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Whistleblowers Use False Claims Act to Expose Medicaid and Medicare Fraud And Recover Huge Payoff

above-the-bar-logo-no12.jpgThe U.S. Department of Justice (“DOJ”) recently settled allegations with Medronic, Inc., the world’s larges maker of heart rhythm devices, who agreed to pay $23.5 million for violating the False Claims Act. The DOJ had charged the device maker with paying kickbacks to physicians who implanted its pacemakers and defibrillators in patients.

The lawsuits were commenced by whistleblowers under the qui tam provision of the False Claims Act. The whistleblowers will receive over $3.96 million from the government’s recovery. If you have evidence of fraud being committed against the government, our attorneys can help you determine the strength of your claim.

Two lawsuits were filed against Medronic in federal court, one in California and one in Minnesota. The suits charged that the company paid physicians $1,000 to $2,000 for each patient who it implanted with one of the company’s devices, in clear violation of the False Claims Act. Medtronic paid these doctors per implant for participating in studies of these devices, which were already on the market. The device maker then submitted false claims to Medicare and Medicaid using the post market studies and two device registries as a means to pay the physicians who were involved in the kickback scheme.

Tony West, the assistant attorney general for the DOJ’s Civil Division, stated that “Patients who rely on their health-care providers to implant vital medical devices expect that those decisions will be made with the patients’ best interests in mind.” He added that “Kickbacks, like those alleged here, distort sound medical judgments with financial incentives paid for by the taxpayers.”

The qui tam provision of the False Claims Act is probably one of the most important laws to help fight fraud against the government as well as taxpayers. If you have evidence of fraud being committed against the government, you may bring an action on behalf of the government under the False Claims Act. Depending on whether the government takes over your lawsuit, you may be entitled to 15% to 30% of the government’s recovery. Most importantly, you must be the first person to bring the evidence of fraud to the government’s attention.

The fraud committed here was not just about the money but also about whether unbiased medical judgment was used in healthcare. It is unnerving to think that your doctor may have persuaded you to undergo major surgery to implant a device or recommended a certain brand of device because he was receiving a kickback, and not because it was the best medical decision for you. Medicaid and Medicare fraud is a huge problem in the healthcare industry which the government can’t fight and detect on its own. The False Claims statute is very complicated with strict requirements including a detailed process for filing, but the payoff and the satisfaction of exposing fraud can be enormous. If you know of fraud being committed against the government, call our experienced Whistleblower Attorneys at Villanueva & Sanchala at (800) 893-9645 to help you figure out if you have a claim under the False Claims Act.

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Sources:

Minnesota-Based Medtronic Inc. Pays US $23.5 Million to Settle Claims That Company Paid Kickbacks to Physicians, Department of Justice Press Release