Medical Justice provides free consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a free consultation – or use the tool shared below.

A qui tam lawsuit allows private individuals to assist the government in a prosecution. The reward for such noble service? Collecting a portion of the proceeds.

More specifically, qui tam allows John Q. Public to make allegations under the False Claims Act, 31 U.S.C. § 3729 et seq. Mr. Public, now a “whistleblower” (or relator) with knowledge of past or present fraud committed against the federal government, either brings suit on his own – or, more frequently, assists the federal government. The whistleblower brings evidence of the allegations, and the government decides whether it will help pursue recovery of funds from those unjustly enriched.

The payout can vary from 15 to 25% of the recovery. Lucrative indeed.

This background serves as a helpful segue to a recent criminal case based on several people bilking Medicare out of $150 M over a decade. And other odious acts.

One protagonist in this saga, Henry McInnis, was convicted by a federal jury of conspiracy to commit healthcare fraud and money laundering, obstruction of justice, as well as six counts of healthcare fraud in November 2019. He was sentenced to 15 years in prison.

McInnis’ partner in the scheme, Rodney Mesquias, was also convicted in the November 2019 trial and was sentenced to 20 years in prison in December 2020. Two other co-conspirators have pleaded guilty and are awaiting sentencing.

Who were these people, and what did they do?

Henry McInnis was CEO of the Texas-based Merida Group of hospice and home health entities. McInnis has no background in healthcare. In a past life, he was employed as an electrician. He was also the “de facto” head of nursing for the corporation.

Hospice programs generally do not admit patients unless they have less than six months to live. No doctor is Nostradamus, and a guess of six months longevity is just that – a guess.

According to a DOJ press release, multiple witnesses testified that McInnis ordered employees at Merida, which has dozens of locations across Texas, to change medical records to make it appear that patients were terminally ill.

“In reality, some were employed or even participating in sporting events,” the DOJ stated.

According to the Department of Justice press release:

McInnis and his partners “directed bribes to physicians under the guise of medical director fees to certify unqualified patients for hospice and home health. In some cases, they improperly offered payoffs to marketers in exchange for recruitment of patients who could be placed on extremely expensive hospice services.”

Some of the “targeted” patients had diminished capacity. Chaplains were directed to patients to deliver last rites.

Many of these patients did not have terminal conditions. Yet, they were told they had months to live. Worse, once these patients WERE enrolled, whatever curative measures these patients would otherwise have received – stopped.

Despicable.

So, patients who did not qualify for hospice services were admitted to hospice. Then they were refused treatments (potentially curative) they would have qualified for had they not been admitted to hospice.

McInnis reprimanded and terminated employees who refused to play along.

Mix that with “McInnis and Mesquias us[ing] the extra funds to buy luxury vehicles, clothing, jewelry, real estate, sporting event tickets, and security services.” What do you have?

Qui Tam. I actually do not know if a whistleblower assisted the Department of Justice in this conviction. If one did, and the amount recovered was $150M, well, you can do the math.

What do you think? Let us know your thoughts in the comments below. In closing, Medical Justice is equipped to address a bevy of medico-legal threats. Visit our consultation page to schedule a complimentary consultation with our Founder and CEO, Jeff Segal, MD, JD.

Medical Justice provides free consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a free consultation – or use the tool shared below.

Learn how Medical Justice can protect you from medico-legal mayhem… 

Jeffrey Segal, MD, JD

Chief Executive Officer and Founder

Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Dr. Segal was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.

Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.

In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.

Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. Byrd Adatto was selected as a Best Law Firm in the 2021 edition of the “Best Law Firms” list by U.S. News – Best Lawyers. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.