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LexisNexis Risk Solutions - Government

According to a press release on February 24, 2023, from the U.S. Department of Justice, Cornerstone Hospital Medical Center was a long-term care hospital that specialized in “providing extended medical and rehabilitative care to individuals who qualified as clinically complex and possessed multiple acute and/or chronic conditions.” They forgot to mention, that Cornerstone also specialized in defrauding the U.S. government.

The Department of Justice investigation began when a whistleblower, who worked at Cornerstone long term care facility, filed a lawsuit on September 28, 2018, claiming blatant Medicare fraud. The investigation took five years which was almost as long as the actual fraud! The DOJ investigation found that from January 1, 2012, through December 31, 2018, Cornerstone fraudulently billed Medicare with for unauthorized services and services not actually provided. Many of the services billed were deemed so inadequate they were considered worthless. During this time, unauthorized, unlicensed students performed the medical procedures.

A slap on the hand seems to be in the only punishment for this crime. Cornerstone Healthcare Group agreed to pay the United States $21 million to resolve any claims of Medicare fraud.Not sure what more these fraudsters had to do to get prison time, because the findings show that not only did Cornerstone bilk the Medicare program out of millions, it also jeopardized the health and safety of patients who trusted the healthcare providers.

The settlement was a historic one. Apparently it is one of the largest civil health care fraud settlements by the FBI in Houston, which is something the FBI should be proud of.  Great job reclaiming $21 million in taxpayers’ money.

Today’s Fraud Of The Day is based on article “Houston medical center fined $21 million for Medicare fraud scheme” published by Chron. On February 24, 2023

A Houston-based medical company care hospital has agreed to pay more than $21 million to settle a federal lawsuit alleging it defrauded Medicare for years.

Cornerstone Hospital Medical Center was a long-term care hospital that specialized in “providing extended medical and rehabilitative care to individuals who qualified as clinically complex and possessed multiple acute and/or chronic conditions,” according to a Wednesday release from the U.S. Department of Justice’s Southern District of Texas.

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