In one recent case, an Alabama nurse was awarded $15 million for blowing the whistle on fraud committed by a national home healthcare company where she was formerly employed.
Her recovery was calculated as a percentage formula based upon the $150 million that Baton Rouge corporation Amedisys, Inc. agreed to pay in a settlement agreement with the U.S. Attorney for the Northern District of Alabama. The Justice Department argued that the company made false claims for Medicare and other government healthcare insurance program. The company, although agreeing to the settlement, has denied any wrongdoing.
Nurse April Brown filed a federal lawsuit in Birmingham against Amedisys. The lawsuit claimed that the company violated the False Claims Act by submitting false home healthcare billings to Medicare for home health services.
Brown claimed that Amedisys was asking her to bill for services she was not actually providing or that were not necessary. It was also alleged that company forms made the patients appear more ill than they actually were. Nurse Brown was fired after questioning what she believed to be corrupt practices.
The False Claims Act is contained in the federal statutes 31 U.S.C. Sections 3729 through 3733. Sometimes referred to as the Qui tam law, it allows persons and entities with evidence of fraud against federal programs or contracts to sue the wrongdoer on behalf of the United States Government. In Qui tam actions, the government has the right to intervene and join the action. If the government declines, the private plaintiff may proceed on his or her own. If there is a settlement or judgment against the wrongdoer, then the whistleblower who filed the claim receives a portion of the proceeds as a reward.