Nevada Healthcare Fraud/Medicare Fraud Enforcement
In Nevada, major healthcare fraud is civilly and criminally prosecuted by the District of Nevada United States Attorney’s Office and the State’s own Medicaid Fraud Control Unit.
The federal government sometimes accomplishes this task with the assistance of the Nevada Medicaid Fraud Control Unit (MFCU). Both entities are, in turn, often assisted in their efforts by the bravery and actions of whistleblowers.
Modeled after the federal False Claims Act, the Nevada False Claims Act (contained in Chapter 357 – Submission of False Claims to the State or Local Government), permits private citizens to bring qui tam actions on behalf of the State of Nevada to recover treble damages and civil penalties. Nev. Rev. Stat. § 357.010 et seq.
Nolan Auerbach & White represents whistleblowers in federal court only. We will bring cases on behalf of whistleblowers under the Nevada qui tam statute as part of an action under the federal False Claims Act. We do so under the Court’s pendent jurisdiction.
The liability provisions of the Nevada False Claims Act, Nev. Rev. Stat. § 357.040(1), provide that it is unlawful for any person who:
(a) knowingly presents or causes to be presented a false or fraudulent ;
(b) knowingly makes or uses, or causes to be made or used, a false record or statement that is material to a false or fraudulent claim;
(h) is a beneficiary of an inadvertent submission of a false claim and, after discovering the falsity of the claim, fails to disclose the falsity to the state or political subdivision within a reasonable time.
(i) conspires to commit any of the acts set forth in this subsection.
Cases completed in Nevada that were originally brought in a Nevada federal court include:
Handled by the U.S. Attorney’s Office for the District of Nevada, the 2019 resolution of a False Claims Act case resulted in Encompass Health Corporation (EHC), f/k/a HealthSouth Corporation paying $4 million to resolve False Claim Act allegations. The Government contended that the company submitted false claims to Medicare resulting in higher reimbursement for services than were warranted. Specifically it was alleged that Encompass Health Rehabilitation Hospital of Henderson, LLC improperly assigned low scores on Patient Assessment Instrument forms and therefore received more monies for these patients than was appropriate.
In 2019, a False Claims Act case against Nevada Heart & Vascular Canter, LLP, a Las Vegas cardiology practice, resolved for $2.5 million. The Government alleged that the practice would refer Medicare patients to genetic testing companies in exchange for payments by these companies. The genetic testing companies named in the Settlement Agreement were Natural Molecular Testing Corp. and Iverson Genetic Diagnostics, Inc. Although False Claims Act kickback cases schemes involving labs started decades ago, genetic testing companies have clearly emerged as a target for fraud and abuse.
“The firm has a great team of brilliant minds that work together.”James Conrad, Former Director of Program Integrity at CMS, and Former FBI Health Care Fraud Analy