Whistleblowers brought two False Claims Act lawsuits for Medicare fraud against UnitedHealth Group, Inc. the first in 2011 and the second in 2014. On August 28, 2014, the Department of Justice joined the two complaints against UnitedHealth. In both lawsuits, whistleblowers alleged that UnitedHealth billed Medicare for hospice care for patients who did not actually need hospice care. According to the 2011 lawsuit, employees were offered a 20% bonus for a large amount of patients, and penalized if too many patients were discharged because they did not require hospice care. The whistleblowers who reported the misconduct were either disciplined or fired as a result.
Whistleblowers are the main source of information regarding employers and companies who engage in misconduct or violate Federal Securities Laws. Recently, there have been changes and improvements to whistleblower protection laws that protect whistleblowers from employer retaliation, but still, whistleblowers are being punished for doing a good deed.
In the lawsuit against UnitedHealth, patients who qualify for hospice care are not expected to live beyond six months. Because of their short time left, hospice care is provided to make the rest of their lives easier and better. In exchange, these patients will no longer receive Medicare coverage, saving them money. However, UnitedHealth’s scheme involved reporting patients who both qualify and more importantly, do not qualify for hospice care to Medicare. By fraudulently reporting unqualified patients to Medicare, UnitedHealth was being paid for hospice services for as long as those patients lived. This misconduct dates back to 2006.
If you think you have a whistleblower/false claim, contact The Evans Law Firm, Inc. at 415-441-8669 or by e-mail at firstname.lastname@example.org. The Evans Law Firm handles qui tam (whistleblower/false claim) actions, insurance/banking/consumer fraud, personal injury, physical and financial elder abuse.