Whistleblower unveils Medicare fraud, will reap reward

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Gregory Kuzma, an Arizona resident with an accounting background, noticed in reviewing a community health system’s Medicare filings that something seemed askew.

He brought his suspicions to attorneys at Kline & Specter and shortly thereafter officially blew the whistle on the Arizona-based Yavapai Regional Medical Center for inflating the hours worked by its employees and thus allegedly defrauding Medicare between 2006 and 2009. The case culminated on Oct. 4 with the announcement by federal prosecutors that the litigation had resulted in an agreement by Yavapai to pay $5.85 million to resolve claims that it had overbilled Medicare. Kuzma filed his lawsuit under the qui tam provisions of the False Claims Act, which allow private citizens to bring civil actions on behalf of the United States and to share a part of any recovery. Kuzma’s reward was $1.17 million. Ironically, the case was the second large settlement in Arizona for Kline & Specter attorneys David Caputo and David Williams. In 2014 they represented a whistleblower in litigation that resulted in a $35 million settlement – and a nearly $6 million whistleblower reward — with a healthcare system over alleged Medicare fraud. That was the largest settlement of its kind in that state’s history.

While Whistleblower lawsuits have flourished in recent years, Caputo noted the importance of filing the actions as quickly as possible since the government uses a “first to file” rule — the first person who brings suit gets the reward. Kline & Specter handles whistleblower lawsuits on a contingent fee basis, meaning the law firm gets paid only if the suit is successful. To contact a whistleblower attorney, use the contact form on this website or call us at 800-243-1100.

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