Two former employees of Martin’s Point Health Care, whose whistleblowing led the federal government to sue the Maine-based company and five other health care providers were rewarded with more than $5.65 million from a settlement with a New York hospital.
SVCMC Inc., formerly known as Saint Vincent’s Catholic Medical Centers of New York agreed to pay $29 million to resolve allegations that it knowingly kept inflated payments from the U.S. Department of Defense for health care services given to retired members of the military and their families, the U.S. Department of Justice announced on Friday.
The case stems from reports of the fraud by whistleblowers Jane Rollinson and Daniel Gregorie, who worked for Martin’s Point and initiated a complaint on behalf of the government in 2016 against Martin’s Point, Brighton Marine Inc., Christus Health, Johns Hopkins Medical Services Corporation, PacMed Clinics, and US Family Health Plan Alliance, Inc. The federal government intervened in the action in 2023.
According to the complaint, in June 2012, the health care service companies learned that calculation errors had inflated the rates they had been paid in prior years. In response, they took steps to conceal the overpayments from the government and continued to submit invoices at the higher payment rates.
During discussions about rates for the subsequent year, the complaint alleges some of the companies asked the government to continue paying them at the higher rates even though they...
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