Emory University Settles Whistleblower Lawsuit Over Fraudulent Medicare and Medicaid Billing
Emory University in Atlanta, GA has agreed to pay $1.5 million to settle claims in a whistleblower lawsuit that claim the school falsely billed Medicare and Medicaid for clinical trials that the government agencies do not cover.
Reportedly, about $70,000 will go to the state of Georgia.
The United States and Georgia, under the False Claims Act, alleged that Emory University billed Medicare and Medicaid for services the clinical trial sponsor had agreed to pay during a clinical trial for new cancer treatments. In many cases, the clinical trial sponsor actually did pay for the services, so Emory was paid twice for offering the same trial.
The case was based off a whistleblower lawsuit filed by Elizabeth Elliot, a former research finance manager at Emory. Under the False Claims Act statutes, she will receive $322,500 for the settlement, with an additional $11,250 for her wrongful termination after filing the lawsuit.
“This settlement demonstrates our office’s continued commitment to protect crucial Medicare and Medicaid dollars,” said United States Attorney Sally Quillian Yates. “Treatment of cancer is expensive, and Medicare and Medicaid dollars should be reserved for patients who need services that properly may be billed to these programs.”
“Our investigation of Emory University revealed the institution’s clinical trial false billing and led to today’s settlement,” said Derrick L Jackson, Special Agent in Charge of the United States Department of Health and Human Services, Office of Inspector General for the Atlanta region. “Protecting Medicare—and taxpayer dollars—remains a top priority.”
False Claims Act Protects Medicare Fraud Whistleblower Lawsuits
Medicare and Medicaid are government-sponsored health care programs that help the needy and the elderly cover health care costs associated with aging and disability. These programs are hugely important for people living on a fixed income, so it is incumbent upon doctors to honestly report costs both to patients and to the government.
Unfortunately, not all health care providers are honest in their assessments. Some health care providers defraud the government, in violation of the False Claims Act, by overbilling for services, double billing, or billing for services not provided. The False Claims Act imposes liability on persons or corporations that defraud the government – and this includes doctors, hospitals, and nursing homes.
The False Claims Act provides protection for those who report agencies or individuals who are defrauding the government. These lawsuits are called whistleblower, or qui tam, lawsuits.
Under the qui tam provision of the False Claims Act, the relator (plaintiff) files an action on behalf of the U.S. Government. The Act allows a wide variety of people and entities to file a qui tam action.
The whistleblower must have first-hand knowledge of the fraud. However, as an incentive for reporting the fraud, whistleblowers are eligible for 15-25% of any recovered damages.
The Strom Law Firm Protects Whistleblowers in South Carolina
The False Claims Act, also known as the Whistle Blower Act or a qui tam action, is intended to encourage people to come forward with information and assist the government in stopping the waste of Government funds.
Common whistleblower actions include:
- Medicare fraud,
- defense contractor fraud, and
- other kinds of fraud.
To bring a qui tam action under the statute, an individual must have personal knowledge and actual evidence of fraud. Successful qui tam claimants will be rewarded a portion of the money the government recovers.
If you have direct knowledge of fraud against the government and believe you have a qui tam or whistleblower case, whether it is against a for-profit long term care facility, a technology corporation, or financial institution, the attorneys at the Strom Law Firm can help. We offer free, confidential consultations so you can discuss the facts of your case with impunity. Contact us today. 803.252.4800