DaVita to Pay $495 Million to Settle Whistleblower Case

May 12, 2015 — On Monday, March 4, 2015, Davita HealthCare Partners announced it will pay up to $495 million to settle a whistleblower lawsuit alleging the Denver company defrauded Medicare and other federal healthcare programs of millions of dollars. This is the third whistleblower suit the company has settled since 2012, with payouts totaling almost $1 billion.

The suit was based on claims by two former DaVita employees, Dr. Alon Vainer and Daniel Barbir, that the company manipulated drug doses administered through its clinics so that the government’s Medicaid, Medicare, CHAMPUS, and CHAMPUSVA programs paid for more pharmaceuticals than were actually dispensed. Dr. Vainer, a board-certified nephrologist, was a medical director for several DaVita clinics in Georgia. Mr. Barbir, a registered nurse, worked as a clinic director at Davita’s Cumming, Georgia clinic.

Largest False Claims Act Settlement Without Government Intervention

This is the largest settlement in history for a False Claims Act case in which the Government has declined to intervene, meaning the Department of Justice has decided not to join the lawsuit and has suspended its involvement in the matter. Marlan Wilbanks, attorney for Vainer and Barbir, said, “In previous decades, if the government did not elector to prosecute a [False Claims Act] case, the whistleblower and their attorney would typically either accept a nominal amount of money or dismiss the case altogether. This case illustrates the true intent of the False Claims Act—to maximize the efficiency of the public-private partnership that Congress envisioned when they passed the act. We invested millions of dollars of our own money and many years of time without any guarantee of success, and we prevailed.”

While Waters & Kraus is not handling this particular False Claims Act case, we are representing whistleblowers in similar lawsuits. If you have comparable claims against a different medical provider, contact us or call our qui tam attorneys at 800.226.9880 to learn more about our practice and how we can work together to notify the government about fraudulent abuses of government-funded programs.

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Anne Izzo is an attorney at Waters, Kraus & Paul in the firm’s Baltimore office. Anne focuses her practice on qui tam whistleblower matters, asbestos litigation, premises liability, product liability, and toxic tort cases. 

Adventist Health Settles Whistleblower Lawsuit for $5.4 Million

April 8, 2015 — The False Claims Act empowers health care insiders to file a whistleblower lawsuit on the government’s behalf. Courageous whistleblowers help to protect the integrity of our federal healthcare programs, like Medicare or Medicaid, for those who need them. Under the Act, the United States may choose to intervene in the lawsuit and take primary control for litigating it. The statute provides for the government’s recovery of three times the actual damages plus civil penalties. For their willingness to notify the government, tipsters — also referred to as “relators” — are rewarded with a portion of the government’s recovery.

Qui Tam Whistleblower Will Receive More than $1 Million for Notifying the Government of Alleged False Claims Act Violations

Adventist Health System Sunbelt Healthcare Corporation (Adventist) has consented to a $5,412,502 settlement in a False Claims Act lawsuit filed in Tampa, Florida. Dr. Michael Montejo, a former radiation oncologist with Florida Oncology Network P.A., alleged in a qui tam lawsuit that Adventist treated patients with radiation oncology services that were not directly supervised by a radiation oncologist. Then, in violation of Medicare and TRICARE rules, Adventist allegedly submitted claims for reimbursement to those federal healthcare programs for treatment of program beneficiaries. For his willingness to come forward and notify the government, Dr. Montejo will receive a $1,082,500 share of the government’s recovery. 

Adventist runs a large network of hospitals in the Midwest and South, including Florida where the company does business as Florida Hospital. Between 2010 and 2013, Adventist allegedly provided radiation oncology services, including radiation treatment delivery and devices, radiation simulation, dosimetry and intensity-modulated radiation therapy, to a large number of beneficiaries of the Medicare and TRICARE federal healthcare programs. Those programs require that beneficiaries’ radiation oncology services must be supervised directly by a radiation oncologist or a similarly qualified health care provider. But several Adventist locations, including those in Orlando, Daytona Beach and Winter Park, reportedly failed to follow the federal healthcare program rules. Adventist nevertheless filed claims for reimbursement with the government, in violation of the federal False Claims Act. 

Contact Us to File a False Claims Act Lawsuit Targeting Abuse by Medical Providers

While Waters & Kraus is not handling this particular False Claims Act case, we are representing whistleblowers in similar lawsuits. If you have comparable claims against a different medical provider, contact us by email or call our qui tam attorneys at 800.226.9880 to learn more about our practice and how we can work together to notify the government about fraudulent abuses of government-funded programs. Michael Armitage and Louisa Kirakosian, two of the firm’s qui tam attorneys in the California office, protect tipsters throughout the whistleblower lawsuit process.