A whistleblower’s medical billing fraud lawsuit, originally filed a couple years ago, has now been taken over by the federal government.

According to the government’s new medical billing fraud complaint, which was filed just this last month, SNAP Diagnostics falsely charged Medicare, billing the government program for items that were medically unnecessary.

The federal government’s medical billing fraud lawsuit alleges that SNAP received almost $9 million from fraudulent Medicare reimbursement since 2009 for this practice. The medical billing fraud was completely intentional, the lawsuit claims, and goes all the way up the company chain.

According to the government’s medical billing fraud complaint, “Despite knowing that only a few hours of home sleep testing in a single night was needed for SNAP’s home sleep test recorders to diagnose OSA, SNAP — at the direction of [company President Gil Raviv] — routinely double- and triple-billed federal health care programs, including Medicare, by submitting claims for beneficiaries’ medically unnecessary second and third nights of home sleep testing.”

The government’s complaint claims that the company not only committed medical billing fraud by billing Medicare for obstructive sleep apnea home testing devices, but even provided kickbacks to health care providers for selling these products. These kickbacks took a few different forms. Firstly, SNAP interpreted test results and also gave physicians access to these unsigned reports, meaning that they could charge for these results as well.

Independent contractors were hired to market SNAP to physicians, who were then allegedly paid commissions for each sleep test they sold. SNAP also allegedly gave health care providers and families free or no-copay tests as further encouragement.

“Because SNAP’s business model was based upon offers of kickbacks, all of the nearly $9 million SNAP has received from Medicare was the result of false certifications in forms submitted to Medicare, which required the provider not to engage in unlawful kickbacks,” alleged the government’s lawsuit.

A former SNAP salesman filed the original whistleblower lawsuit in 2014, and the government intervened in October 2017. Whistleblowers are usually given between 15 and 30 percent of any money recovered in a government medical billing fraud lawsuit. Many whistleblower lawsuits end up bringing in millions in settlement money, so a whistleblower monetary reward can be substantial.

Filing a Whistleblower Lawsuit

Whistleblower lawsuits are filed by employees or former employees who have found evidence of fraud or other illegal activities against the government. Many of these employees choose to come forward, acting as whistleblowers, because they feel that their employer’s actions are wrong—even if they are worried about retaliation.

While a person considering becoming a whistleblower on behalf of the government, they may worry about being fired or otherwise retaliated against at work. However, there are regulations in place to protect whistleblowers. On top of these protections, whistleblowers are typically given a substantial reward for calling attention to the suit.

If you believe you have witnessed some kind of fraud against the government by your current or former employer, such as medical billing fraud, you may be able to file a whistleblower lawsuit (also known as a qui tam lawsuit) against your employer on behalf of the government. Such lawsuits have been filed over Medicare and Medicaid fraud, health insurance billing fraud, physician/hospital kickbacks, and many other types of government financial fraud.