Harris County Hospital District

Houston, TX: (Mar-27-07) Robert McCaslin, the whistleblower who revealed the fraudulent business practices of the Harris County Hospital District (HCHD), helped recover almost $15.5 million from the hospital district. First suspecting a systemic problem in the way HCHD was submitting Medicare claims in May 2003, he reported the discrepancy to several supervisors, though observed that the erroneous claims continued. He then anonymously notified HCHD's Medicare fiscal intermediary, Trailblazer Health Enterprises LLC, of a specific fraudulent claim. He saw that Trailblazer required HCHD to correct the claim. McCaslin sought outside legal assistance to pursue the matter. Based on its investigation, the government estimated that incorrect claims were filed on behalf of thousands of patients, and HCHD agreed to reimburse the federal and Texas state governments for improperly filed health insurance claims during a period of six years, making the $15,449,126.97 settlement among the largest cases settled in the Southern District of Texas. [BUSINESS WIRE: MEDICARE CLAIMS]

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Published on Mar-30-07