Over Charging Overdraft Fees -- Thanks Comerica Bank

 

New York- Final approval has been granted in the $14.5 million settlement of consumer fraud class action involving overdraft fees charged by Comerica Bank NA. The class action involved people who had been charged overdraft fees on their Comerica Bank accounts between 2004 and 2010. The Comerica overdraft class action lawsuit alleged the bank posted debit card transactions in dollar amounts ordered from highest to lowest so as to maximize the number of overdraft fees it could levy against its customers.
According to the lawsuit, rather than declining transactions that would put a customer into overdraft, Comerica authorized the transactions, subsequently processing them in an order that would increase the banks’ overdraft revenue.

Eligible class members include anyone who held a Comerica bank account in Arizona, California, Florida, Michigan or Texas and incurred one or more overdraft fees as a result of Comerica’s non-consecutive posting of transactions between 2004 and 2010. Specific class periods vary by state.

The Class Periods by state are:

• For Settlement Class Members who opened accounts in Arizona, the period from February 18, 2004 through August 15, 2010.

• For Settlement Class Members who opened accounts in California, the period from February 18, 2006 through August 15, 2010.

• For Settlement Class Members who opened accounts in Florida, the period from February 18, 2005 through August 15, 2010.

• For Settlement Class Members who opened accounts in Michigan, the period from February 18, 2004 through August 15, 2010.

• For Settlement Class Members who opened accounts in Texas, the period from February 18, 2006 through August 15, 2010.

Eligible class members must have had two or more Overdraft Fees caused by debits posted to their accounts on a single day during the time period listed above. For further information on the Comerica class action lawsuit settlement, and to download forms, visit: http://comericabankoverdraftsettlement.com

Medicare Fraud Why is it so Easy to Commit??



Medicare Fraud Again!

DALLAS -- A North Texas physician has been convicted of Medicare fraud in a $3 million billing scam for unnecessary home services since 2006.

Prosecutors say Dr. Joseph Megwa of Arlington was convicted of conspiracy to commit health care fraud and three counts of health care fraud. He faces up to 10 years in prison on each count.

Megwa was also convicted of four counts of making false statements related to claims submitted to Medicare. Prosecutors say some home visits or house calls to patients were never made. The doctor faces up to five years in prison for each of those counts.

More than 230 home health agencies were involved with Megwa, but PTM’s Ikhile and Eghobor were the only others indicted in the case. This case affected a multitude of states and other endorsers.

 The U.S. Department of Health and Human Services recently ordered a moratorium on licensing new home health care agencies in Dallas because of fraud concerns.

 

A jury in Dallas also convicted a home health care manager and registered nurse, Ebolose Eghobor of Grand Prairie, of conspiracy to commit health care fraud.

CVS Does It Again!



Alabama Supreme Court on Friday allowed a class action lawsuit seeking more than $3 billion to go forward against CVS Health Corp and several insurance companies, agreeing with the ruling by a lower court which said the plaintiffs could be certified as a class.

 

The case dates back to a 1999 class action settlement for $56 million over alleged accounting fraud at MedPartners, a physician and pharmacy benefits management corporation.

 

CVS Health could not be reached for comment.

 

MedPartners became Caremark and merged in 2007 with CVS, now known as CVS Health.

In 2003, Alabama attorneys filed a lawsuit on behalf of a stockholder John Lauriello, alleging fraudulent insurance information was given in court by MedPartners and its insurers.

The plaintiffs allege that MedPartners and its insurers hid the fact that unlimited insurance coverage was available at the time of the initial class action in 1998, enabling them to settle for $56 million, instead of $3 billion in stockholder losses, according to court documents.

Planned Parenthood Fraud



In 2011, Susan Thayer filed an action on behalf of the United States and the State of Iowa against Planned Parenthood of the Heartland, Inc. It alleges that Planned Parenthood violated the federal False Claims Act and its Iowa state analog. Thayer's complaint asserted that her former employer submitted false or fraudulent claims for Medicaid reimbursement by seeking payment for services that were either not reimbursable at all or not in the amounts sought. Thayer claimed her knowledge of Planned Parenthood's billing practices was gained during her years of employment as a manager of two of the organization's clinics in Iowa.

Planned Parenthood moved to dismiss the complaint on the grounds that Thayer failed to allege fraud with particularity as required by Federal Rule of Civil Procedure 9(b). The United States District Court for the Southern District of Iowa granted Planned Parenthood's motion, ruling that Thayer did not satisfy Rule 9(b) because she did not plead any "representative examples" of the alleged fraudulent conduct. Thayer appealed.

On August 29, 2014, the United States Court of Appeals for the Eight Circuit largely reversed the district court's decision, holding that an FCA plaintiff who pleads details of the defendant's billing practices and personal knowledge of the defendant's submission of false claims does not need to provide representative examples of the false claims in order to satisfy Rule 9(b).

Reimbursements at higher rates than permitted and the plaintiff alleged that every claim submitted over a sixteen-year period was fraudulent, but did not identify the details of any of the allegedly false claims. The Court dismissed Joshi's complaint for failing to plead fraud with particularity under Rule 9(b), holding that because Joshi was a doctor rather than a member of the hospital's billing department, he could not plead that false claims were actually submitted. Therefore, in order to establish a factual basis for the allegedly systematic practice of presenting false claims, the Court held that he would have to provide representative examples.

Declining merely to employ the test it adopted in Joshi, the Court observed that Thayer's allegations were based on personal knowledge of the billing practices at issue, suggesting greater reliability than the allegations in Joshi's complaint. In these circumstances, the Court held, the complaint could satisfy Rule 9(b) by identifying particular details of the alleged scheme, without the necessity of providing specific examples. Applying this standard to Thayer's allegations, the Court reinstated the majority of her claims, effectively reversing its own earlier decision in Joshi.

Coming soon after the Third Circuit's June 2014 ruling, the Thayer decision tips the balance, suggesting that the federal courts may coalesce around a more flexible standard for FCA complaints, rather than a strict requirement for representative examples. Such a development should be welcomed by whistleblowers who uncover FCA violations, because they are often unable to provide actual billing records.

Possible Types of Fraud in Nursing Homes



A common type of fraud in nursing homes is unnecessary billing for tests and medical procedures. A nursing home may prescribe an extremely expensive medication to a patient when the reality is that he or she doesn't need that medication at all. The patient may receive medical procedures that are not required to treat his or her condition, and these procedures may even cause unnecessary pain to the patient. Family members have the right to question the medications and procedures administered to their loved one, and they should not be afraid of critiquing the use of certain medications and procedures. It may even be wise to have a second medical opinion when a patient is receiving costly drugs or requires expensive medical procedures. These expensive medications and procedures may be another way to provide “kickbacks” to pharmaceutical companies and other entities. These “kickbacks,” however, are considered illegal in the United States and violate the Fair Claims Act.

ONE SUCH EXAMPLE

Two courageous nurses who worked at Momence Meadows Nursing Center reported that they had  witnessed fraudulent billing practices at the facility to government officials who in turn conducted an investigation into how owners of the facility were providing care. After determining that the allegations of the nurses’ were well founded, the nurses were then permitted to pursue the matter against the nursing home on the government’s behalf in a case referred to as a false claims act lawsuit.

After hearing the evidence in this case, a jury in Federal Court of Southern Illinois reached a verdict against the former owner of the facility.  All told, the jury awarded approximately $28M based upon the fraudulent billing at the facility– billing for services either never provided or provided in an inferior manner. As individuals who initiated this fraudulent billing lawsuit, the nurses are entitled to a percentage of the verdict– reported to be approximately $7 million.