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Nov 9, 2023 by |

San Francisco False Claims Act Whistleblower Attorney: Whistleblowers Receive $5 Million in Record Health Care Fraud Settlement


Two Former Employees Blow Whistle On Alleged Fraud

Alleged Overbilling For Oxygen Equipment

Whistleblowers Will Share $5,655,000 Reward

Civil lawsuits under the False Claims Act, (“FCA”), 31 U.S.C. § 3729 et seq., may be brought by private citizens to recover money fraudulently obtained from the government by suppliers, contractors, service providers and others.  In Fiscal Year 2022, private citizens and businesses helped the government recover $1.9 billion in cases of fraud against the government.  The private individuals or businesses, known as “relators,” brought the cases, referred to as “qui tam” cases,” under the FCA. If the government recovers, these individuals are eligible for rewards. 31 U.S.C. § 3730(d).  Much government fraud, and the majority of the qui tam cases brought every year, relate to fraud in the healthcare field, under programs like Medicare and Medicaid (known as Medi-Cal in California).  Relators of fraudulent conduct are often employees or managers, or former employees or managers, or (in healthcare cases) patients of the business engaging in the fraud.  If you have credible information of fraud against the government in violation of the FCA in 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 Settlement[1]

In a recent press release by the U.S. Department of Justice (DOJ), a medical equipment provider agreed to pay $29 million to settle charges that it violated the FCA by overbilling Medicare and Medicare Advantage Plans for oxygen equipment provided primarily to elderly patients. The settlement stems from a whistleblower suit filed by two former employees of the equipment provider. In this settlement, the whistleblowers are set to receive $5,655,000.

The case centers around oxygen equipment leased to patients with respiratory ailments such as Chronic Obstructive Pulmonary Disease (COPD). The U.S. Attorney’s press release explains that traditional Medicare (also known as Medicare Part B) reimbursed defendant for the lease payments on oxygen equipment, but after three years of monthly lease payments, defendant was required to continue to provide the oxygen equipment to the patient, but was not eligible for additional rental payments because Medicare had already reimbursed the provider for the full purchase price of the equipment.

“One of the most important responsibilities we have is protecting vulnerable members of our community such as the elderly,” said U.S. Attorney Vanessa Waldref. “Elderly members of our community are among the most likely to be targeted by fraud, false billing scams, and abuse. This is one reason that the U.S. Attorney’s Office, the Department of Justice, and our law enforcement partners, have made combatting elder fraud and abuse a top priority.”

How A Qui Tam Action Begins

Any False Claims Act whistleblower case begins by a relator filing a complaint under seal in the federal court usually for the District in which the defendant is located or does business. At the same time, the relator submits a disclosure to the DOJ outlining the material evidence the relator has of the alleged false claims. 31 U.S.C. § 3730(b). The seal period of the complaint lasts 60 days during which the DOJ investigates the claims.  31 U.S.C. § 3730(b)(2). (If necessary, the government can, and often does, extend the 60-day period during which the allegations are kept under seal.)  If the government decides to intervene in the case, the government essentially takes over the litigation. 31 U.S.C. § 3730(c)(1).   If the government declines to intervene, the relator may proceed with the litigation on his or her own.  31 U.S.C. § 3730(c)(3).

Contact Us

If you have credible information of government fraud in San Francisco or elsewhere in California, call Ingrid M. Evans at (415) 441-8669, or toll-free at 1-888-50EVANS (888-503-8267) or by email at <a href=””></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. 

[1] Evans Law Firm, Inc. was not involved in the case in any way. 

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