$1 Million Whistleblower Reward for Medical Lab Billing Manager

A former billing manager for Pharmasan Labs, Inc. will receive more than $1 million as a whistleblower reward for reporting false Medicare claims for lab tests.

The former billing manager initially raised concerns about false billing with the company’s management.  When they did not respond, he filed a whistleblower lawsuit under the qui tam provisions of the False Claims Act.  

The False Claims Act allows individuals to start a lawsuit “under seal” (i.e., in secret) on behalf of the government for false claims submitted to Medicare and Medicaid.  The government is required to conduct an investigation before deciding whether or not to pursue the lawsuit.  If the government recovers money as a result of the lawsuit, then the whistleblower is entitled to a reward of between 15% and 30% of the amount recovered.

In this case, the government investigated the whistleblower’s claims that Pharmasan submitted false information for laboratory services billed to Medicare and improperly sought reimbursement for services referred by non-physician practitioners. 

Pharmasan agreed to settle the lawsuit for $8.5 million.  The settlement resolves claims that it falsely billed Medicare for ineligible food sensitivity testing and submitted false information to Medicare concerning the nature of the tests.  The settlement also resolves claims that its patient referrals for laboratory services came from non-physician practitioners who were not eligible to refer Medicare paid services.

If you have evidence that a healthcare provider is submitting false claims to Medicare or Medicaid, then you should consult with an experienced whistleblower lawyer immediately to protect your rights.  You may be eligible for a substantial financial reward and legal protections as a whistleblower.

To schedule a free and confidential consultation, call John Howley, Esq. at (212) 601-2728.