The United States Attorney's office for the District of Maryland has requested that we forward this Bulletin to alert our providers to the existence of the U.S. Attorney's Health Care Fraud Hotline. The Hotline number is 1-800-377-5879 and can be used to report suspected fraud in the practice of health care across the State in the areas of Medicare, Medicaid, CHAMPUS etc.

The United States Attorney advises that her office is committed to fighting health care fraud in Maryland. They have prosecuted a number of criminal health care cases and recovered millions of dollars in civil settlements under the False Claims Act. They have engaged in prevention efforts, educating health care providers and beneficiaries about fraudulent and false health care schemes. Some of the schemes identified include: kickbacks for patient referrals, billing for services not provided, inflating invoices to Medicare to obtain more money than is allowed, misrepresenting services, supplies and procedures provided, providing medically unnecessary services for financial gain and denying patients access to quality health care.

Since 1994, the U.S. Attorney's Office in Maryland has recovered over $32 million dollars in fines and damages for health care fraud and abuse. Just recently, they settled a $2.1 million dollar civil case with a southern Maryland hospital to resolve allegations that the hospital improperly billed Medicare for home IV infusion therapy. They also settled a $827,000 civil case against a local hospital for improperly billing Medicare for denied room and board charges by rebilling the denials as ancillary charges. Another settlement involved a local hospital which paid the government $564,000 to settle allegations that it improperly billed Medicare for ambulance transportation of inpatients who were actually transported on gurneys.

U.S. Attorney Lynne A. Battaglia stressed that many of her Office's health care cases are developed from complaints brought by beneficiaries or persons working for health care providers who bring the false or fraudulent conduct to the attention of the U.S. Attorney or the health care contractor. Ms. Battaglia urges those in the health care professions to pay attention to billing practices by their offices and by billing companies.

The U.S. Attorney's Hotline represents yet another means for reporting suspected instances of health care fraud and abuse in Maryland. Another method is the Department of Health and Human Services, Office of Inspector General (OIG) Hotline, which can be accessed at 1-800-HHH TIPS. The OIG Hotline may also be used to report suspected health care fraud and abuse throughout the United States.

If you have questions regarding this Bulletin, contact either Clarke Bowie (410) 561-4102 or Donna Blaschak (410) 561-4111, Maryland Medicare Part A, Fraud and Abuse Unit.