Major Settlement Achieved in Medicare Fraud Case Against Former Doctors
Legal Victory in Medicare Fraud Case
Louis J. Cohen, P.C. has recently announced a significant legal development with a $15 million settlement stemming from a whistleblower lawsuit against former physician Mohammad Rasekhi, his spouse Sheila Busheri, and Southern California Medical Center, Inc. (SCMC). This settlement highlights the critical importance of transparency and accountability in the healthcare sector.
Details of the Allegations
The whistleblowers uncovered a multitude of fraudulent practices employed by Rasekhi and Busheri, which severely compromised the integrity of Medicare, Medi-Cal, and Tricare programs. Allegations include unlawful kickbacks paid per patient to marketers who directed patients to SCMC, along with kickbacks offered to physicians for funneling lab tests to Universal Diagnostics Laboratories (UDL), a lab owned by Rasekhi.
Additionally, it was revealed that Rasekhi inaccurately referred patients for lab tests to UDL, violating the Physician Self-Referral Law, also known as the Stark Law. This manipulation of patient referrals is not just unethical, but illegal, and leads to detrimental effects on patient care.
The Structures of Fraud
Since its inception, SCMC was allegedly misused by Rasekhi and Busheri as a personal resource to extract excessive salaries and charge inflated rents for the clinics located in properties they owned. Such exploitation raises serious concerns about the ethical obligations of healthcare providers and the systems in place to protect vulnerable patient populations.
The federal and state governments recognized the need to intervene in this grave matter, resulting in a joint settlement agreement that amounted to $10 million. In addition to this, the whistleblowers and Cohen pursued the remaining claims, securing a further $5 million in settlement.
The Impact of the Settlements
The U.S. Department of Justice underscored the significance of justice in health care provision, affirming that schemes threatening to skew healthcare practices for financial gain will not be tolerated. U.S. Attorney for the Central District of California, Martin Estrada, emphasized the commitment to maintaining the integrity of federally funded healthcare programs throughout the country.
Over three short years, SCMC billed Medi-Cal over $100 million, receiving payments exceeding $55 million. Such figures underline the extensive nature of the alleged fraudulent activities and the considerable financial drain on public healthcare resources.
Serious Concerns Raised About Patient Care
One particularly troubling allegation was that Rasekhi misappropriated free vaccines, intended for underprivileged children, administering them to adult Medicare patients. This effort not only violates trust but also reflects a severe disregard for ethical medical practices and ultimately places patients at risk.
Moreover, on October 3, the Medical Board of California brought forth allegations of misconduct against Rasekhi related to inappropriate conduct involving both a whistleblower and patients from SCMC, leading to the surrender of his medical license.
Gratitude for the Whistleblowers
Attorney Louis J. Cohen expressed deep respect for the whistleblowers, acknowledging their courageous action to expose these frauds. Their testimonies have been essential in bringing these injustices to light, ultimately protecting the welfare of patients and safeguarding taxpayer money.
About Louis J. Cohen, P.C.
Louis J. Cohen, P.C. is a national firm specializing in representing whistleblowers in cases of Medicare and Medi-Cal fraud, and offers assistance in various employment-related legal matters. The firm has achieved remarkable outcomes in False Claims Act cases, amassing settlements exceeding $100 million and earning recognition for consistently securing substantial whistleblower awards.
Frequently Asked Questions
What led to the $15 million settlement?
The settlement was prompted by allegations of fraud in Medicare, Medi-Cal, and Tricare programs related to kickbacks and self-referrals by former physician Mohammad Rasekhi and his associates.
Who were the key people involved in this case?
The key individuals included former physician Mohammad Rasekhi, his wife Sheila Busheri, and the Southern California Medical Center.
How did the whistleblowers contribute to the case?
The whistleblowers provided credible evidence of fraudulent practices that led to the investigation and subsequent settlements.
What are the implications of this settlement?
The settlement signifies a substantial legal accountability for fraud in federally funded healthcare programs and aims to restore integrity in the health system.
What is the role of Louis J. Cohen, P.C. in this settlement?
Louis J. Cohen, P.C. represented the whistleblowers and successfully negotiated the $15 million settlement while advocating for accountability in healthcare fraud.
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