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Qui Tam

: Whistleblower Law Blog

Las Vegas woman charged in $3.5 million Medicare fraud Scam by DME company

By LaBovick Law

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Recently, Jummal Joy Ibrahim, of Las Vegas, Nevada, pleaded guilty to her role in Medicare fraud of a durable medical equipment company that generated over $3.5 million in false Medicare claims. Between January of 2006 and September of 2009, the woman and her brother worked in conjunction to dupe Medicare into paying false claims submitted for high-end power wheelchairs and other expensive pieces of durable medical equipment.

Setting up fake companies or applying an owner's name to a company as a straw owner - as was the case with Ibrahim - distorts the process of tracking claims to a distinct service provider and often involves many separate fabricated identities. Ibrahim opened a bank account for her company and allowed her brother unrestricted access so that he could conduct business in her name. It was admitted at trial that the Medicare fraud scam was able to conceal ownership and submit approximately $3.5 million in false power wheelchair and DME claims to Medicare. Medicare reimbursed Contempo Medical Supplies approximately $1.7 million for the false claims.

The Medicare Fraud Strike Force and the U.S. Attorney's Office for the Central District of California are responsible for the successful prosecution of this case. In 2009, Health Care Fraud Prevention & Enforcement Action Team (HEAT), created the Medicare Fraud Strike Force to help prevent and deter fraud and enforce current anti-fraud laws around the country.

The Strike Force has operations in nine districts and has charged 1,000 defendants who collectively have falsely billed the Medicare program for more than $2.3 billion. The government is taking a stand to thwart unscrupulous providers from bilking the system with fraudulent claims. Thanks to valiant whistleblowers coming forward, more Medicare fraud is being reported.

Whistleblowers should seek an experienced qui tam attorney to discuss their potential whistleblower claim. As mentioned previously on the whistleblower law blog, a successful qui tam outcomes can result in substantial settlements or judgments. A whistleblower may be entitled to a whistleblower reward reward of 15-25% due to provisions in the False Claims Act.

If the government does not intervene in the case, the whistleblower can pursue the case, and may be entitled to a whistleblower reward of 25-30%. A qui tam attorney can evaluate the strength of the complaint and protect the privacy, rights and interests of those clients with a legitimate whistleblower claim.

Full post as published by Whistleblower Law Blog on March 14, 2011 (boomark / email).