Multi-Million Dollar Whistleblower Award Issued In Health Care Billing Fraud False Claims Act Case
On July 20th, 2022, the United States Attorneys’ Office for the District of Massachusetts announced that Inform Diagnostics—a Texas based medical industry company that previously operated Miraca Life Sciences—has agreed to pay $16 million as part of a health care billing fraud case. The False Claims Act settlement includes a nearly $2.75 million whistleblower award. In this article, our health care billing fraud whistleblower attorney discusses the multi-million dollar whistleblower award approved by the Department of Justice (DOJ).
Health Care Billing Fraud: Six Years of Medically Unnecessary Tests
With a main headquarters in Irving, Texas, Inform Diagnostics has a number of different medical laboratories throughout the United States, including in Needham, Massachusetts. Based on an acquisition that occurred in the spring of 2022, Inform Diagnostics is now a subsidiary of the California based medical conglomerate Fulgent Genetics.
The settlement agreement reached between the DOJ and Inform Diagnostics covers 2013, 2014, 2015, 2016, 2017, and 2018. During that six year period, the company reportedly conducted and billed the federal government for medically unnecessary tests. The tests in question were additional follow-up tests on biopsy specimens.
Inform Diagnostics routinely and automatically conducted and billed for a number of different follow-up tests. However, federal policies hold that an individual determination of each patient is needed to evaluate the medical necessity of follow-up testing. The company will pay approximately $16 million to resolve the False Claims Act lawsuit.
Whistleblower Initiated the Case and Receives 17 Percent of Recovery
Similar to many billing fraud cases that come out of the health industry, the claim against Inform Diagnostics was initiated by a whistleblower. The whistleblower raised their concerns and the case was eventually taken over by federal authorities. In connection with the settlement reached by the U.S. Attorneys’ Office for the District of Massachusetts, the whistleblower will receive 17 percent of the government’s recovery. In this case, that amounts to a nearly $2.75 million whistleblower award.
The False Claims Act authorized individual whistleblowers to take private action on behalf of the federal government through a type of lawsuit called a qui tam claim. The government may or may not choose to intervene in the case. It did intervene in the case involving Inform Diagnostics. If the federal government determines that there was a False Claims Act violation and it successfully obtains money on behalf of the taxpayers, the whistleblower is entitled to a share of the recovery.
Speak to Our National False Claims Act Whistleblower Protection Lawyers Now
At Guttman, Freidin & Celler, we represent whistleblowers in the full spectrum of qui tam cases under the False Claims Act. If you are considering disclosing health care billing fraud, we are here as a resource. Our mission is to protect the legal rights and financial interests of our clients. Contact us now for a free, no strings attached assessment of your rights. Our whistleblower protection law firm handles False Claims Act cases nationwide.