Medicare Whistleblower Proceeds Alone; Recovers $40M

Taxpayers have former marketing representative turned whistleblower, Scott Pogue, to thank for recovering $40 million in alleged fraudulent medicare payments and penalties from Nashville-based Diabetes Treatment Centers of America. The Government declined to intervene in the case, and Pogue took up the flag and carried it for over a decade before reaching the settlement with DTCA which was recently approved by the Government. Pogue will collect over $10 million for his effforts.  After years of litigation, the lawsuit finally gained traction with a court opinion issued  last summer, holding  that Pogue sufficiently stated a claim and demonstrated evidence that DTCA illegally provided kickbacks to “medical directors” in exchange for referrals to DTCA’s hospital customers:

In sum, the Court finds that relator has produced a wealth of evidence supporting his claim that defendant compensated physicians for their referrals to DTCA centers, and a reasonable jury could decide the issue in relator’s favor.

Read a complete copy of the Court’s opinion here

To report Medicare fraud & abuse or learn more about whistleblower litigation, contact Frohsin & Barger.