Residents of Wisconsin may be interested to learn that a company recently agreed to pay over $14 million to the United States in order to settle a Medicare fraud lawsuit. Purportedly, the former regional vice president of Sound Physicians acted as a whistleblower and reported his company’s misconduct. The company has allegedly cheated the government out of millions of dollars.
According to the lawsuit, Sound Physicians had been upcoding its bills to Medicare, thus resulting in a higher payout. The whistleblower stated that internal audits of the company revealed as many as 90 percent of the company’s physicians’ visits with patients were upcoded to a more expensive level than those supported by patient records. The results of the audit revealed that Medicare had overpaid Sound Physicians to the tune of tens of millions of dollars.
He went on to state that, after discovering the issue, he expressed his concerns with company executives only to have his claims rebuffed. The case itself has lasted around four years, during which time the whistleblower and his family have suffered tremendous stress. With rising health care costs and budget cuts a rampant problem all over the United States, any fraudulent acts committed against taxpayers and programs like Medicare should be taken very seriously by authorities.
Sometimes, doing the right thing is difficult. In the case of a whistleblower lawsuit — whether here in Wisconsin or somewhere else — having the courage to report wrongdoing can result in a great deal of heartache. Thankfully, anyone who may be experiencing a moral dilemma and is currently considering coming forward with his or her knowledge of wrongdoing of any kind will be able to find support throughout the duration of his or her ordeal. Supportive legal representation in these situations can prove a whistleblower’s best hope for maintaining a sense of normalcy as legal proceedings unfold.
Source: Fort Mill Times, “Hagens Berman: Sound Physicians Whistleblower Plays Key Role in Exposing Fraud Leading to $14.5 Million Settlement with the Government,” July 03, 2013