The Orlando Sentinel reports that a qui tam lawsuit brought by two whistleblowers alleging that several Adventist Health hospitals in Central Florida violated the False Claims Act has been settled for an undisclosed amount. An Order of Dismissal was entered in the United States District Court for the Middle District of Florida on December 18, 2013. The Order of Dismissal contains no details; rather, it simply indicates the complete settlement of all claims subject to the right of any party to re-open the matter within 60 days upon good cause shown.
The lawsuit was initially filed in July 2010 and named Adventist Health, based in Altamonte Springs, Florida. The two whistleblowers, Amanda Dittman and Dr. Charlotte Elenberger, were formerly affiliated with Florida Hospital Orlando. The whistleblowers complaint alleged violations of the federal False Claims Act and Florida’s False Claims Act statute. In the qui tam complaint, the whistleblowers alleged that several Adventist hospitals – Florida Hospital Orlando, Florida Hospital Altamonte, Florida Hospital Apopka, Florida Hospital East Orlando, Florida Hospital Celebration Health, Florida Hospital Kissimmee and Winter Park Memorial Hospital – engaged in rampant overbilling of federal and state healthcare programs.
One of the whistleblowers was a bill-coding and reimbursement compliance officer for Florida Hospital Orlando from 2001 to 2008. The other whistleblower was formerly a radiologist at Florida Radiology Associates with staff privileges at Florida Hospital Orlando.
The qui tam complaint alleged that the Adventist Hospitals submitted tens of millions of dollars in false or inflated claims to Medicare, Medicaid and Tricare. In addition, it was alleged that billing-code “modifiers” were routinely used which resulted in excess payments to the hospitals, the hospital submitted bills for larger doses of drugs than were actually administered, and billed for services that were not performed.
The trial had been scheduled to start in December 2013.
The whistleblowers will be entitled to share in a percentage of the settlement proceeds under the qui tam provisions of both the federal and Florida False Claims Act statutes.
For additional information how to bring a qui tam or whistleblower case, read here.