Frank A. Rubino, ESQ.

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Medicare fraud leads to $85 million settlement in Florida

A hospital in Florida has decided to settle a whistleblower lawsuit with the federal government for $85 million. This all came about because one of the hospital's employees, working in the capacity of the director of physician services, decided to file the lawsuit. This can be done by whistleblowers on behalf of the federal government, and this man decided to take action when he claimed that the hospital was paying doctors in an improper manner and committing fraud when it came to Medicare cases.

The settlement has been reached because the directors at the hospital did not want to admit responsibility for the specific actions that were laid out in the case. However, they were willing to say that they had violated laws that prohibited the hospital's physicians from increasing their own earnings by referring patients to health service centers where those same doctors had any type of financial interest. By sending the patients to those centers, they were reaping unfair benefits, and they were making decisions that were based more on their own financial gain than on the best interests of the patients in question.

The settlement is due to pay out $85 million in total, but the whistleblower law works in such a way that the person who filed the lawsuit as a representative of the federal government is given about 25 percent of the money. In this case, the man will get just over 20 million dollars for alerting the federal government to what was happening in the hospital.

When a federal investigation is carried out in a case like this, the people or the organization that has been accused has a right to fully defend themselves from the allegations if they suspect that the employee made them without proper evidence. Even when evidence is present, they have a right to a fair ruling or a legal settlement.

Source: The Star Tribune, "Florida hospital must pay $85 million in settlement over Medicare fraud whistle-blower lawsuit" No author given, Mar. 11, 2014

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