Phillips & Cohen represented Dr. Michael Mayes of South Carolina in a whistleblower lawsuit against three blood testing labs and a healthcare marketing company alleging that the labs and the marketing company were paying illegal kickbacks to physicians.
Dr. Mayes’s case and his testimony at trial resulted in a federal judge in South Carolina ordering the former CEO of Health Diagnostic Laboratory (HDL) and the owners of BlueWave, the marketing company, to pay the government $114 million in trebled civil damages and penalties. HDL, Singulex and Berkeley Heartlab (and Quest Diagnostics, which acquired Berkeley Heartlab) paid a total of $54.5 million to settle charges against them. Below is an excerpt from a story about Dr. Mayes in the Columbia, SC, newspaper, The State.
South Carolina doctor risked it all to blow the whistle on a national Medicare fraud
Since 2010, [Dr. Michael Mayes] worked mostly in secret to gather information, turn it over to the government and help build a federal case to expose national Medicare fraud that affected his own patients on Hilton Head — and those around South Carolina and the nation too.
His work blew the lid on a national scam where physicians ordered panels of lab tests that were not always medically necessary for their patients and received illegal kickbacks. As a result, Medicare, and other government healthcare programs, paid upward of $500 million in fraudulent claims. If Mayes hadn’t risked his career, relationships with fellow physicians and future job prospects, the fraud could still be going on today.
He asked a representative for the company about the tests, who assured him not to worry about it. After all, the patients weren’t being charged, and Mayes was being paid for it.
But Mayes knew Medicare was footing the bill. And with his business background, he couldn’t help but dwell on the fact that the solvency of Medicare was at risk if these claims and payments continued. And he assumed — correctly — this was going on across the country.
To learn more, read the entire story, “South Carolina doctor risked it all to blow the whistle on a national Medicare fraud.”