As part of the settlement, two whistleblowers will share $1.1 million.
As reported by The Atlanta Journal-Constitution (8/4/15), whistleblower Sheila McCray, an employee of PSA Healthcare, discovered that her employer was sitting on millions of dollars in government overpayments from Medicare and Medicaid. According to the recently unsealed healthcare fraud whistleblower lawsuit, McCray, a billing specialist, duly noted her findings to her employer.
In response, according to court documents, McCray alleges she was told by upper management to sit on her observations in order to see whether or not the feds would catch the overpayments.
As reported in The Atlanta Journal-Constitution, McCray was subsequently demoted, endured intimidation by management (or so it was alleged), endured a cut to her hourly pay rate and was ultimately terminated from her position.
McCray then joined with another former employee of PSA Heath, Yvette Odumosu, in bringing a healthcare fraud whistleblower lawsuit against PSA alleging failure to disclose and return overpayments, submission of claims under the Georgia Pediatric Program without proper documentation, and submission of claims to federal healthcare programs that overstated the length of time that PSA staff provided services.
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The defendant has more than 6,000 employees in 17 states. PSA noted in a statement appearing in The Atlanta Journal-Constitution the resolution of an issue “that arose in part from our own self-disclosure,” the company said. This included “an internally identified billing error stemming from a software upgrade in 2008 that resulted in .08 percent of charges being billed incorrectly.”
For much of the alleged healthcare fraud, Portfolio Logic was owned by PSA Healthcare. In March PSA Healthcare, based in Norcross, Georgia, was purchased by J.A. Whitney Capital Partners, a private equity firm.