Our experienced whistleblower attorneys helped secure a victory for our clients, the taxpayers and advocates for the elderly when a hospice company entered into a settlement with the federal government to resolve a whistleblower lawsuit that alleged Medicare fraud. Our firm represented two nurses who exposed fraudulent billing practices of their former employer, Compassionate Care Hospice Group.
Under the umbrella of Compassionate Care, two hospices in Atlanta, Georgia and Bensalem, Pennsylvania were accused of taking in patients who were not qualified for hospice care and then billing Medicare and Medicaid for the services provided to those patients. Government investigations into both hospices began after our firm, representing two former nurses for Compassionate Care, filed a lawsuit against the company under the False Claims Act, which prohibits contractors from sending fraudulent invoices to the government.
After witnessing the hospices admit numerous patients who didn’t belong in hospice care, Cathy Morris and Josie King came to our firm to assist them in filing a whistleblower lawsuit against Compassionate Care on behalf of the federal government. We filed a complaint on their behalf alleging that Compassionate Care had been paying “kickbacks” to doctors in exchange for patient referrals, which included patients who were neither terminally ill nor otherwise qualified for hospice care. After admitting non-terminally ill patients into their hospices, Compassionate Care fraudulently billed Medicare and Medicaid for medically unnecessary services it provided those patients.
This type of fraud is particularly harmful. When hospices like Compassionate Care increase their patient populations through fraud, scarce resources for improving the quality of life of terminally ill patients are shared with patients who belong in hospitals or home care. These non-terminally patients reside in hospices longer than terminally ill patients, stretching hospice resources even further. Meanwhile, hospices and doctors scamming the government profit from admitting dozens of new patients. Like many lawsuits under the False Claims Act, it took the courage of whistleblowers like Ms. Morris and Ms. King to alert the federal government to the fact that it was being defrauded.
The False Claims Act provides stiff penalties and fines for any organization that submits false invoices or claims to the federal government. The Act specifically targets businesses and organizations that regularly bill the government for their services, such as military contractors or healthcare providers serving Medicare and Medicaid patients.
The False Claims Act has a “whistleblower provision,” authorizing private individuals to bring lawsuits on behalf of the federal government against organizations committing fraud. In order to protect these individuals from employer retaliation and incentivize others to report fraud, the False Claims Act allows whistleblowers to initiate lawsuits anonymously, and rewards them by letting them share in whatever recovery the government obtains. It was under this whistleblower provision that Ms. Morris and Ms. King exposed Compassionate Care’s fraud.
The results of this case illustrate how competent representation in False Claims Act litigation can help whistleblowers expose corporate wrongdoing while still protecting themselves. Working with the U.S. Attorney’s office, we helped negotiate settlements with Compassionate Care Hospice Group totaling $2.4 million, a portion of which goes to Ms. Morris and Ms. King for initiating the investigation.
Whistleblowers like Ms. Morris and Ms. King help the government root out fraud, save taxpayers’ money, and protect those that rely on government services. By empowering individual citizens this way, the False Claims Act gives the government the teeth it needs to clamp down on fraud, protect vulnerable patients, and ensure fairness in the health care market.