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Whistleblower Cases: Additional Getnick Law Successes

LabCorp $187 Million Recovery Whistleblower Case Study

Laboratory Corporation of America (LabCorp), the largest clinical testing laboratory in the world, paid $187 million in a global settlement following a qui tam lawsuit brought by Getnick Law on behalf of a North Carolina doctor.

The lawsuit alleged that LabCorp had included unnecessary blood tests in standard packages of routine tests. LabCorp marketed the packages of tests to doctors at prices that were often lower than the price for a single test as an incentive to doctors to order the package when a single test may have sufficed. However, when the packages were billed to Medicare and Medicaid, LabCorp “unbundled” them and charged separately for each test, many of which were neither needed nor wanted and had not been affirmatively ordered by the doctor. Since the doctors never saw the bills that were sent to the government and other third-party payors, they were unaware of the inflated charges, which were often more than eight times the price that the lab charged the doctor.

Medical Device Lymphedema Pumps Whistleblower Case Study

The Department of Justice reached a $4.9 million settlement with a New Jersey medical device manufacturer, Huntleigh Healthcare, based on a qui tam case brought by Getnick Law on behalf of a Florida medical equipment dealer alleging fraudulent marketing of lymphedema pumps.

Getnick Law’s qui tam suit alleged that Huntleigh was selling a lymphedema pump to medical equipment dealers for less than $500, and falsely claiming that it had design features making it eligible for reimbursement by Medicare as a top-of-the-range, $4,000 pump, when in fact, the pump was the same as a low-grade pump also manufactured by Huntleigh and eligible for only about $475 reimbursement. A Texas medical equipment dealer, Breathco, Inc. aka Jalopy Shoppe, Inc., also agreed to a settlement of $1.4 million. Getnick Law’s client was awarded 18% of the recoveries in each case.

Medical Device Bone Growth Stimulators Whistleblower Case Study

Orthofix International NV agreed to pay the United States government $42 million to settle civil and criminal charges relating to its marketing and sale of bone growth stimulators to Medicare and other federal health plans. The settlement was the result of a whistleblower lawsuit filed by Getnick Law on behalf of a Midwest healthcare billing consultant who brought the allegations to the government’s attention. In addition to the criminal plea by Orthofix, eight individuals also pleaded guilty or were convicted of various crimes including bribery, altering medical records and lying to the grand jury. Orthofix agreed to pay $42 million, and Getnick Law’s client received a 27% share of the civil recovery of $34.23 million.

Hospital Fraud Case Studies

Curative Health Services, Inc., which operated wound care centers in the hospital corporation HCA, Inc. (formerly Columbia/HCA Healthcare Corporation) and other hospitals nationwide, agreed to pay $16.5 million to settle allegations that it caused the hospitals to submit fraudulent cost reports to the government. The settlement resulted from qui tam lawsuits filed by Getnick Law in cooperation with a Florida law firm on behalf of two whistleblowers, one a former hospital Chief Financial Officer and the other a former hospital reimbursement manager. The whistleblowers received 19.5% of the recovery.

HCA reached a $4 million settlement with the Department of Justice arising from a related lawsuit brought by Getnick Law on behalf of a former hospital reimbursement manager alleging that HCA submitted claims to Medicare for a biological product whose safety and effectiveness had not been established and was not reimbursable. The settlement was part of a $631 million settlement with HCA. The government’s investigation into HCA involved more than 25 qui tam lawsuits, most of which were not pursued by the Department of Justice. Getnick Law’s client was one of eight whistleblowers whose cases were joined by the Department of Justice in reaching the settlement.

The national hospital chain Tenet Healthcare paid $175,000 to settle allegations that it falsely billed three times the legitimate charges for outpatient surgical pathology procedures. Although a small dollar recovery, this case, which was brought by Getnick Law on behalf of a Florida retiree who noticed the multiple billing on his own medical bills, exposed Tenet’s non-compliance with a government-imposed Corporate Integrity Agreement and put a stop to the overbilling of Medicare beneficiary co-payments and private-pay patients for the pathology procedures. The whistleblower received 21% of the recovery.