Allegations Of Medicare Payments For Non-Covered In-Patient Admissions
Ineligible Admissions For Non-Medical Reasons
Former Medical Center Employee Blew Whistle
Private whistleblower suits (known as qui tam cases) under the False Claims Act (FCA), 31 U.S.C. §§ 3729 et seq., recover billions for the government every year from companies and individuals defrauding it. In fiscal year 2020, the DOJ recovered $1.8 billion in FCA qui tam settlements and judgments involving the health care industry in particular. Private parties bringing these qui tam suits under 31 U.S.C. § 3730(b)(1) are referred to as “relators” under the statute but are more commonly known as whistleblowers. Whistleblowers personally recover anywhere from 15% to 30% of the damages and penalties or settlement once the government recovers. 31 U.S.C. § 3730(d). If you have credible information of fraud against the government here in San Mateo County, San Francisco, or elsewhere in California, call us today at (415)441-8669 and we can help. Our toll-free number is 1-888-50EVANS (888-503-8267).
Recent County Medical Center Settlement
The U.S. Department of Justice (DOJ) recently announced a settlement with San Mateo County Medical Center of certain False Claims Act allegations brought against the Center in a qui tam case. In the reported settlement, the Center agreed to pay approximately $11.4 million to resolve alleged violations of submitting or causing the submission of claims to Medicare for non-covered inpatient admissions. The United States alleged that for a period of years the Center admitted certain patients for whom inpatient care was not medically reasonable or necessary, including patients who were admitted for reasons other than medical status, including social reasons and lack of available alternative placements. The Center allegedly billed Medicare for such patients despite allegedly knowing that the costs for admitting them were not reimbursable by Medicare.
Remedies for Employer Retaliation
The reported case was brought by a former employee of the defendant medical center. The False Claims Act protects employees against retaliation from their employers for blowing the whistle on fraud against the government. Despite the legal prohibition companies continue to retaliate against whistleblowers. But the law allows employee whistleblowers to fight back. 31 U.S.C. § 3730(h). If you are fired because you brought any fraud to light, you may be entitled to sue your employer in court and seek double back pay (with interest), reinstatement, reasonable attorneys’ fees, and reimbursement for certain costs in connection with the litigation. 31 U.S.C. § 3730(h)(2). Evans Law Firm, Inc. can represent you in any action for retaliation as well as represent you in your underlying whistleblower application.
If you have credible information of government contractor fraud against Medicare or Medi-Cal call Ingrid M. Evans at (415) 441-8669, or toll-free at 1-888-50EVANS (888-503-8267) or by email at <a href=”mailto:firstname.lastname@example.org”>email@example.com</a>. In addition to FCA and CFCA whistleblower cases, Ingrid also handles bank fraud whistleblower cases under FIRREA/FIAFEA, commodity trading and securities fraud under the Commodities Futures Trading Commission Whistleblower Program and the Securities and Exchange Commission Whistleblower Program, and tax fraud under the Internal Revenue Service Whistleblower Program.
 Evans Law Firm, Inc. was not involved in the case in any way. The qui tam case is captioned United States ex rel. Levy v. San Mateo County and the San Mateo County Medical Center, Case No. 16-CV-5881 (N.D. Cal.).