Vanguard Health Systems (doing business as The Detroit Medical Center Inc. (DMC)) and Tenet Healthcare Corporation has recently settled a False Claims Act (FCA) lawsuit for $29.7 million. The government accused the providers of exchanging referrals for kickbacks in violation of the Anti-Kickback Statute. The whistleblower in the case, a former employee of a DMC affiliate, received $5.2 million for his contribution under the qui tam provisions of the FCA.

Case background

Dr. Jay Methaler, a former employee at Wayne State University Medical School (affiliated with DMC) filed a civil claim under the FCA. He alleged that the healthcare providers were offering kickbacks in violation of the Anti-Kickback Statute. The statute “prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare and other federally funded programs.” The government asserted that physicians must evaluate where to send patients based on the patient’s needs and quality of care, rather than the potential for financial benefits.

Qui tam whistleblower claims

The False Claims Act allows private citizens to file whistleblower claims under its qui tam provisions. In this case, the Justice Department intervened to help hold DMC and Tenet responsible for the alleged kickback scheme to defraud the government.

Under the FCA, qualified whistleblowers may receive between 15 and 30 percent of the government’s eventual recovery. This is designed to encourage whistleblowers to come forward and report wrongdoing.

If you’re ready to blow the whistle on fraud or other wrongdoing, you may be eligible to receive a percentage of the recovery. A trusted whistleblower attorney at Kardell Law Group can help—call today for a consultation.