The Justice Department has decided to join a whistle-blower lawsuit against a chain of federally qualified safety net health clinics in the San Francisco Bay area that stand accused of submitting false paperwork in order to inflate Medicaid reimbursements.
Justice Dept. joins safety net clinic suit
Whistle-blowers Loi Trinh and Ed Ta-Chiang Hsu filed a sealed False Claims Act lawsuit in 2010 alleging a variety of complaints against North East Medical Services, a not-for-profit federally qualified health center with seven clinic locations.
Though the lawsuit is still sealed from public view, the Justice Department's civil division revealed its existence this week when it announced that it would join the case as a plaintiff against the network of clinics with regard to the allegation of Medicaid overbilling. The other allegations remain secret.
The Justice Department alleges that North East Medical Services significantly underreported to California's Medicaid program its reimbursements from private managed-care companies. Doing so allowed the center to receive inflated Medicaid payments, since centers that treat poor and underserved populations are eligible for enhanced payments that are supposed to be decreased when revenue from other sources is received, a news release says.
A spokeswoman for the center said Wednesday morning that she could not comment on the litigation because the center had not yet received a copy of the complaint.
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