Nurse’s reward $15 million for blowing whistle on health care fraud

 A Monroeville nurse will get just over $15 million for blowing the whistle on fraud at a national home healthcare company where she once worked. That company Amedisys Inc., a home health company operating in 37 states, agreed to pay $150 million in a settlement announced today.

“Amedisys made false Medicare claims, depriving the American taxpayer of millions of dollars and unlawfully enriching Amedisys,” The U.S. Attorney stated in a press release. “The vigorous enforcement work by assistant U.S. attorneys in my office, along with their colleagues in North Georgia, Eastern Pennsylvania, Eastern Kentucky and the Civil Division of the Justice Department, has secured the return of $150 million to the taxpayers and stands as a warning to future wrongdoers that we will aggressively pursue them.”

April Brown, a nurse in Monroeville, in 2010 filed a federal lawsuit in Birmingham against Amedisys. The lawsuit claims the company violated the False Claims Act by submitting false home healthcare billings to Medicare for home health services, her attorney said.

Brown was a home health nurse and was seeing patients in the Monroeville area.

Nurses had to check off boxes on computerized forms during patient visits, Barger said. But the way the electronic forms were set up the patients were always coded for the highest level of service and the forms did not represent the patients’ true condition.

Brown was fired after questioning the practice, was the first to file a qui tam – or whistleblower – lawsuit. Her suit and six others filed around the nation against Amedisys alleging improper billing by the company between 2008 and 2010 were consolidated in a federal court in Pennsylvania. The lawsuits were sealed from public view until today when the settlement was announced.   

Under the federal False Claims Act a person can file a lawsuit against someone or a company on behalf of the U.S. Government for a wrongful act. If the U.S. Attorney’s Office agrees to intervene after an investigation, and there’s a settlement or judgment in the case, the person who filed it can get a small portion of that money.

According to today’s announcement from the Justice Department the whistleblowers who filed lawsuits – primarily former Amedisys employees – will collectively split over $26 million. Brown will get $15 million of that.