Former Call Center Employee Blew Whistle On Alleged Fraud
Allegations Of Kickbacks And Ineligible Recipients
Waived Co-Pays Illegal
Healthcare providers of all sorts receive revenue from government reimbursements under government-sponsored health programs like Medicare, Medicaid, and the VA. Health care spending in the U.S. reached $3.8 trillion in 2019, and whenever there is that much money, there’s bound to be fraud. Healthcare fraud costs the government billions every year, and private individuals do more to recover that money for the government than the government itself does. Under the False Claims Act (FCA), 31 U.S.C. §§ 3729 et seq., individuals are authorized to bring actions on behalf of the government, known as “qui tams.” The individuals bringing the cases are referred to as “relators.” 31 U.S.C. § 3730(b). Individuals with knowledge of the fraud can be rewarded for bringing suit if the government recovers against the offending companies. 31 U.S.C. § 3730(d). If you have credible information of Medicare fraud, illegal kickbacks or other healthcare fraud in San Diego 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).
Alleged Fraud By Mail-Order Diabetes Testing Firm
In a recent settlement announced by the U.S. Department of Justice, a large mail-order diabetic testing supplier, and its parent company have agreed to pay $160 million to resolve allegations that they violated the False Claims Act. The settlement resolves allegations that defendants made, or caused, claims to Medicare that were false because kickbacks were paid to Medicare beneficiaries, patients were ineligible to receive meters, or patients were deceased. The case alleged that the companies paid kickbacks to Medicare beneficiaries by providing them “free” or “no cost” glucometers and by routinely waiving, or not collecting, their copayments for meters and diabetic testing supplies. Defendants also allegedly routinely waived, and failed to make reasonable efforts to collect, Medicare copayments. It allegedly failed to send invoices to beneficiaries, and failed to take other basic steps, like sending collection letters or making phone calls, to collect copayments. The settlement also resolves allegations that the supplier billed Medicare for products without regard to the patients’ eligibility for one. Finally, the settlement resolves claims that the company submitted false claims to Medicare on behalf of deceased beneficiaries. A former employee of defendant’s call center blew the whistle on these practices and is eligible for 15-25% of the $160 million settlement.
Claims For Wrongful Termination
Although the relator in this case was a former employee, often current employees are the individuals who have the original information of the fraud. Current employees, agents, executives, officers, and others are protected from employer retaliation for bringing false claims qui tam cases. 31 U.S.C. § 3730(h). But despite this legal protection, employers continue to retaliate against whistleblowers. If you are fired because you brought any fraud to light, however, you can fight back under the False Claims Act which prohibits retaliation against you for exposing the wrongdoing. 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:email@example.com”>firstname.lastname@example.org</a>. In addition to FCA and CFCA whistleblower cases, Ingrid and Evans Law Firm, Inc. also handle 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 cases in any way. The qui tam case is captioned United States ex rel. Goodman v. Arriva Medical LLC et al., Case No. 3:13-cv-00760 (M.D. Tenn.).