Imagine starting a new job. You’ve probably left behind another job and made other changes to prepare for the new experience, perhaps even relocating. No matter how experienced and educated you are, it is a nerve-wracking experience. It takes time to learn company practice. Now suppose you are asked to do something you know is wrong. What would you do? In the case of health care fraud and other forms of government contracting fraud our Northern California whistleblowers’ law firm helps people who find themselves in this situation, helping them report the wrongdoing while protecting their own interests.
False Claims Allegations Brought Thanks to Whistleblower and Supported by Another Inside Witness
Last week, an FBI press release detailed federal health care fraud charges filed against Jocelyn Gumila, a nurse who served as the manager for Doctor At Home (“DaH”). The release details allegations including double-billing, over-billing, and improperly certifying patients as eligible for home-based care. Doctor At Home allegedly helped home health agencies pursue false billings such as claims for more than $1,000 per month to provide nurse visits that were not medically necessary.
An affidavit details interviews with one current and seven former DaH employees as well as company patients and their primary care providers. This included a physician’s assistant who reached out to investigators in January 2014. Additionally, a former company doctor, known as “Physician D”, had been independently recording concerning conversations and saving records like e-mails, claims data, and patient files. Physician D had only been working for DaH for a few weeks when she recorded a conversation where she told Gumila that several patients were not qualified for certain services. In reply, Gumila told Physician D to act as an “artist [and] paint the picture” of the patients so that Medicare would pay for the services.
According to the FBI, investigations revealed a number of other actions that Gumila allegedly took and that would violate Medicare rules, resulting in improper payments by Medicare to DaH. It appears clear the case could not exist without individuals willing to speak out. While press release provides more detail about Physician D, it appears a physician’s assistant is the realtor in this case, the whistleblower who initiated the case by coming forward with information. We applaud this move.
Protecting Whistleblowers & Stopping Fraud
When such individuals come to our whistleblower’s law firm in Oakland or our other offices, we make sure they receive all the protections provided by the law. The primary law used to prosecute these fraud cases is the False Claims Act. Section 31 U.S.C. 3730(h) protects realtors and others who help in the case from retaliatory employment actions due to their involvement. The statute provides double damages; for every dollar the employee lost due to the defendant “punishing” him or her for involvement, the defendant will owe the employee two dollars. Realtors are also eligible for very substantial rewards for their role in bringing and pursuing a successful case.
We will always consider the people who walk into our office and report fraud on the government to be brave. We want anyone considering taking that step to know we will support them and we will fight for their legal rights. Let us help you. Together we can pursue justice and recover government funds that are critical to all of our fellow citizens.
See Related Blog Posts:
The Experience of Whistleblowers
Addressing Medicare Fraud
(Image by Flicker user 401(K) 2013)