A whistleblower lawsuit has been filed by a Millennium Health sales representative who claims to have witnessed the company targeting Medicare patients and charging them for testing that is not medically necessary.

The qui tam lawsuit was unsealed just one day after the government announced they reached a $256 million settlement with Millennium Health over similar allegations.

Plaintiff S.L., who works for the laboratory testing company, states that Millennium’s business strategy is to find Medicare patients and issue a pharmacogenetic test bypassing a physician’s authorization.

S.L. claims that Millennium then charges both state and federal government for the investigative genetic testing which is a violation of the False Claims Act.

The qui tam lawsuit states that sales representatives at Millennium are instructed to test all Medicare patients for the genetic testing regardless if their medical history deems it necessary.

S.L. further claims that Millennium sales reps are informed that physician authorization is not required and that they only need to obtain the patient’s signature. According to the whistleblower lawsuit, representatives are paid an incentive of $9 per specimen collected.

The pharmacognetic testing is done by collecting a saliva sample to determine which medications will work better for a patient based on their genetic make-up.

While some doctors may order the testing so they can customize a drug regimen, plaintiff S.L. states that the Millennium charges Medicare for the testing without prior authorization which is a government requirement.

The recently filed qui tam lawsuit comes just after a settlement was reached with Millennium over allegations that the company billed for excessive and unnecessary urine tests between January 2008 and May 2015. The $256 million settlement also settled claims that the company submitted false bills for genetic testing.

 What is a Whistleblower Lawsuit?

A whistleblower lawsuit (or qui tam lawsuit) can be filed by an individual who has evidence against their employer which proves the company has committed government fraud. The most commonly filed qui tam lawsuits accuse businesses of committing Medicare or Medicaid fraud, health insurance fraud or government contractor fraud.

Medicare fraud occurs when businesses bill the federal government for services or supplies that were never given to Medicare patients. Likewise, healthcare insurance fraud takes place when doctors bill for tests that were never performed. While government contractor fraud occurs when security, environmental and defense contracts overcharge for work or bill for services that were never performed.

Individuals who personally witness such actions can file a whistleblower lawsuit that if successful can earn them up to 30 percent of whatever the case is able to recover.

Whistleblowers are federally protected from being demoted, harassed or fired because they filed a qui tam lawsuit.

 How to File a Whistleblower Lawsuit

Often times whistleblowers choose to hire an attorney to help them navigate through the qui tam lawsuit process. Once a whistleblower attorney is hired, the qui tam lawsuit is sent to the Justice Department for review.

From there, the government has about 60 days to decide if they want to join the whistleblower lawsuit. While having the government join the lawsuit generally means the case will be more successful, it is not necessary for the plaintiff to obtain. Individuals can continue to pursue legal action on their own if the government does not join.

The Whistleblower Lawsuit is United States of America et al v. Millennium Health, LLC, Case No. 6:15-cv-01367 in the U.S. District Court for the Middle District of Florida, Orlando Division.