A Roundup of Recently Unsealed Health Care Qui Tam Whistleblower Cases

There were 36 different qui tam cases related to healthcare law that have recently been unsealed, eight of which were filed just within the past year and others of which were filed as far back as nine years ago.

These 36 cases comprised claims filed in federal courts across 18 states. Eight of the cases were either brought in or transferred to Georgia federal courts, and most of them were filed in the Northern District of Georgia. Five other cases were brought in California courts, and three in New York courts.

The federal government fully stepped in with six of the cases and partially intervened in six more, while declining to intervene in 19. The government’s decision as to whether it will intervene is still unknown in four other cases. Finally, one of the cases was settled and voluntarily dismissed before the government decided to intervene.

There were nine settlements out of the 36 total unsealed cases, with a total value of about $51 million. The average settlement amount was $5.7 million per case. The subject matter of the claims varied, and the following were some highlights:

  • Exactly half of the 36 cases involved both federal and state claims
  • Nine of the cases included claims for relief under federal or state anti-whistleblower retaliation rules
  • Three of the cases were brought against one defendant, Family Dermatology
  • Most False Claims Act claims included allegations that healthcare providers were billing Medicare for services not needed or rendered, engaged in “up-coding” for more costly healthcare procedures or submitted Medicare claims for 100 percent of the costs of the services provided by various mid-level health practitioners, despite doctors not being present when the services were performed.
  • Relators in 53 percent of the cases were either former or current employees of defendants.

We will continue to analyze these recent cases to stay on top of the trends in healthcare whistleblower actions. For the legal guidance your organization needs, contact the skilled Dallas attorneys at Whistleblower Law for Managers.