The Birmingham News reports that Pinnacle Medical Solutions, a Southhaven, Miss. medical equipment company, agreed to pay nearly $1.8 million to settle a False Claims Act lawsuit brought by two former employees.
Wendy Horne, a former reimbursement specialist for Pinnacle, claims that she found fraudulent practices within the company in the handling of insurance reimbursement for delivery of medical supplies to patients from September 2006 through May 2009.
According to her lawsuit, soon after Horne was hired in 2007, she reported the fraudulent charges and suggested they repay the money to the insurance companies. The lawsuit claims that the management ignored her, and she was fired in 2009.
The article says that “after Horne reported problems to the U.S. Department of Health and Human Services, Pinnacle made a voluntary repayment of $236,204. Under the agreement…the company agrees to re-pay an additional $1,771,522.
As a condition of the settlement, Pinnacle is also required to enter into a Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General, under which the company will be monitored for a period of five years to ensure that in the future it complies with all federal health care program rules.”
In the agreement, however, Pinnacle does not make an admission that it is liable.
Under the False Claims Act, Horne and her fellow whistleblower, Nancy D. Weart, can receive 15% – 25% of the money recovered in a case.