Pope McGlamry Works to Fight Medicaid Fraud

Several Pope McGlamry attorneys, including Tim Morrison and Jay Hirsch, are working on a whistleblower lawsuit against medical giant Tenet Healthcare.  Lead counsel, Marlan Wilbanks, filed suit on behalf of whistleblower Ralph D. Williams.  The Pope McGlamry attorneys are part of a legal team put together by Wilbanks.

Other defendants include:  Hispanic Medical Management, Clinica de la Mama and Clinica del Bebe – clinics that recruited pregnant Hispanic women who are undocumented aliens, and which charged for and provided prenatal services to these women, as well as Health Management Associates (or “HMA”) and several hospitals owned by Tenet and HMA.

This civil lawsuit, which has been joined by the United States and the State of Georgia, alleges that five hospitals in Georgia and South Carolina paid these clinics that provided prenatal care to undocumented Hispanic women to refer patients to their hospitals for the delivery of their babies.  The lawsuit alleges that such payments violate the federal Anti-Kickback Statute, 42 U.S.C. § 1320a-7b, which makes it illegal to pay for the referral of patients for medical care that is covered by a government health plan.  The complaints allege that the kickbacks were disguised as payments for translation services and other services.

In addition, when the hospitals submitted claims to Medicaid for the costs of these deliveries, Plaintiffs contend that they violatedboth the federal False Claims Act, 31 U.S.C. § 3729, and its Georgia counterpart, the Georgia Medicaid False Claims Act, because such claims included certifications that no kickbacks had been paid.

Following a hearing in Columbus, Georgia, on June 24, 2014, United States District Judge Clay Land denied the Hospitals’ motions to dismiss the lawsuit and held that the Plaintiffs’ claims can proceed.  As the parties were gearing up for the formal discovery process, the Court, ruling on a motion by the Criminal Division of the United States Justice Department, stayed the case pending the parallel criminal case proceedings.

If you or someone you know has knowledge of kickbacks or other fraudulent conduct regarding the procurement of Medicare, Medicaid, or other government benefits, we would like to hear from you.  Contact Pope McGlamry at 877-285-7656 or submit a case evaluation online at www.popemcglamry.com to schedule a complimentary legal consultation.sity of Alabama Law Review from 1975-1976. Following his graduation from the University of Alabama, Mr. Morrison began practicing law in 1976.