Qui Tam Case Involving Medicare Fraud Results in $2.1 Million Settlement

Massive government healthcare programs such as Medicare and Medicaid lack the resources to catch every instance of fraud that victimizes taxpayers and makes it more difficult to serve beneficiaries. However, the False Claims Act gives employees of companies engaged in fraud against the government a strong incentive to report what they’ve seen. In a legal action known as a qui tam lawsuit, a whistleblower can file a lawsuit and receive a portion of any payment recovered by the United States, usually between 15 and 30 percent of the total amount. 

This occurred in South Carolina when Jeri Harris noticed that her employer, known as Hillrom, submitted false claims to the Medicare, TRICARE, Department of Veterans Affairs, and Medicaid programs. The company’s fraudulent scheme involved selling used hospital beds and pressure support systems to the government providers while charging for them as if they were new. This misconduct occurred between 2011 and 2019.

HIllrom was also accused of selling equipment to federal healthcare programs using a “miscellaneous” code rather than the proper designation. This mischaracterization was aimed at obtaining higher government reimbursements. Moreover, the company allegedly billed travel time for durable medical equipment repair as reimbursable repair time, inflating the amount that could be charged. 

In response to the False Claims Act charges, Hillrom agreed to a settlement of $2.1 million, a percentage of which will go to Harris based on her status as qui tam plaintiff. As fraud relating to Medicare and other federal health programs is so common, there are likely thousands of employees in the same position as Harris who have information that could lead to a financial recovery if they pursue a whistleblower lawsuit. 

Whether you work in a hospital, at a doctor’s office, as a home health aide or in some other capacity, you could play a valuable role in rooting out illegal conduct involving medical claims. If you are considering acting as a whistleblower, the first step is reaching out to an attorney about the merits of your claim and the potential compensation you could collect through a qui tam lawsuit. When you call Kardell Law Group, we will listen to you and answer all of your questions.