In May 2012, the former top administrator of the John B. Amos Cancer Center filed a suit under the Federal False Claims Act. Also known as a qui tam action, these cases are placed under seal while the federal government investigates the whistleblower’s allegations. This particular case was placed under seal for more than a year, meaning that Columbus Regional didn’t know about the suit during that time. After extensive investigation and litigation, the suit was settled on Sept. 4, 2015.

Qui tam actions are initiated by a whistleblower on behalf of the federal and state governments. These cases are allowed under the False Claims Act when a party has defrauded the federal government. About half of the states in the Union have also adopted state versions of the False Claims Act to protect state taxpayers from fraudulent schemes.

In this particular suit, the complaint alleged that the John B. Amos Cancer Center was practicing improper coding and billing. The complaint went on to allege that the physicians were overcharging Medicare, Medicaid, Tricare/Champus and the Federal Employee Health Benefits Program. If true, then Columbus Regional has received potentially millions of dollars in unearned fees from the federal government.

Instead of facing the continued litigation, Columbus Regional has decided to settle the claims. In settling, Columbus Regional has agreed to pay up to $35 million. The federal government is committed to insuring that the health care industry is held accountable to the law and not wasting taxpayers’ monies. Furthermore, the service that hospitals provide their communities are vital; therefore, as a part of the settlement, Columbus Regional has agreed to enter into a “Corporate Integrity Agreement” with the U.S. Government. The “Corporate Integrity Agreement” is to insure the community continues to have a proper and functional health care provider.

The Federal False Claims Act was strengthened in 1986, 2009, and again in 2010 as amendments were added that increased incentives and protections for whistleblowers. These incentives include 15 percent to 30 percent of the funds the government recovered. These incentives ― rewards ―  have helped the government (1) detect more fraud, (2) ensure money intended for health care is properly spent on health care, and (3) deter other companies from committing the same fraud.

If you are aware of fraud being committed against the federal or state governments, you could be rewarded for doing the right thing by reporting the fraud. If you have any questions about whether you qualify as a whistleblower then please feel free to contact an attorney at Beasley Allen, for a free and confidential evaluation of your claim. There is a contact form on this website, or you may email one of the lawyers on our whistleblower litigation team: Andrew Brashier, Archie Grubb, Larry Golston or Lance Gould.

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