Court Grants “Taxpayers Against Fraud” to File Brief Against Stanford, Accused of $468 Million Medicare Fraud

Stanford's $2 billion new "arcade" funded by healthcare fraud funds

Department of Justice Files its Second Statement of Interest in Stanford Medicare Fraud Lawsuit

Taxpayers Against Fraud Education Fund (TAFEF) to file Amicus Brief against Stanford Hospital and Stanford Health Care, in the landmark case U.S. vs. Stanford

WASHINGTON, DC , USA, November 5, 2021 /EINPresswire.com/ -- The Ninth Circuit Court of Appeals newly ordered that the non-profit foundation Taxpayers Against Fraud Education Fund (TAFEF) to file hard copies of their Amicus Brief against Stanford Hospital and Stanford Health Care, in the landmark case United States vs. Stanford Health Care et al.

TAFEF is a United States based organization which supports the Government’s recovery of taxpayer dollars from fraudulent health care providers. Here, TAFEF filed their “friend of the court” Amicus Brief in Court in support of the Government’s lawsuit against Stanford for nearly $500 million of alleged Medicare billing fraud.

The federal watchdog group and public interest non-profit organization filed its independent support of the false claims action (“FCA”) against Stanford Health Care. The Complaint brought on behalf of the U.S. Government alleges Stanford engaged in a decade long fraud on the Government in excess of $468 Million, medical claims which Stanford filed primarily against the aged and disabled.

The Complaint factually alleges a number of key schemes in which Stanford Health Care and its surgeons including breast cancer surgeon Dr. Fred Dirbas freely took advantage of a flawed medical payment system by habitually upcoding and unbundling major surgical codes, They also charged exorbitant fees for otherwise free services under Medicare. The alleged schemes included that Stanford "cattle-prodded" their doctors and billers to bill high and maximal in every case, regardless of lack of medical documentation or medical necessity. The suit also asserts that Stanford University surreptitiously collected unlawful money from Stanford Hospital through an undisclosed slush fund entitled the "Dean’s Tax". Stanford used the unlawful Medicare funds to monetize Stanford's new $2 billion dollar “arcade” which opened in late 2019.

The Complaint explains that Stanford executives and department managers pushed aggressive billing, and maintained a culture of pushing profits at any cost. It also alleges that Stanford also habitually manipulated and altered medical records to upcode time and units of surgical supplies, many of which were never used.

The Complaint in Federal Court alleges that Stanford began its scheme on or about 2008 whereby Stanford exploited a newly implemented “EPIC” electronic medical record system and fraudulently circumvented loopholes in medical billing. The suit alleges that Stanford upcoded services resulting in hundreds of thousands of unlawful health insurance claims and that Stanford egregiously instructed and required that its medical billers and coders always bill at the maximum level and fees, regardless of medical necessity, lack of substantiating medical records, and failure to adhere to national Correct Coding Initiatives (CCI). The complaint further alleges Stanford’s failure to mitigate or cease the conduct once put on notice and demanded to cease unlawful billing.

The lawsuit alleges that Stanford knew they were submitting fraudulent claims and failed to correct their misconduct because they demonstrated repeated willingness to send refund check after refund check to certain patients multiple times in 2017 and 2018 and 2021 for admitted upcoded billings. The patients then made these refund checks available to the Department of Justice (DOJ). Stanford is also alleged to periodically unlawfully write off certain patient balances when the patients detected the upcoding and filed grievances.

The Federal lawsuit brought on behalf of the United States Government against Stanford Hospital, captioned, United States vs. Stanford et. al. (Case No. CV 17-08726-DSF) (AFMx) is a live case in now before the Ninth Circuit Court.

GLORIA JUAREZ LAW OFFICES OF GLORIA JUAREZ +1 949-288-3402
email us here