A group of hospitals nationwide owned and operated by Vibra Healthcare LLC settled a qui tam lawsuit at the end of September for $32.7 million plus interest. During the course of an investigation, it was found that Vibra defrauded the U.S. government by billing Medicare for unnecessary services between 2006 and 2013. The fraud allegedly took place when Vibra sent patients to five of its long-term care hospitals and one of its inpatient rehabilitation facilities without those patients exhibiting any reasons to be admitted. Vibra also kept patients in the hospital longer than medically necessary so that it could continue to bill Medicare for its services.
The whistleblower in this case, Sylvia Daniel, used to work for Vibra Hospital of Southeastern Michigan as a health information coder. It was in this capacity that she noticed the fraud and filed the lawsuit. For her work in bringing the suit on behalf of the government, Daniel will receive $4 million of the recovered funds.
As Benjamin C. Mizer, head of the Justice Department’s Civil Division and the principal deputy assistant attorney general, said, “Medicare beneficiaries are entitled to receive care that is determined by their clinical needs and not the financial interests of healthcare providers.” The outcome of this case serves as an important reminder of that, and of the high costs of healthcare fraud.