AseraCare, a provider of end-of-life services, admitted patients who were not eligible for hospice care — just to turn a better profit. The spotlight was focused on the company after a whistleblower provided evidence about fraudulent claims on behalf of Medicare beneficiaries being submitted by AseraCare. The federal government filed a lawsuit under the False Claims Act based, in part, on information supplied by a valuable whistleblower.
In the first of what will be a two-part case, an Alabama jury found the company did submit false claims to Medicare. More specifically, the jury reviewed medical records from AseraCare, a subsidiary of Texas-based Golden Living, and found that of the 121 hospice claims, 104 were “false or unsupported.”
The next phase of the trial will focus on whether or not the hospice provider knowingly submitted the false claims. If the jury find that, indeed, the company knew about the fraud and displayed “reckless disregard for the truth” it could face up to $200 million in damages. Many legal professionals close to the case expect AseraCare to settle the case before it enters the second trial phase to avoid further potential damages.
The initial evidence in this case was provided by a whistleblower who reported ongoing fraudulent activity at the hospice center. Once the case is either settled or a verdict is handed down, the whistleblower stands to make a considerable amount of money in terms of obtaining a percentage of damages collected by the federal government.
The decision to “blow the whistle” is never easy. However, stepping forward with evidence of fraudulent activity can be rewarding in two ways. First, a whistleblower can take pride in knowing they are doing the right thing. Financial crimes against the government, Medicare fraud as an example, affects everyone who pays taxes in the United States. Often, “doing the right thing” is enough to convince a whistleblower to come forward with information.
However, if a False Claim Lawsuit concludes with the government recovering financial damages, the relator (the name assigned to the person bringing forth the information) will be paid a substantial percentage of damages. The amount a whistleblower can receive in a successful qui tam claim is based on whether or not the federal government joins the legal action and on how much money was recovered.
If you or someone you know has information that may lead to a qui tam lawsuit, speak to a whistleblower attorney who can review your case and advise you about how to proceed. Ross Begelman of Begelman & Orlow is a successful qui tam lawyer who will protect your rights as a whistleblower and provide sound legal representation.