties.

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