A doctor and nurse fighting fraud on behalf of federal taxpayers may soon receive more than $110 million for their efforts. The nurse and doctor filed a qui tam lawsuit under the Federal False Claims Act. Although they were working to uncover fraud against government programs, the government did not take up the case and the nurse and doctor battled one of the nation's largest healthcare companies on their own. Like other whistleblowers who bring wrongdoing to light and help the government recover funds paid out due to fraud, the doctor and nurse may be compensated for their efforts in raising the alarm about fraudulent acts.
Doctor and Nurse May Receive $110 Million in False Claims Act Case
The federal False Claims Act encourages whistleblowers to come forward and report fraud against the government by allowing whistleblowers to receive a percentage of any settlement money obtained from the fraudulent individuals or businesses. Whistleblowers may receive as much as 15 to 25 percent of total money recovered in a settlement. Whistleblowers may also have their attorney fees covered if a False Claims Act case ends in a settlement and the government recovers funds.
The case filed under the False Claims Act here was against DaVita Healthcare Partners, which the Atlanta Journal Constitution reports is the largest provider of kidney dialysis services in the nation. The nurse and doctor claimed DaVita Healthcare Partners was intentionally instructing staff members to use vials of a vitamin D supplement called Zemplar that were larger than necessary. Staff members were also instructed to use vials of an iron drug called Venofer that were too large. The remaining drugs in the vial were thrown away and the drugs wasted.
The purpose of the instructions to use vials that were too big was to get more federal reimbursement. The scheme ended up costing hundreds of millions of dollars in taxpayer funds as medical payments were made for drugs that went into the garbage.
When the doctor and nurse brought the case against DaVita Healthcare partners, federal officials did not become involved in the case. The litigation went on for eight years, with the whistleblowers presenting evidence in court about wrongdoing by the dialysis provider. The acting U.S. attorney general for the district noted "exceptional and extensive litigation efforts" were engaged in to bring the corruption to light and protect taxpayers from further loss of funds.
The case has finally been resolved, with DaVita Healthcare Partners agreeing to pay $450 million to settle the allegations against it. The company did not admit wrongdoing, however in court documents it referred to "regrettable mistakes" that had been made. The whistleblowers could receive up to $110 million for their role in bringing the scam to light. The acting U.S. Attorney General praised the courage of the whistleblowers in fighting the case and helping to recover funds for taxpayers.