Court dismisses Florida Medicare fraud suit

The U.S. 11th Circuit Court of Appeals affirmed the dismissal of a former employee’s lawsuit alleging Miami-based Sun Healthcare Group committed Medicare fraud, according to documents released by the court.

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The court’s decision said that the case brought forth by ex-employee Margaret Jallali lacked specific allegations of a false claim for government reimbursement.

In 2015, Ms. Jallai filed a lawsuit against Sun Healthcare alleging that employees changed patient records and partook in other improper documentation practices. She also alleged that the organization violated the Anti-Kickback Statute by paying employees for falsifying records.

The government declined to take part in the lawsuit.

On appeal, Ms. Jallali argued that U.S. District Judge Kathleen M. Williams ruled erroneously. She also said that the court should not ignore testimonies from former employees detailing the organization’s misdeeds.

In response, Sun Healthcare argued that Ms. Jallali’s allegations were insufficiently supported.

According to the opinion released by the 11th Circuit Court, Ms. Jallali’s alleged personal knowledge of Sun Healthcare committing billing fraud was not enough to allow the case to go forward.

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