Medicare Fraud: Prison or $9 Million Whistleblower Reward

When Orthofix, Inc. pleaded guilty to Medicare fraud, felony charges were filed against several its employees.  And a former healthcare consultant turned whistleblower walked away with a $9 million reward.

Jeffrey Bierman, the former healthcare consultant, brought a whistleblower lawsuit alleging that Orthofix violated the federal False Claims Act by:

• improperly waiving patient co-payments for its bone growth stimulator devices
• submitting false certificates of medical necessity
• failing to advise patients of their right to rent rather than purchase the devices
• paying kickbacks to induce the use of the company’s products in violation of the Anti-Kickback statute

Orthofix agreed to settle the lawsuit by paying the government more than $42 million.  Under the qui tam provisions of the False Claims Act, Mr. Bierman received more than $9 million from the settlement as his reward.

Other employees are facing a much different future.

A physician’s assistant was sentenced to six months in prison, six months in home confinement, and two years of supervised release for taking kickbacks.

A former regional manager pleaded guilty to making a false declaration to a federal grand jury.  He was sentenced to three months home confinement, one year probation, and a $2,000 fine.

A former vice president pleaded guilty to paying kickbacks, and three former territory managers pleaded guilty to creating false medical records used to support Medicare claims.

This is a wake-up call.  You are personally at risk of criminal prosecution if you know that your employer is falsifying medical records, paying kickbacks, or submitting false claims to Medicare or Medicaid.  The government investigates everyone who had knowledge of the false claims, including those who did not personally sign false medical records or participate actively in the fraud.

You may be able to protect yourself from criminal charges and earn a substantial reward if you help the government as a whistleblower.  An experienced False Claims Act attorney will review your case at no charge.  If your claims are viable, your lawyer will file a complaint under seal (in secret) and present your evidence to the local prosecutor.  If the case is pursued and the government recovers money, you will be entitled to a reward of between 15% and 30% of the amount the government recovers.

If you are already under investigation or have been charged with a crime, you can no longer be a whistleblower, but you still have options.  An experienced Medicare fraud lawyer can explain those options and help you prepare your defense.  Your lawyer may also be able to negotiate with the government to avoid or reduce the possible charges.

Do not go to prison for your employer’s fraud.  Get an experienced Medicare and Medicaid fraud attorney on your side.  For a free and confidential consultation, call John Howley, Esq. (212) 601-2728 or click here to reach our office via email.

John Howley, Esq.

---

The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation.  I invite you to contact our law offices and welcome your calls, letters and electronic mail.  Contacting us does not create an attorney-client relationship.  Please do not send any confidential information to us until such time as an attorney-client relationship has been established.  I practice law and offer legal services only in jurisdictions where I am properly authorized to do so.  I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules.