Consumer Fraud

Whistleblower Case Recovers $1.65 Million From Vermont Hospital

Pills Stethascope on Money 435x289 Whistleblower Case Recovers $1.65 Million From Vermont HospitalA whistleblower complaint filed against a Vermont hospital by one of its former administrators has ended in a $1.65 million settlement.

Brattleboro Memorial Hospital agreed to pay the U.S. and the State of Vermont the sum to resolve allegations that it knowingly submitted or caused the submission of false claims to the Medicare and Medicaid programs.

Amy Beth Main filed the lawsuit on behalf of the U.S. and Vermont under the whistleblower provisions of the federal and Vermont False Claims Acts. Plaintiff’s counsel told the Brattleboro Reformer that Ms. Main, an administrator in Brattleboro Memorial’s financial services department, “protested internally” and “vigorously” about “irregular, inappropriate, improper and illegal billings” that she observed there.

But instead of addressing the problem, Brattleboro Memorial “made life miserable for her” until Ms. Main was forced to quit her job.

“It was hugely stressful for her to live and work under those conditions,” her lawyer told the Brattleboro Reformer.

According to the U.S. Attorney’s office for the District of Vermont, the federal government investigated Ms. Main’s whistleblower allegations and chose to intervene in the case, effectively taking over litigation of the case.

Federal prosecutors alleged that from approximately Jan. 2012 through Sept. 2014, Brattleboro Memorial Hospital “knowingly submitted or caused to be submitted a number of outpatient laboratory claims lacking documentation necessary to support reimbursement by Medicare and Medicaid.

Brattleboro Memorial agreed to pay $1,655,000 to resolve the allegations. False Claims Act cases that go to trial can result in civil penalties of between $5,500 to $11,000 per false claim and three times the amount of actual damages.

The recovery from Brattleboro Memorial will be returned to Medicare, federal Medicaid, and Vermont Medicaid programs.

Whistleblowers whose False Claims Act cases result in a settlement or judgment receive an award that ranges from 15-25 percent of the total recovery, or up to 30 percent if the federal government declines to intervene.

Ms. Main’s attorney told the Brattleboro Reformer that her whistleblower award will be between 15 and 20 percent.