Two doctors will split a $2.7 million award after winning a False Claims Act lawsuit in which they claimed another physician at a nonprofit hospital in Florida was performing unnecessary cardiac studies and procedures. The total settlement was worth $12 million.
The doctors filed the lawsuit against South Miami Hospital and one of its physicians under the False Claims Act’s qui tam provision. The law allows private citizens to file a lawsuit on behalf of the federal government when they discover these types of false claims. If successful, the claimants may earn a certain percentage of the money recovered in the case.
Unnecessary procedures for greater reimbursements
The two doctors reportedly became aware of the third doctor performing unnecessary procedures solely to increase the number of reimbursements he received from Medicare and various other federally funded programs. The physician performed these procedures on thousands of patients, many of them seniors. They included electrophysiology studies, echocardiograms, cardiac device implants and head upright tilt tests, among others.
While the doctors making the claims had previously reported their concerns to the hospital, administrators reportedly defended the physician’s wrongdoing, saying he was an important medical producer for the health care center. The hospital did not admit guilt as part of the settlement agreement.
This case illustrates a problem common within business and organizations of all types: managers and administrators ignoring the complaints of whistleblowers. If you would like to learn more about filing a qui tam action, speak with a trusted Dallas attorney at Whistleblower Law for Managers.
