Dive Brief:
- A whistleblower lawsuit filed in Miami federal court by an ex-executive of Plaza Health Network alleges the non-profit company scammed the federal government for $130 million.
- The FBI, the Miami US Attorney's Office and attorneys with the civil division the Department of Justice are investigating as a result of accusations made by Steven Beaujon, Plaza Health's chief financial officer from September 2002 to February 2012. Beaujon stands to collect a substantial reward if his allegations prove true.
- According to Beaujon's 2012 lawsuit, Plaza Health's CEO and its board of directors concocted a scheme to dole out secret kickbacks to dozens of south Florida physicians who referred hundreds of Medicaid and Medicare patients to Plaza Health's eight nursing and rehabilitation centers. Plaza Health allegedly used the patients to submit false claims to Medicaid and Medicare for therapy services that were never provided or charged at inflated cost. The chief executive and head of the board of directors declined comment.
Dive Insight:
This ex-executive's accusations are nothing short of salacious—especially considering 64-year-old Plaza Health Network's great reputation for providing care and services to "senior citizens of all denominations who can no longer take care of themselves," as the Miami Herald noted. Yet as good as the FBI is at unearthing big schemes, Medicare and Medicaid fraud still persists, and is expected to continue, accounting for more than $200 billion in annual healthcare spending, according to some estimates.