Two occupational therapists came forward to file a nursing home Medicare fraud lawsuit against Signature Healthcare LLC, an organization based out of Louisville, Tenn. that runs over eight dozen elder care facilities in multiple states.

The two women—LeeAnn H. and Kristi E.—registered the nursing home Medicare fraud lawsuit as ‘relators’, persons who choose to blow the whistle and sue on behalf of the federal government for violations of the False Claim Act (FCA).

The women, employed in Columbia, Tenn., started collecting evidence for the nursing home Medicare fraud lawsuit back in 2014. The government’s investigation was not far behind.

The women say they were motivated in part by the fear that some of the abuses of ordered services such as occupational, physical, and speech therapy sessions would eventually cause problems for them.

According to LeeAnn in an article posted at Nashville Public Radio, one of her elderly, terminal cancer patients drew her attention to the fact that unnecessary care was being ordered by telling her that she needed to focus her skills on someone else that could benefit from them.

This patient said she didn’t want to spend her remaining time doing occupational therapy when she could be spending it with her family members.

The women and the Department of Justice brought allegations against Signature Healthcare of scheduling therapy sessions in order to maximize all potential government Medicare reimbursements regardless of necessity. When these therapies were needed, the organization purportedly withheld them if reimbursements for this type of care had reached the maximum limit.

Recently, this nursing home Medicare fraud lawsuit was settled between the federal government and Signature Healthcare LLC for a staggering $230 million. For their willingness to come forward and take the associated risks, the women will be rewarded with a percentage of the settlement totaling $6 million. They will of course have to divide this among themselves.

What is the False Claims Act?

The FCA is a federal law that allows the government to litigate on its behalf for entities that defraud the U.S. by bringing false claims of services either not actually provided or unnecessarily provided against public health or other programs.

The most common target for false claims is Medicare and Medicaid—two of the largest public health subsidies.

The two women relators in this nursing home Medicare fraud lawsuit illustrate a provision of the FCA known as qui tam. Qui tam allows persons who are otherwise not affiliated with the federal government to sue on its behalf.

Although it is not always the case, often the government chooses to take on the action and any proceeds—known as damages—that are recovered then are shared with the relator. Usually, around 15 to 25 percent of the regained funds are eligible to be shared in this manner.