In United States ex rel. Vainer v. DaVita, Inc., No. 07-cv-02509 (N.D. Ga.), whistleblowers alleged that the defendants deliberately manipulated medicine dosages (by using larger-than-necessary vials or spreading dosages over multiple treatments) to receive higher Medicare payments. Although the Government declined to intervene, the case settled for approximately $450 million. The whistleblowers are expected to receive a percentage of the settlement amount.

Last year, the United States Justice Department recovered nearly $2.3 billion from cases involving false claims against federal health care programs such as Medicare, Medicaid and TRICARE, the health care program for the military. Like the cases above, companies often provide illegal kickbacks to physicians and/or hospitals to induce patient referrals for services covered by government health care programs. These kickbacks cause physicians to order unnecessary and unreasonable services and the submission of false claims to federal health care programs. These acts violate Anti-Kickback Statutes and the federal False Claims Act.

Whistleblowers are key to the Government’s recovery of money received in violation of the federal False Claims Act. Whistleblowers typically work for or are associated with the companies who commit health care fraud. The False Claims Act allows whistleblowers to file lawsuits on behalf of the Government and allege the submission of false claims. If the action is successful, whistleblowers can receive up to 30% of the Government’s recovery. 

Cotchett, Pitre & McCarthy has successfully represented whistleblowers in numerous False Claims Act cases throughout California and the United States.