Jewish Hospital & St. Mary’s Healthcare, Inc., d/b/a Pharmacy Plus and Pharmacy Plus Specialty paid the United States over $10.1 million to settle liability under the False Claims Act for multiple fraudulent Medicare schemes.
These schemes included submitting claims that violated requirements ensuring Medicare paid only for reasonable and necessary drugs. The government also alleged that Jewish Hospital illegally gave patients free items and waived co-payments and deductibles for insulin. These items and waivers violate the Anti-Kickback Statute.
Our client, Robert Stone, a licensed pharmacist who worked at Jewish Hospital, brought the fraud to the attention of the government by filing a qui tam complaint under the False Claims Act in 2017.
For over two years before filing his complaint, Mr. Stone had tried in vain to raise these concerns to his superiors, but his efforts at compliance were fruitless. Together, however, we were able to bring his concerns to the attention of government prosecutors at DOJ and the United States Attorney’s Office in the Western District of Kentucky and successfully put the practices to rest. “When they failed to make corrections, I filed my qui tam lawsuit so the United States whose Medicare program was being defrauded could take action,” Mr. Stone explained.
“I am very grateful to my attorneys Bob Thomas, Suzanne Durrell, and David W.S. Lieberman for their expertise, guidance, and support, and to the government attorneys and investigators for their commitment to my case.”
Under the False Claims Act, a private citizen who knows of fraud against the government can file a sealed complaint on behalf of the government. If the case is successful, the whistleblower is entitled to a share of the government’s recovery. In this case, Mr. Stone received $1.85 million from the government for his help in ending this fraud.
United States ex rel. Stone v. Jewish Hospital, Civil Action No. 3:17-CV-294-RGJ (W.D. Ky.)