Court Reinstates $255 Million Jury Verdict in Qui Tam Case Against Medicare Fraudsters

The United States Court of Appeals for the Eleventh Circuit reinstated a jury’s verdict of over $85 million in a case brought by a whistleblower against Consulate Health Care. As the False Claims Act triples the final amount of damages that a company caught committing fraud will have to pay, this brings the total to over $255 million. Angela Ruckh, a career nurse and healthcare professional, first brought the complaint after noticing a pattern of upcoding claims and falsifying Medicaid and Medicare billing reports. By inflating small therapy claims and charging patients $10-$100 extra for services they did not need, Consulate Health Care (formerly La Vie Rehab) slowly defrauded the Medicaid and Medicare programs out of tens of millions of dollars over a few years.

Ruckh filed her False Claims Act complaint in 2011, but the federal government decided not to intervene and aid in her case. In most instances where the government passes on a False Claims Act lawsuit, the case is doomed to failure, either because of the high legal fees required to continue or countersuits brought by the defendants, usually large and wealthy companies. With the reinstatement of this verdict, Ruckh and her attorneys will have their legal fees paid for by the defendants under the False Claims Act’s provisions. This decision reinforces the False Claims Act’s sweeping power to produce justice even in cases where the federal government chooses not to intervene.

False Claims Act whistleblowers, or qui tam relators, can earn rewards of 15 to 30% of the funds recovered by the federal government. In cases where the government does not intervene, the whistleblower is entitled to 25 to 30% of the total funds recovered. This verdict is a victory for both the relator and the taxpayers who were defrauded in the scheme.

Read:

Consulate Health Care, Florida’s largest nursing home company, faces quarter-billion-dollar fraud judgment.

United States ex rel. Ruckh v. Salus Rehabilitation, LLC, No. 18-10500, 2020 WL 3467393 (11th Cir. June 25, 2020).

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