Sometimes it might seem as if whistleblower suits and multi-million dollar settlements happen only in other places. But we’ve got a case from late July, 2016, that occurred in the federal court right here in Columbia.
Lexington Medical Center, located in West Columbia, SC, agreed to pay $17 million in a qui tam case brought by a whistleblower under the provisions of the False Claims Act (FCA). A qui tam suit initiated under the FCA allows a person to bring a false claims case on behalf of the government and to share in any financial recovery.
The whistleblower alleged that the medical center violated both the Stark Law (also known as the Physician Self-Referral Law) and the False Claims Act because of improper financial arrangements involving 28 doctors. The Stark Law is designed to ensure that referrals made by a doctor are based on the patient’s genuine medical need and not for financial gain. Generally speaking, a hospital cannot bill Medicare for services they provide that are based on doctors’ referrals, if the doctors have a financial relationship with the hospital. Some exceptions to the law do exist.
The whistleblower that brought the case, Dr. David Hammett, had been previously employed by the Lexington Medical Center. Dr. Hammett, a neurologist, alleged that he and other physicians were required by the Lexington Medical Center to direct patients to its own hospital for further testing. In exchange, they would receive compensation for making such referrals, which is illegal. Dr. Hammett will share in the recovered funds, receiving an approximately $4.5 million award.
Lexington Medical Center is a public hospital with 6,000 employees and 428 beds, employing 300 doctors. It is Lexington County’s largest employer and one of South Carolina’s busiest hospitals. Although it entered into the settlement with the Justice Department, Lexington Medical Center admitted no fault by doing so.
Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department’s Civil Division, was quoted as saying, “This case demonstrates the United States’ commitment to ensuring that doctors who refer Medicare beneficiaries to hospitals for procedures, tests and other health services do so only because they believe the service is in the patient’s best interest, and not because the physician stands to gain financially from the referral.”
More than $18.3 billion has been recovered since January, 2009, because of suits brought against those alleged to have submitted false claims to federal health care programs. In the cases brought by whistleblowers, awards have amounted to between 15 and 30 percent of the recoveries.
Making a difference.
If you think you have the facts needed to bring a whistleblower case, the experienced whistleblower attorneys at the Louthian Law Firm can review your case and help you file the appropriate disclosure statement. Under some circumstances, the government will intervene, or join in your lawsuit.
Your chances of succeeding are greater if your whistleblower claim is substantive, clear, and to the point. Because of this, meeting with a qualified whistleblower attorney can increase your chances of winning. The Louthian Law Firm can help you form your claim so that the government will be more inclined to intervene in your case; government intervention can sometimes increase the chances of recovering reward money. Even if the government decides not to intervene, it could still be a good idea to pursue your case without government involvement. Our strong support system can assist you through every step of the process.
For a free, confidential evaluation of your case, call the Louthian Law Firm today at 1-803-454-1200 or, if you prefer, you can fill out our online contact form.