Whistleblowers will be paid $230,000 plus attorneys fees and costs for their role in uncovering more than $1 million in improper Medicare and Medicaid payments to the Mayo Clinic.  The bounty will be paid as part of a $1.26-million settlement of a lawsuit alleging that the Mayo Clinic and three related entities submitted false claims to the government for surgical pathology services that were never actually provided.

The whistleblowers commenced the lawsuit under the qui tam, or “whistleblower,” provisions of the False Claims Act.  That statute allows private individuals to file civil actions on behalf of the United States and share in any recoveries obtained as a result of those actions.

The U.S. Department of Justice intervened in the part of the qui tam action alleging that the Mayo Clinic knowingly billed Medicare, Medicaid, and other federal health care programs for the preparation and examination of permanent human-tissue slides that the Mayo Clinic never made or examined.

After the government issued a subpoena to the Mayo Clinic seeking information about its surgical pathology billing, the Mayo Clinic paid approximately $263,000 to the government.  The settlement agreement reflects this payment, and the Mayo Clinic agreed to pay an additional $1 million.  Once payment has been received, the federal government will pay $229,822 to the whistleblowers who participated in the qui tam action.  The Mayo Clinic will also pay the whistleblowers' attorney fees and legal expenses.

John Howley
New York, New York

Sources:  Press Release, The United States Attorney's Office, Minnesota

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