The U.S. Attorney for the Middle District of Florida announced a $5.5 million settlement has been reached with ambulance provider AmeriCare over allegations that the company had engaged in billing Medicare and TriCare for medically unnecessary ambulance rides. According to the Tampa Bay Business Journal, the whistleblower will receive over $1 million as a reward for coming forward with the information.
The U.S. District Court for the District of Delaware entered a judgement against Orthopaedic and Neuro Imaging LLC (ONI) for submitting false claims for Medicare reimbursement. Of the $16.2 million judgement, Richard Pfarr, the owner of ONI, is liable for over $6 million. The lawsuit alleges that ONI and Pfarr knowingly billed Medicare for administering contrast dye – a substance used to improve the visibility of tissues on MRI scans – without proper supervision by a physician. The News Journal reports that the whistleblower, a former employee of ONI, will receive roughly $3 million of the settlement for bringing the case.
A Ninth Circuit panel has reversed a lower court dismissal, allowing a False Claims Act case against QTC Medical Services Inc. to proceed after it had been dismissed for failure to state a claim. QTC was hired by the VA to review disability cases related to Agent Orange claims. The whistleblower, a former QTC claims file analyst, alleges that QTC incentivized analysts to review as many cases as possible at the expense of accuracy and completeness. Although the case was previously dismissed because the whistleblower did not have full access to the terms of the contract between QTC and the VA, the panel found that he had sufficient evidence and overturned the decision. You can read more about this decision at PRWeb.
The National Law Review provides valuable insight into fluid attempts by courts to define the proper causation standard in whistleblower retaliation cases. Specifically, whether the “but for” standard is really different from the “motivating factor” test. Additionally, the article highlights the importance for whistleblowers who have suffered retaliation to determine whether the 2013 Defense Authorization Act (NDAA) provides protection, especially in light of the less burdensome “contributing factor” causation standard.
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