A whistleblower case claiming that the kidney dialysis company DaVita had defrauded Medicare through overuse of Epogen has settled for $55 million. The case, which was brought by an employee of Epogen maker, Amgen, claimed that DaVita was using more Epogen than medically necessary and was double-billing Medicare for Epogen left over in vials and unused. At the time, Medicare reimbursed dialysis companies fully for all drugs used in the treatment.
Source: Denver Post
This case was brought under the federal False Claims Act, which allows whistleblowers to file suit against companies that are defrauding the federal government such as by billing Medicare for medically unnecessary medications or procedures or double-billing as allegedly was done here. The False Claims Act also allows the whistleblower to retain a percentage, usually 15-25%, of the money recovered from the company that has defrauded the government.