Under The False Claims Act
A meaty whistleblower award of 25% went to a courageous individual for exposing Medicare Fraud by filing a False Claims Act lawsuit with her whistleblower law firm. Based on the $1.6 million settlement, the courageous individual stands to receive $400,000 as a representative whistleblower award. The False Claims Act was enacted to prevent and penalize fraudulent billing against the federal government, which in turn hurts the taxpayers. The Act has proven to be extremely successful, particularly in the last decade, through the diverse fraud recoveries and settlements arrived at through various judgments and cases. Recently, the U.S. Department of Justice made two large recoveries against healthcare companies that indulged in illegal activities by committing Medicare Fraud. The False Claims Act, through its whistleblower or qui tam provision, empowers private individuals and entities to report companies that seek to enrich themselves by causing a loss to public funds. A qui tam complaint through the False Claims Act (FCA) must be filed with the use of a whistleblower law firm.
Shreveport Prosthetics, Inc., a Louisiana based corporation which provides extremity prosthetics for different body parts, recently agreed to pay $1.6 million apart from interest to the Federal Government for violating provisions of false billings under the Medicare program via the False Claims Act. An office administrator who also worked as a billing specialist initiated the whistleblower lawsuit through the qui tam whistleblower provisions of the False Claims Act.
The settlement was reached based on allegations that Shreveport Prosthetics was routinely waiving off patients’ Medicare and Medicaid coinsurance amounts for over three years. Allegations also include Shreveport Prosthetics, Inc. funneling its claims to Medicare through a supplier in Texas, despite services being rendered in Louisiana when its Medicare provider number was deactivated. This resulted in the U.S. Federal healthcare system, Medicare, being overcharged for the billed services. This case was prosecuted by the United States Attorney’s Office.
Shreveport Prosthetics, Inc. has also entered into a three-year Corporate Integrity Agreement (“CIA”) with the Office of the Inspector General (OIG) to ensure strict compliance with all the healthcare norms, statutes, and written directives of Medicare and other federal health programs as part of the settlement. Meanwhile, the whistleblower, Kimberly Throgmorton, has been awarded over 25% of the settlement amount to not just reward her for reporting such an unlawful practice, but to also incentivize whistleblowers under the qui tam provisions of the False Claims Act, to report such practices and assist the U.S. government in investigating and preventing such unlawful practices.
It should be noted the claims were settled without any determination of liability. The Department of Justice and the Department of Health and Human Services, on their part, assured the public that through their enhanced co-operation, they will reduce and prevent Medicare and Medicaid financial fraud, particularly using the modalities of the powerful False Claims Act. They further urged whistleblowers to assist them in ensuring that the integrity of the federal healthcare system is not compromised by availing the qui tam provisions of the False Claims Act.
It is critical for individuals aware of Medicare or Medicaid Fraud to speak with a whistleblower law firm. Some of the best whistleblower law firms dedicate a portion of their practice to litigating whistleblower claims, like Brown, LLC, led by a former FBI Special Agent, Jason T. Brown. If you know about systemic Medicare Fraud or Medicaid Fraud you should speak with a whistleblower lawyer right away to educate yourself about your rights and responsibilities.
 United States ex rel. Throgmorton v. Shreveport Prosthetics, Inc., et al., No. 17-881 (W.D. La.).
The United States Attorney’s Office, Western District of Louisiana, Shreveport Prosthetics, Inc. Agrees to Pay $1.6 Million to Resolve False Claims Act Allegations, September 10, 2020, https://www.justice.gov/usao-wdla/pr/shreveport-prosthetics-inc-agrees-pay-16-million-resolve-false-claims-act-allegations#:~:text=Van%20Hook%20announced%20that%20Shreveport,billings%20to%20the%20Medicare%20program.