Agnesian HealthCare, based out of Wisconsin, has brought an end to a lawsuit alleging it engaged in illegal kickbacks with a $10 million whistleblower settlement.

Back in 2014, Dr. Clark Searle, M.D., an orthopedic surgeon with Agnesian HealthCare, filed a whistleblower lawsuit alleging that his employer’s compensation plan for doctors had included an illegal kickbacks scheme. Dr. Seale alleged that for years, this compensation plan included improper compensation meant to encourage them to illegally refer patients to particular hospitals and medical facilities associated with it for medical services paid for by government healthcare programs.

According to Dr. Seale’s complaint, Agnesian HealthCare gave further compensation to the physicians who referred many patients to its hospitals and programs. Moreover, the complaint claimed, the company also limited the extent to which physicians could refer patients to competitors.

Under federal law, hospitals and medical providers are not allowed to pay physicians in exchange for referring patients to them for services paid for by government-funded healthcare programs, such as Medicare and Medicaid. Plus, claims submitted to such government-funded healthcare programs that rely on a kickbacks scheme are considered false under federal law.

Dr. Seale alleged that this violated a number of laws, including the federal False Claims Act, the Wisconsin False Claims for Medical Assistance Law (which has since been repealed), the Stark Law, and the Anti-Kickback Statute.

The $10 million whistleblower settlement will go to both the federal government and the state of Wisconsin.

Filing a Whistleblower Lawsuit

Individual employees or other witnesses to fraud can help the government identify these kinds of violations by becoming whistleblowers. Blowing the whistle by filing a qui tam lawsuit alerts the government to these allegations, and the government can then choose to step in. Whistleblowers are often awarded a substantial portion of any settlement award that results from a qui tam lawsuit for their part in bringing the matter to the attention of the government. This is usually between 15 and 30 percent of the total settlement amount, which can be substantial.

Healthcare fraud can be committed by hospitals, physicians, pharmacies, medical product or medical device providers, labs, ambulance transport companies, home healthcare agencies, and more.

If you have witnessed your employer or another company engage in healthcare fraud, such as an illegal kickbacks scheme, or another type of fraud against the government, you may be able to file a whistleblower lawsuit on behalf of the government. While some people may worry about possible retaliation from their employer for such an action, such as being fired, demoted, or otherwise punished, there are anti-retaliation laws in place at the federal and state level alike to protect whistleblowers from this kind of pushback.

Filing a whistleblower lawsuit can be a daunting prospect, so Top Class Actions has laid the groundwork for you by connecting you with an experienced attorney. Consulting an attorney can help you determine if you have a claim, navigate the complexities of litigation, and maximize your potential compensation.

This article is not legal advice. It is presented
for informational purposes only.