According to current figures from the U.S. Department of Justice, since 2009, legal claims brought under the federal False Claims Act have led to the recovery of more than $23.9 billion. About 63 percent of that -- more than $15.2 billion -- has been recovered from cases involving fraud against health care programs, including Medicaid and Medicare.
The qui tam provisions of the Act allow whistleblowers to file lawsuits on behalf of the government, and the whistleblowers may receive a significant percentage of the amount recovered. In one of the most recent False Claims Act cases, four whistleblowers sued two cardiovascular disease testing laboratories, claiming the labs billed Medicare for unnecessary medical tests and paid kickbacks to doctors.
Health Diagnostics Laboratory Inc (HDL) and Singulex Inc settled the claims by agreeing to pay a total of $48.5 million. HDL will be responsible for $47 million, while Singulex will pay $1.5 million.
Specifically, the labs are believed to have paid doctors between $10 and $17 per patient whom the doctors referred to the labs for blood testing.
The kickbacks and fraudulent billing allegedly occurred on HDL's part between November 2008 and January 2015, and on Singulex's part between January 2010 and October 2014.
Neither company admitted guilt in the settlement. The Justice Department has not yet determined how much each of the four whistleblowers will receive for their roles in the recovery.
The attorneys of Shepherd, Finkelman, Miller & Shah have experience in handling a variety of kinds of whistleblower lawsuits and qui tam claims, including claims of kickback violations and Medicare and Medicaid fraud. To learn more, please see our qui tam recovery overview.