Four former employees of William Beaumont Hospitals in Detroit, Michigan turned whistleblower and filed separate lawsuits under the federal civil False Claims Act. These lawsuits claim their employer made false claims in billing Medicare.
These false claims included:
- payment for physicians which was above fair marker value,
- payment for unneeded services
- payment for services not provided, and
- making referrals to other doctors in their own group for additional billing to Medicare.
Once these Plaintiffs filed their lawsuits, the United Stated Department of Justice stepped in and took over the lawsuits. On August 2, 2018- the Department of Justice announced the lawsuits settled for $84.5 million dollars.
Qui tam lawsuits are whistleblower lawsuits brought under the False Claims Act. The False Claims Act rewards whistleblowers in successful cases where the government recovers funds lost to fraud. If the government intervenes in the lawsuit, the whistleblower, or “relator,” is entitled to 15-25% of the recovery. Alternatively, if the government doesn’t intervene in the case, the whistleblower reward is between 25 and 30 percent of the recovery. Defendants found liable under the False Claims Act may have to pay as much as three times the government’s losses plus penalties for each false claim.
There is also a Tennessee False Claims Act which would apply to the same type of claims made to the State of Tennessee.
If you are aware of someone who receives payment from a governmental agency and has committed fraudulent billing; feel free to contact our office to discuss. We have handled Qui Tam cases previously and can help you determine if you have a valid claim and if so, what your next steps should be.