A Florida jury recently ruled in favor of a nursing home whistleblower in a case containing allegations that her former employer routinely submitted false claims to Medicaid and Medicare.
Angela Ruckh worked for La Vie Management, a company now known as Consulate Health Care. She claimed providers regularly presented fraudulent reimbursement claims, which added up to more than $115 million in damages to Medicaid and Medicare. She initially filed the lawsuit in 2011, when she said the company had been engaged in a “years-long corporate scheme” to defraud the federal programs by upcoding therapy claims.
The company attempted to counter in December by saying Ruckh did not have sufficient evidence to back up her claims, and saying the time she spent working at the two facilities did not give her sufficient knowledge of the way the company operated at its 51 other locations. However, a federal judge ruled the case should proceed, and the jury ultimately sided with Ruckh.
False Claims Act violations can cause millions in damage
Upcoding is one of the most common forms of False Claims Act violations. Healthcare providers engaged in upcoding schemes typically bill for services not rendered, or bill for treatments that were either unnecessary or were for more serious conditions than those actually experienced by patients.
In many cases, the federal government is unable to uncover these fraudulent schemes without the assistance of whistleblowers. For their part, whistleblowers stand to earn a significant amount of money in awards if they provide useful information to the federal government that aids their investigation.
To learn more about the steps you should take if you believe you have uncovered an FCA violation, contact a trusted Dallas attorney at Whistleblower Law for Managers.