November 18, 2013 — Sometimes the government uncovers False Claims Act violations in the health care industry without help from insiders. But much of the time, the Justice Department has assistance from conscientious whistleblowers who collaborate with the government. The federal False Claims Act includes qui tam language that enables tipsters to fight fraud directly by filing a claim in federal court for the government’s benefit. To reward whistleblowers with the strength to do the right thing, the Act allows informants to share any proceeds from the suit.
Three Former Employees Plead Guilty for Roles in $20 Million Power Wheelchair Fraud Scheme
Jacob Kilgore, the former co-owner of a medical equipment supply company in Salt Lake City, Utah, has been indicted for his part in an alleged $20 million Medicare fraud scheme. The alleged scheme involved power wheelchairs sold by Orbit Medical Inc. (Orbit). In addition to being a co-owner of the business, Kilgore was also the vice president and regional sales manager.
Between September 2008 and June 2011, reports the Department of Justice, Kilgore crafted a scheme to submit false claims to Medicare for power wheelchairs. Kilgore and former Orbit employees allegedly falsified physicians’ chart notes and prescriptions for power wheelchairs so it appeared that Medicare beneficiaries were eligible to receive Medicare-reimbursed power wheelchairs when in actuality, they were not. Kilgore and the Orbit employees then relied on the falsified medical records to support phony Medicare reimbursement claims. Three former Orbit sales representatives have pleaded guilty for their part in the power wheelchair scam: Morgan Workman; David Evans; and Hunter Hartman.
The power wheelchair scheme allegedly involved over $20 million in Medicare claims from Orbit. Medicare paid over $15 million in reimbursements to Orbit as a result of the scam.
Informants Help the Government Uncover Phony Medicare Claims
Insiders are often the first to identify Medicare fraud because they may be pressured to take part in it. That’s when many employees choose to file a False Claims Act lawsuit. Waters & Kraus has knowledgeable whistleblower attorneys in Texas, California and Maryland. We realize that many of our clients find themselves in an awkward, frustrating and often frightening spot. When you’re committed to collaborate to stop health care fraud, email us or call our False Claims Act lawyers at 855.784.0268 to talk about what we can do to make the process easier for you.