FBI Thanks the Honesty of Whistleblowers in Catching Medicare Fraud


On June 20, the U.S. Attorney’s Office for the Northern District of Georgia announced that a chain of urgent healthcare providers in Georgia agreed to pay $1.6 million to resolve allegations that they violated the False Claims Act (FCA) for improperly charging Medicare for the testing and treatment of patients with exposure to COVID-19.

Former employees of CRH Healthcare, LLC, who were not publicly named, filed a civil suit under the qui tam provision of the FCA. Qui tam claims enable private citizens to file lawsuits on behalf of the government if they know of an individual or company defrauding the government. Qui tam whistleblowers are eligible to receive between 15 and 30% of the government’s recovery. The unnamed whistleblowers will share in $320,000 from the settlement in this matter. 

“The FBI is thankful for the honesty of the whistleblowers who stepped forward to identify this alleged fraud,” said Keri Farley, Special Agent in Charge of FBI Atlanta. “The FBI and our law enforcement partners will continue to pursue reports of medical facilities filing false or misleading claims, choices that ultimately rob our citizens.”

The investigation into CRH Healthcare, LLC and Peachtree Immediate Care FP, LLC was part of a joint effort by U.S. Department of Health and Human Services, Office of Inspector General and the FBI. In 2021, the Attorney General established the COVID-19 Fraud Enforcement Task Force to specifically tackle pandemic related fraud. The government acknowledged the importance of the FCA and of whistleblowers in pursuing allegations of fraud stemming from the Coronavirus pandemic. 

“Health care professionals provided an invaluable service to the public during the Coronavirus pandemic. But medical practices that seek to misrepresent the services they provide to patients, and to improperly profit from such practices, must be held accountable,” said U.S. Attorney Ryan K. Buchanan. “The Department of Justice will work diligently to protect taxpayer dollars by ensuring that medical providers fairly and accurately bill federal health care programs.”

In recent weeks, the U.S. Supreme Court has issued two decisions in False Claims Act whistleblower cases. On June 16, the Supreme Court issued an 8-1 ruling in United States, ex rel. Polansky v. Executive Health Resources, Inc. The decision grants the DOJ the authority to dismiss qui tam whistleblower lawsuits in cases in which it chose not to intervene.

On June 1, the U.S. Supreme Court issued an unanimous decision in U.S. ex rel. Schutte v. SuperValu Inc. The decision, heralded as a major victory by whistleblower advocates, overturns U.S. Court of Appeals rulings which allowed fraudulent companies to escape liability under the False Claims Act if they could prove their fraudulent actions could be based on a “reasonable interpretation of the law” regardless of whether or not the company intended to commit fraud.

Further Reading:

Georgia urgent care chain agrees to pay $1,600,000 to resolve False Claim Act allegations

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