An organization known as Osteo Relief Institutes and its previous owners recently resolved claims of fraud against the government with a settlement of more than $7.1 million.

The allegations of fraud against the government involved claims that Osteo Relief Institutes were involved in unnecessary knee braces and injections with the intention of billing Medicare for these medically unnecessary proceduresand items. The United States will receive a collective payment of over $7 million from 7 previous Osteo Relief Institutes Organization and their owners.

It is illegal for organizations to provide unnecessary care in an effort to increase their profits by billing government programs such as Tricare, Medicare, and Medicaid. Many of these claims are often brought to light by the involvement of a whistleblower. A whistleblower is usually an inside employee or former employee who has specific knowledge about an ongoing practice of fraud.

The special agent in charge of the Office of Inspector General of the U.S. Department of Health and Human Services commented on this most recent settlement of claims of fraud against the government; stating that patients are also put at risk when unnecessary care is provided to them.

According to the allegations against these health organizations, the treatment centers were involved in providing viscosupplementation.

During this procedure, the doctor uses a gel-like fluid to inject into the patient’s knee joint. The purpose of this fluid is to supplement natural joint fluid properties and to serve as a lubricant.

As explained in the investigation against the named organizations, patients who did not need viscosupplementation injections received them anyways and that multiple brands of viscosupplements were used repeatedly on patients where there was no clinical support documenting that this would be necessary or helpful for them.

The ORI clinics were located in Arizona, California, Kentucky, New Jersey, Texas, and Colorado. This particular case was identified and confirmed by a government investigation and analysis of Medicare claims data.

The government chose to intervene in this whistleblower case and take over the management of the litigation. The whistleblower will receive $857,550 award as part of the lawsuit brought under the False Claims Act.

Arguments of fraud against the government could develop from mere accusations all the way to formally filed criminal charges or a whistleblower lawsuit. Federal and sometimes state laws protect those who alert the government to this kind of illegal misconduct.

If you have evidence or reason to believe that a company you’re working for or previously worked with was engaged in an ongoing scheme of fraud against the U.S. government, the information you have could spark an investigation or a lawsuit against that company.

Based on the type of fraud and the information you present to bring a case, you could be eligible to receive an award, which is a portion of the funds recovered by the government.

While claims of abuse frequently have to do with Medicaid, Medicare, and Tricare, there are many different kinds of whistleblowers who report insider information through different programs. Some of these lead to awards as well as to protections for the whistleblower.

This article is not legal advice. It is presented
for informational purposes only.