June 19, 2013 — Every year, the U.S. Justice Department employs the federal False Claims Act to recover millions of tax dollars stolen from the government through Medicare fraud. The qui tam provisions of the False Claims Act allow health care workers who discover Medicare overbillings to bring a lawsuit against the unethical health care providers involved and retain a percentage of any monies collected. Health care workers, such as employees in dialysis clinics or hospitals, are often the best situated to observe fraudulent billings when they occur and notify the government.
Texas Dialysis Company Settles False Claims Act Suit
A Plano, Texas company, U.S. Renal Care, has settled a whistleblower lawsuit filed under the False Claims Act for $7.3 million. The False Claims Act lawsuit was filed by Laura Davis under the qui tam provisions of the Act. Ms. Davis will keep a share of the government’s recovery — in this case, $1,314,000.
U.S. Renal Care, which runs over a hundred outpatient dialysis facilities across the country, acquired Dialysis Corporation of America (DCA) in June 2010. The suit alleged that DCA submitted false claims to Medicare for more Epogen than dialysis patients at DCA facilities actually received.
Patients with renal disease use Epogen to manage their anemia, a common condition for end-stage patients. Epogen is administered intravenously from vials that hold a small amount of overfill to make up for unusable medication that remains in the vial or the syringe during an injection. According to the Justice Department, between 2004 and 2011, DCA submitted repeated claims to Medicare seeking reimbursement for the ten to eleven percent overfill. The government maintains, however, that the type of syringes DCA used made it impossible for the health care provider to extract and use the overfill. Therefore, the government alleged, DCA submitted false claims to Medicare because the provider overstated the amount of Epogen actually administered to patients.
Health Care Insiders First to Spot False Claims Act Violations
False Claims Act violations involving overbillings for prescription medication, like this one, often are revealed when concerned insiders notify the government. Informants who are brave enough to collaborate with the Department of Justice should know their rights before stepping forward. With Medicare fraud lawyers across the country, Waters & Kraus offers whistleblowers the experienced legal representation they need. Contact us by email or call our False Claims Act lawyers at 855.784.0268 to learn more about our qui tam practice.
