On August 18, 2014 the Department of Justice (DOJ) announced that Carondelet Health Network (CHN), has agreed to pay $35 million to settle allegations that its affiliate hospitals, Carondelet St. Mary’s and Carondelet St. Joseph’s in Tucson, Arizona, knowingly violated the False Claims Act by overcharging the U.S. Government when it submitted false bills to Medicare and other Federal Health Care programs. DOJ also announced that the whistleblower, Jacqueline Bloink, formerly employed by the CHN, is entitled to a share of the settlement payment for reporting fraud against the government, which amounts to $6 million.

Ms. Bloink originally filed the lawsuit under the whistleblowers provisions of the False Claims Act, which is one of the most effective methods that the government has implemented for combating fraud.  Under the FCA, any person, who knows of an individual or company that has financially defrauded the federal government, can file a "qui tam” lawsuit to recover damages on behalf of the government.  Additionally, a whistleblower who files a case against a company that has committed fraud against the government, may receive compensation for up to 30 percent of the settlement. In this case, Ms. Bloink’s share of $35 million is approximately 17.5 percent of the settlement.

According to the lawsuit filed in 2011, in the United States District Court for the District of Arizona under the qui tam provision of the False Claims Act, Bloink alleged that between April 7, 2004, through December 31, 2011, Carondelet St. Mary’s and Carondelet St. Joseph’s knowingly submitted claims to Medicare, the Federal Employees Health Benefit Program, and to the Arizona Health Care Cost Containment System (Arizona state’s Medicaid program), for inpatient rehabilitation facility services that, in fact, qualified for outpatient services, thereby overcharging the government and violating the False Claims Act. The United States alleged that as a result of these false claims, federal health care programs paid substantially more than was warranted. Although this settlement is neither an admission of liability by CHN hospitals, it is one of many examples that the government will do everything in its power to safeguard taxpayers from fraud.

If you have information concerning a potential case involving Medicare fraud or Government Health Care billing fraud, do not hesitate to take action. It is possible that you might be able to bring your own qui tam lawsuit under the False Claims Act, acting as a whistleblower on behalf of the US government. Before filing your lawsuit, be sure to consult with an attorney familiar with the intricacies of the False Claims Act and qui tam lawsuits, as these attorneys are best equipped to help protect your rights and help you gain your share of any monetary reward from a potential settlement.