Department of Justice Rewards Medicare Whistleblower

Physician Gets Large Whistleblower Award

Recently, the Department of Justice (DOJ) awarded a physician over $11 million as an award for original information the doctor provided about large-scale Medicare fraud. Specifically, the whistleblower’s information led to a lengthy DOJ investigation that recouped $60 million plus interest from his former employer for its wrongdoing. The whistleblower’s information revealed large scale violations of the False Claims Act, a federal law imposing liability on persons and companies (typically federal contractors) who defraud governmental programs, such as Medicare and Medicaid.

The whistleblower case (also known as a qui tam case) is a great example of how citizens can assist the government in fraud prosecutions and receive big rewards for doing just that. The fraud was an overcharging scheme, on a huge scale. The whistleblower’s former employer offered bonus money to physicians based on the services they provided and penalized hospitals that did not meet billing targets. These tactics resulted in doctors billing Medicare, Medicaid and insurance companies for more comprehensive and more time-consuming services than doctors actually delivered.

Based on the whistleblower’s information, the DOJ launched a multiyear investigation that resulted in the huge recovery. Last year in total the DOJ recovered more than $4.7 billion in settlements and judgments under the False Claims Act. The majority of those False Claims Act cases were in the healthcare industry and began as whistleblower or qui tam cases. Over 700 whistleblower or qui tam suits were initiated during last year alone. In the past six years, the government has paid out some $3 billion to individual whistleblowers as awards for information.

Contact Us

If you have information regarding Medicare or Medicaid fraud and are looking to be a whistleblower in San Mateo County or in any California county, contact the Evans Law Firm elder attorneys at (415) 441-8669, or by email at info@evanslaw.com. Our attorneys have experience with complex qui tam or whistleblower cases, complex financial contract cases and cases against large insurance companies. We can help guide your case through a jury trial or toward an equitable settlement. We also handle cases involving physical and financial elder abuse, nursing home abuse, whole life insurance and universal life insurance, and indexed, variable, and fixed annuities.