A whistleblower who filed a False Claims Act lawsuit against her former employer, Pentec Health Inc., has helped the U.S. government recover $17 million for Medicare and other federal health care programs.
Jean Brasher filed the whistleblower lawsuit in October 2013 accusing Pennsylvania-based Penter Health Inc. of billing Medicare and other government programs for excessive amounts of its renal drug Proplete.
According to the U.S. Justice Department, the whistleblower lawsuit alleged that Pentec also routinely waived patient copayments and deductible obligations to incentivize beneficiaries of the government programs to get Proplete prescriptions, even when more affordable options were available.
Additionally, Pentec submitted duplicate and improperly coded claims to the Federal Employee Health Benefits Program, the whistleblower complaint asserted.
Pentec allegedly engaged in these fraudulent billing practices from 2007 to 2018, causing U.S. taxpayers to overpay millions of dollars for the company’s drugs and services.
“We thank [Jean Brasher] for her invaluable contribution in this case. Together with her lawyers, they provided vital assistance to the government throughout this case. Without information from citizens like [her], detecting fraud and conserving government program funds would be far more difficult,” said U.S Attorney William McSwain.
In addition to paying the U.S. $17 million, Pentec also agreed to enter into a five-year Corporate Integrity Agreement (CIA) with the Department of Health and Human Services, which will subject the company to increased federal scrutiny. The CIA also subjects Pentec to exclusion from all federal heath care programs if in the future it is found to have violated the agreement.
The DOJ’s announcement didn’t say how much of the $17 million settlement it will award Ms. Brasher for her bringing the whistleblower lawsuit. Under the terms of the False Claims Act, she is entitled to an award of up to $4.25 million – 25 percent of the total recovery.