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Kentucky False Claims Act Case Results in $16.5 Million Settlement

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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.

Court our team of Kentucky false claims act lawyers to guide you through the complex legal process.

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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    Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

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    Kentucky False Claims Act A Possible Reality

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    Our team of Kentucky False Claims Act lawyers was pleased to see in the news a recent string of settlements and news under the False Claims Act.  The first involves Kentucky House Speak Greg Stumbo’s efforts to pass a state version of the False Claims Act. There are already state false claims acts in dozens of states, including Illinois, Indiana, Tennessee and Virginia.

    Under the legislation, those found guilty would be liable for up to three times the amount they had fraudulently billed the state, and whistleblowers would be eligible to receive anywhere from 15 to 30 percent of the monies recovered as a reward for their service.  Other civil penalties and attorney fees would be an additional cost for those found guilty.

    While Stumbo has been unsuccessful in the past, he is hopeful that due to budgetary constraints, the Kentucky legislature will pass the state Kentucky False Claims Act this year.  Stumbo pointed to successes other states and the federal government have seen using their False Claims Acts.  During the 2012 fiscal year alone, according to the Taxpayers Against Fraud website, these governments saw more than $9 billion returned, $300 million of which came from a single case of Medicaid fraud in California.  It makes perfect sense for Kentucky to join the other states that have already received funds that should have never been paid or incurred in the first place. More information can be found by clicking HERE.

    Even though Kentucky does not have a state version of its False Claims Act, there is a federal cause of action under the qui tam statute.  If you have any questions please do not hesitate to let us know today as we would be honored to speak confidentially to you about a Kentucky False Claims Act case.

    FOR FALSE CLAIMS ACT HELP, PLEASE CONTACT US.

    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, or visit our False Claims Act Litigation Source.

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      Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

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      Kentucky False Claims Act Lawyer: Hospital Fraud Discussed

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      Our team of Kentucky False Claims Act lawyers would like to advise that The New York Times recently reported through contributors Julie Creswell and Reed Abelson that a hospital chain has been said to scheme to inflate its bills in violation of Federal law.  Health Management Associates is a for-profit hospital chain based in Naples, Florida, which kept tabs on an internal strategy that regulators and others say was intended to increase admissions, regardless of whether a patient needed hospital care, and pressure the doctors who worked at the hospital.  This month the United States Department of Justice said it had joined eight separate whistleblower lawsuits against H.P.M.A. in six states.

      The lawsuits describe a wide ranging strategy, including billing software system fraud, financial incentives, and threats.  Those accusations include some against former Chief Executive Officers, who many of the whistleblowers point to as driving the strategy of fraud.  HMA is not the only hospital chain currently being investigated, as the New York Times reported that federal regulators have multiple investigations currently pending against other questionable hospital admissions, procedures and billings, including the country’s largest hospital chain, HCA.  Community Health Systems, based out of Franklin, Tennessee, sent its former Chief Executive in 2008 to HMA, and currently faces similar accusations that it inappropriately increased admissions to enhance the bottom line.

      HMA also faces shareholder lawsuits and a federal securities investigation.  The New York Times points out a disappointing piece of evidence, that being that many companies consider false claims settlements to be a slap on the wrist and merely a cost of doing business when such settlements run only into the tens of millions of dollars.  The point is well made that a company should be punished with a $500 million dollar or more fine to serve as a deterrent to future conduct.  Only time will tell if such large hundred million plus settlements in the False Claims Act could truly serve as a deterrent to the widespread fraud that currently presides across the country.

      Our firm has a team of whistleblower lawyers that want to help you with potential claims.  Whether it relates to appropriate medical services provided, up charging of medical products, billing fraud, governmental contract fraud including for disadvantaged or minority business enterprise, or more, please contact us as soon as possible for a free case evaluation.

      If you have confidential information about a fraud against the government in Tennessee, Kentucky, Mississippi, Alabama, Arkansas or another state, please contact us as soon as possible for a free case evaluation.

      FOR HELP, PLEASE CONTACT US.

      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, or visit our False Claims Act Litigation Source.

      CALL 1-800-632-1404

      or fill out this form below for a free initial consultation.

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        Case Details

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        Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.