Whistleblower who stopped Medicare fraud to receive $3.3 million

On Behalf of | May 3, 2018 | Whistle-blower Claims

Here’s a hypothetical situation: you land a new job with a Milwaukee employer, but quickly realize that the company is defrauding the federal government. What do you do? How long will you wait to report the illegal activity? And what do you do if your employer does not agree to end the fraud?

A registered nurse far from us had to grapple with these questions after she was hired by an Arizona company. Her decision was to quit her job after just three months and then file a whistleblower lawsuit under provisions of The False Claims Act.

According to a recent news report from a health industry publication, the Phoenix-based nonprofit Banner Health recently settled the lawsuit for more than $18 million. The Department of Justice said in a press release about the case that the former Banner employee will receive “roughly $3.3 million” as her part of the settlement.

She is also to receive $144,000 in legal fees, the report said.

Soon after she was hired as corporate director of clinical documentation, she realized that Banner was regularly improperly billing Medicare. The company was allegedly admitting patients who did not require hospitalization to a hospital and then discharging them that same day. Banner then billed Medicare for hospital care.

She went to her supervisors about the improper billing practice, but got nowhere with them.

“It became clear to her very quickly that the interest was on enhancing revenue and not on guaranteeing compliance or integrity,” her attorney said recently.

She then resigned and filed her lawsuit.

If your employer is engaged in fraud of a U.S. government agency, contact an attorney experienced in whistleblower litigation.


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