FORT LAUDERDALE, Fla.--(BUSINESS WIRE)--Please replace the release with the following corrected version due to multiple revisions.
The corrected release reads:
DIGNITY HEALTH WHISTLEBLOWER CASE RETURNS OVER $36 MILLION TO THE FEDERAL GOVERNMENT
Today, Nolan Auerbach & White announces the successful resolution of its client’s 5-year-long civil False Claims Act case against Dignity Health (formerly named Catholic Healthcare West). The qui tam case was brought in November 2009 by client Kathleen Hawkins, a former Dignity Health Director of Medical Management. Dignity Health has agreed to pay $36,744,423 to resolve Ms. Hawkins’ qui tam lawsuit.
The settlement included the resolution of allegations that thirteen (13) of Dignity’s Hospitals, from January 1, 2006 through December 31, 2010, knowingly submitted or caused to be submitted claims for payment to the Federal Healthcare Programs for scheduled cardiovascular procedures, billing these services as inpatient procedures when they should have been billed as outpatient procedures. The settlement involved claims submitted by the Dignity Hospitals that met, inter alia, all of the following criteria: (a) For beneficiaries whose length of stay after inpatient admission was one (1) day or less; (b) For beneficiaries whose admission did not originate in the Emergency Department.
The settlement also resolves allegations that from January 1, 2006 through December 31, 2010, thirteen (13) Dignity Hospitals knowingly submitted or caused to be submitted claims for payment to the Federal Healthcare Programs for certain inpatient admissions, billing these services as inpatient when they should have been billed as outpatient or observation services. The settlement involved claims submitted by the Dignity Hospitals that met, inter alia, all of the following criteria: (a) For beneficiaries whose length of stay after inpatient admission was (1) day or less; (b) For beneficiaries who were not transferred in from or transferred or discharged to another acute care facility, did not leave the Dignity Hospital to which they originally presented against medical advice, and did not die while in a Dignity Hospital.
“Billing Medicare for higher cost inpatient services that patients do not need is a major strain on the public fisc,” explained former federal prosecutor and Nolan Auerbach & White partner Marcella Auerbach. “The False Claims Act provides substantial whistleblower rewards to incentivize people to step forward when they uncover such billing practices.”
The False Claims Act allows private citizens with detailed knowledge of fraud to bring an action on behalf of the government and to assist in the recovery of the government’s stolen dollars. The statute allows the government to recover three times the amount it was defrauded, in addition to civil penalties of $5,500 to $11,000 per false claim. Successful whistleblowers can receive between 15 and 30 percent of the governments’ recovery. Pursuant to the qui tam statute, the United States has agreed to reward Ms. Hawkins with a relator’s share of over 17%.
The settlement was achieved through the coordinated efforts of the U.S. Justice Department and the Office of Inspector General of the U.S. Department of Health and Human Services. The government was represented by an exceptional team of government attorneys and investigators, including Civil Division Chief Sara Winslow, U.S. Attorney’s Office in the Northern District of California; Assistant U.S. Attorneys Ila Deiss and Erica Hitchings, U.S. Attorney’s Office in the Northern District of California; Senior Trial Counsel Marie Bonkowski, U.S. Justice Department, Civil Division, Commercial Litigation Branch; and Investigator Ellen Kotler, Office of Inspector General of the U.S. Department of Health and Human Services.
The case is United States ex rel. Hawkins v. Catholic Healthcare West, Inc., et al., No. CV-09-5604-JCS (N.D. Cal.). For information about Medicare fraud whistleblower cases, see www.whistleblowerfirm.com.
