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A healthcare fraud case highlights whistleblower efforts

A Florida case involving healthcare fraud finally settled in 2017 after years of undercover work by the whistleblower and his team. Freedom Health in Tampa was the company that came under intense government scrutiny following the “qui tam” complaint filed by employee Darren Sewell.

What happened

Darren Sewell was a vice president at Freedom Health in Tampa, a company owned by wealthy entrepreneur Kiran C. Patel. The company thrived on the administration of Medicare plans. Sewell became convinced Freedom Health was also bilking the government out of millions of dollars by running scams involved with the Medicare Advantage plan.

Filing a complaint

In becoming a whistleblower, Sewell filed a “qui tam” complaint under the False Claims Act, backing it up with hundreds of supporting documents, including spreadsheets and emails. Basically, this meant that on behalf of the government, he was filing suit against Freedom Health, whom he believed was defrauding the government. This kind of complaint is filed in secret, allowing the government to pursue its own investigation. Meanwhile, Sewell went to work as usual. Every night, he shared any information pertinent to the case with an FBI agent and an attorney who had experience working with whistleblowers.

Final results

In 2016, the Justice Department joined the lawsuit Sewell had started seven years earlier. In 2017, Freedom Health finally settled for $31.7 million against charges that the company had violated the False Claims Act. The company president, Sidd Pagidipati, paid $750,000 to settle his part of the charges. However, neither he nor founder Patel ever admitted to committing fraud. Unfortunately, Darren Sewell did not live to see the results of his hard work. After taking a fall at his home, he died as the result of a brain injury. His estate shared in the whistleblower recovery of $6.4 million.

Other protections

Becoming a whistleblower is not an easy decision to make, but those who do may expect protection under OSHA, Sarbanes-Oxley and the Florida Whistleblower Act. In addition to the False Claims Act, those who file a complaint of wrongdoing against an employer and/or participate in a government investigation can seek legal assistance.

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