Whistleblower Doctor Paid $598,000 For Exposing False Claims Scheme

On July 12, 2012, the Department of Justice reported that it had recovered $3.15 million and settled claims against certain defendants and has filed a complaint under the False Claims Act against the remaining defendants.The settling defendants are six health care providers: Advanced Physical Medicine & Rehab Group Inc., Advanced Occupational Rehabilitation, Inc., Advanced Medicine and Rehabilitation of Texas, Inc., Advanced Medicine and Rehabilitation of Texas and the two physicians located in Oakland who own Advanced clinics.The Justice Department awarded the whistleblower physician $598,000 for his/her contribution in providing the U.S. Government with insider information on companies’ false claims scheme.

The United States alleged that the defendants had filed false claims for payment to Department of Labor, Office of Workers’ Compensation Programs (DOL-OWCP) “for supplies and services not provided, not supported by medical documentation and/or not medically necessary.”The majority of the patients were United States Postal Service (USPS) employees claiming work-related injuries.

United States Attorney Melinda Haag stated that “[t]his settlement is part of the government’s commitment to combating health care fraud. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover billions of dollars in cases involving fraud against federal health care programs.”

The False Claims Act allows private citizens to act as whistleblowers and sue on behalf of the government and share in the amounts the government recovers through legal action.The False Claims Act allows the government to recover treble damages and $5,500 to $11,000 for each false or fraudulent claim filed.The whistleblower in this case was paid approximately 19% of the proceeds from the government settlement.Whistleblower rewards typically range from between 15-30% for claims brought under the False Claims Act.

SOURCE: http://www.justice.gov/usao/can/news/2012/2012_07_12_us.settled.press.html