Adventist Health System has agreed to pay over $2 million to the government in response to healthcare fraud allegations at a hospital in Central Florida.
The whistleblower, Heather Huddleston, used to work as a nurse at Adventist hospitals. In 2013, Morgan & Morgan assisted her in filing a lawsuit against Adventist on behalf of the government.
The lawsuit alleged multiple False Claims Act violations, including the mismanagement of chemotherapy treatments. Chemotherapy drugs can be administered in single-use vials, which are approved for use one time on one patient.
According the suit, certain Adventist healthcare providers routinely used a portion of the drugs in each vial on one patient, and then would reopen the vial and use the remainder on additional patients at a later time.
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The potential health risks involved in this practice are immense. Cancer patients are already coping with weakened immune systems, so exposing chemotherapy drugs to possible contaminants could do great damage to the patients’ care or recovery.
As Huddleston claimed, the actions that Adventist allegedly took may have led to some patients requiring treatment they otherwise wouldn’t have needed.
The lawsuit also included accusations that the hospital inappropriately administered platinum-based drugs and submitted fraudulent invoices to the government requesting more reimbursement than it was owed. The latter is an unfortunately common practice known as upcoding.
About False Claims Act Lawsuits
The False Claims Act prohibits any individual from submitting false claims to the federal government. This pertains to any invoice submitted to a government healthcare program such as Medicare, Medicaid and TRICARE.
Common violations of the False Claim act include:
- Submitting inaccurate billing amounts on invoices
- Routinely waiving co-pays for Medicare and Medicaid patients
- Allowing unqualified parties to perform healthcare service on Medicare patients
- Billing Medicare and Medicaid for tests and services that never occurred.
The federal government enables any person who witnesses False Claims Act violations to file a qui tam lawsuit. The contents of the lawsuit are kept confidential and sealed until it is resolved.
If the government is able to recover more than $1 million in the resolution of the case, whistleblowers may be entitled to anywhere between 15% and 30% of the total settlement or penalty amount.
Morgan & Morgan Whistleblower Attorneys
This is the second case in the past year in which Morgan & Morgan has helped secure a government settlement and whistleblower award from Adventist. Our Complex Litigation Group specializes in qui tam lawsuits, and has vast experience recovering taxpayer dollars from fraudulent healthcare corporations.