Aveta Settles Suit Alleging it Defrauded Medicare of $1 Billion

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Josh Valdez, a former executive for a subsidiary of Aveta Inc., sued the company, claiming it had spent years engaged in a scheme to defraud Medicare of hundreds of millions of dollars.

The lawsuit was originally filed in April 2011, but was under court seal until early 2014 and went through an extensive court process since then.

Case background

Valdez took an executive position in April 2010, tasked with improving medical services at a pair of Puerto Rican Medicare Advantage plans owned by an Aveta subsidiary. Several months after he took up his position, he discovered the PMC Medicare Choice and MMM Healthcare plans he was assigned to had been cheating Medicare to the tune of hundreds of millions of dollars over the course of several years.

The fraudulent schemes Valdez accused Aveta of perpetrating involved these health plans overcharging Medicare by $300 to $350 million each year from 2007 through 2010.

Valdez claimed that when he reported his findings to his superiors, the Aveta Chief Executive Officer Richard Shinto fired him in December 2010 as direct retaliation for speaking out against those schemes.

Aveta publicly disparaged Valdez as a “former disgruntled employee” after the lawsuit information was unsealed, and categorically denied all wrongdoing. However, this summer, the company settled the lawsuit for $1 billion. In doing so, it admitted no wrongdoing.

Whistleblowers are afforded federal protections to prevent them from becoming victims of workplace retaliation for speaking up about internal wrongdoing. It is illegal to retaliate against people who blow the whistle, with forms of illegal retaliation including termination, reassignment, demotion, failure to promote, decreased compensation and other types of negative actions.

If you have experienced any form of retaliation as a result of blowing the whistle on illegal company practices, you can take legal action to protect yourself and exercise your rights. For more information about how to proceed with your case, contact an experienced Dallas whistleblower lawyer at Kardell Law Group.

By Steve Kardell | Published October 9, 2020 | Posted in Fraud, Whistleblower Litigation | Tagged Medicare Fraud, retaliation, whistleblower protection

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