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The Kentucky False Claims Act provides incentives for Kentucky whistleblowers reporting fraudulent activities impacting the government over a broad area. It allows filing of qui tam lawsuits in Kentucky courts by whistleblowers or relators seeking prosecution of the guilty and recovery of defrauded taxpayers’ money. One area of False Claims Act involves Hospital Fraud.
Kentucky False Claims Act: Hospital Pays $16.5 Million To Settle Whistleblower Lawsuit
St. Joseph Hospital of London paid $16.5 million to settle a Kentucky False Claims Act lawsuit that accused the health care center of pervasive false billing for Medicaid and Medicare reimbursements. The hospital allegedly bribed cardiologists who superfluously referred patients for heart procedures and doctors at the hospital also performed needless surgeries to bill more. Kentucky qui tam lawsuits have led to the recovery of more than $50 million health care funds from hospitals in the last six months. Ashland-based King’s Daughters Medical Center also agreed to pay $40.9 million in June 2014 after investigations indicted it for seeking federal reimbursements for unneeded medical procedures carried out on patients.
The federal false claim act that applies to the state in the absence of any such law of its own mandates a reward amounting to 15 to 30 percent of the total amount settled for whistleblowers and initiators of qui tam lawsuits in Kentucky.
Qui Tam Lawsuit Against St. Joseph Hospital
A whistleblower lawsuit was filed in 2011 against the hospital, owned by Denver-based Catholic Health Initiatives and now part of KentuckyOne Health, for paying to cardiologists who unnecessarily referred patients for expensive heart procedures, such as bypass surgery, that were not actually needed. Three doctors from Lexington initiated the qui tam lawsuit in Kentucky according to the federal false claims act after they discovered the wrongdoing by the hospital management. They examined many patients, who were treated at St. Joseph hospital, to realize that their medical history did not require procedures they were recommended to undergo at the health care center between 2008 and 2011.
The Kentucky qui tam lawsuit led to further investigations by the authorities and one of the doctors who was accused of receiving kickbacks for unnecessarily sending patients to the hospital turned an approver. He admitted to have falsified diagnoses to refer patients to St. Joseph, which, in turn, paid money and allowed him and other doctors to seek facility fee from Medicaid and Medicare funds as a hospital subsidiary. The sham system of false billing also included hundreds of unnecessary stent insertion and other heart procedures performed on these patients.
St. Joseph hospital got $10,000 to $20,000 in health care reimbursements for each heart procedure billed, the Kentucky false claim lawyer representing the plaintiffs claimed. About $2.5 million is awarded to the three whistleblowers as per legal provisions.
Kentucky False Claims Act Lawsuit: Things To Know
- Kentucky has no false claims act of its own. All whistleblower actions in the state are covered under the federal false claims act that encourages citizens to file a claim for themselves and on behalf of the state based on their information on defrauding of public money.
- A qui tam litigation is a civil action and only punishable with monetary fine. However, it does not forbid any criminal action by affected individuals. St. Joseph faces over 200 medical malpractice lawsuits, claiming unnecessary medical procedures at the health care facility.
- Filing a false claim lawsuit in Kentucky must be done within six years of the fraud committed or within three years of its discovery subject to a maximum of 10-year limitation.
- Whistleblowers are set to 15 to 30 percent of the total recovery, including fines, punitive damages, and defrauded money, as incentive. The award is on the higher side when they fight their own Kentucky false claims lawyers without any participation of the state. When public prosecutors take up the case, they are assured of at least 15 percent of the settled amount.
- A qui tam lawsuit can be brought in Kentucky against any type of fraud, leading to losses to the national exchequer or false submission or misrepresentation.
- There is a provision for comprehensive protection of a Kentucky whistleblower from any retribution or retaliation.
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Contact a Kentucky False Claims Act Attorney
We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.
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