That's what happened at Amerigroup, which was contracted by the Illinois Department of Public Aid (IDPA) to provide healthcare to Illinois Medicaid recipients. While Medicare is regulated federally, Medicaid is a state responsibility, and the IDPA entered into an agreement with Amerigroup that paid the latter based on the expectation of providing healthcare to all who qualified to be enrolled in the system.
However, it didn't quite work out that way, as Amerigroup is alleged to have spurned patients with costly health conditions, or pregnant women in their third trimester. All this, while allegedly collecting fees from IDPA based on the expectation that those individuals would be provided the services they required.
Amerigroup is alleged to have pocketed the money, and a jury in 2006 agreed with that allegation, handing down a $48 million verdict against Amerigroup under the False Claims Act and the Illinois Whistleblower Reward and Protection Act.
The initial award of $48 million was tripled by law to $144 million, with an additional $190 million added in civil penalties. Although an agreement has yet to be signed, a settlement has been reached.
All this, because a former Amerigroup vice-president of government relations had the balls to blow the whistle on his employer. The actions of Cleveland Tyson helped to preserve the spirit of Medicaid for those disadvantaged Americans who can ill afford to look after their own health needs, while taking to task an entity that allegedly sought to profit off the backs of innocent people who were in no position to boost the coffers of a multi-million dollar company.
It should be noted that the final settlement in the aforementioned case was reached just as new, federal legislation aimed at easing the restrictions on the whistleblower process, is under consideration by Congress. The proposed legislation would remove obstacles that might otherwise prevent whistleblowers from seeking redress against contractors and agents that are committing fraud against the federal government.
Meanwhile, in California State Senator Leland Yee (D-San Francisco) has introduced a bill allowing University of California (UC) employees who were punished for reporting wrongdoing, to sue for damages.
The legislation is aimed at overturning a recent California Supreme Court decision relating to the experience of two former computer scientists at UC's Lawrence National Laboratory.
According to reports, both former employees reported to supervisors what they viewed as safety violations in 2003. For their efforts, they were allegedly rebuffed. According to the text of the lawsuit one employee was fired, while his co-worker—hearing through the grapevine that she was about to be fired, quit on her own. The situation was duly investigated by a university complaints officer, who concluded that the claims and allegations against them were unfounded.
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A damage suit brought against the university by the two former employees was dismissed July 30th by way of a unanimous ruling based on the letter of the law, although it was noted by the Senator from California that three of the seven Supreme Court justices issued a dissenting opinion taking issue with the university's protected status, and urging a change to the law.