Tenet Healthcare, Inc., operator of the nation’s second largest health care chain at the time, paid more than $900 million to settle claims in multiple qui tam whistleblower lawsuits that it had over-billed Medicare through use of an overstated “cost-to-charge” ratio that inflated “outlier” and other cost-based payments sought by this hospital chain.
VSG’s qui tam lawyers, while in private practice and previously with the Department of Justice, have successfully represented whistleblowers and the government, winning many significant False Claims Act recoveries and qui tam settlements. Our whistleblower lawsuits have received national coverage in the media, including The New York Times, Wall Street Journal, Washington Post, Los Angeles Times, Boston Globe, and 60 Minutes.
The following are summaries of some of our cases.
HCA, Inc., the nation’s largest hospital chain at the time, paid $225.5 million to resolve claims by multiple qui tam whistleblowers that HCA unlawfully paid kickbacks to physicians, and violated the federal “Stark” law, to induce physicians to refer patients whose care would be billed to federal health programs.
EmCare, Inc. paid more than $30 million to settle qui tam claims brought by VSG clients and another set of relators, alleging that EmCare received kickbacks from a major hospital chain in exchange for pressuring hospital emergency room (ER) doctors to increase the rate of ER-to-hospital admissions. EmCare also entered into a confidential settlement with VSG’s client on her unlawful retaliation claim.
Extendicare Health Services, Inc., a nationwide nursing home chain, paid $10 million to settle qui tam whistleblower claims that the company’s skilled nursing facilities were providing patients with unnecessary rehabilitation therapy services for the sole purpose of obtaining higher reimbursements from Medicare. Extendicare paid VSG client Tracy Lovvorn an additional $990,000 in settlement of her claims for unlawful retaliation and attorney’s fees.
Adventist Health System Sunbelt Healthcare Corporation, a hospital system, paid $8.7 million to resolve whistleblower claims in a qui tam case that it overcharged Medicare for costs of ambulance services.