I have said it before—if you want to know where the next big whistleblower case will come from, “follow the money.” In the United States, if you follow the money, it will lead you to health care. Healthcare comes into play in False Claims Act cases because the federally-funded Medicare and Medicaid programs pay the vast majority of medical bills. As a result, if you commit fraud in the medical industry, you are likely defrauding the U.S. government. As you probably know from other blog posts I have posted, if you cheat the U.S. government through over-billing or selling sub-par services—whether it is a missile, a mammogram, or mortgage-backed security—you are violating the False Claims Act, a 150-year-old law written to prevent war profiteering. I found the following False Claim Act case to be an excellent example of the sort of case, and whistleblower bounty, that entices employees in the medical industry to come forward about fraud. I have provided a link to the Department of Justice’s press release if you want to read more about the DaVita settlement.
If you are considering becoming a whistleblower here in Mississippi, you will need the help of an experienced whistleblower attorney. Contact Barrett Law now at (601) 790-1505 to attain the guidance you require.
DaVita Medical will Pay $270 Million—Whistleblower to Receive $10.2 Million
DaVita Medical Holdings has agreed to pay $270 million to settle False Claims Act violation allegations related to fraudulent billing information submitted by DaVita contractors in an attempt to attain inflated Medicare payments. The facts of this case illustrate how one does not even have to work for the government contractor in question, but instead can be a sub-contractor or sub-sub-contractor and still be a whistleblower.
Physicians contracting for DaVita submitted incorrect diagnosis codes. DaVita collected and submitted diagnoses and received a share of the payments. In one example, physicians used an improper code for a spinal condition treatment that increased reimbursement. The case against DaVita alleged that it provided guidance to the doctors that resulted in fraudulent diagnosis aimed at increasing DaVita’s profits.
Due to DaVita’s self-disclosure of this fraud and decision to cooperate with the Department of Justice’s investigation, the U.S. agreed to a settlement that was less than what DaVita might have paid had the matter been fully prosecuted. DaVita agreed to pay $270 million which settles whistleblower allegations.
A whistleblower brought these allegations of fraudulent billing and diagnosis under the qui tam, or whistleblower, provisions of the Federal False Claims Act. The whistleblower in this action is James Swoben, who was a former employee of a medical provider that subcontracted with DaVita. Swoben will receive $10,199,100 for the settlement of these allegations.
What Should You Do if You are Considering a Whistleblower Claim?
Do you know about fraud occurring within the medical industry? Are you considering filing a whistleblower case? The reward for submitting a successful claim can be massive, as this DaVita case illustrates. But you will only receive this sort of award with the help of an experienced False Claims Act attorney. The United States Department of Justice gets thousands of potential whistleblower claims each year, and only those that are reported in a way that triggers their interest are investigated. Contact Barrett Law now at (601) 790-1505.
Experienced Mississippi whistleblower lawyer Barrett can provide you with the advice you will need to file a successful qui tam case. Having expert legal advice by your side can mean the difference between receiving your share of a whistleblower reward and losing your career and livelihood. Call us today.
