Ex-Medical Manager in Indiana Awarded $3.6M in Whistleblower Case

An Indianapolis-based medical supply company’s former manager has won $3.6 million in a settlement of her whistleblower lawsuit accusing that company and a health insurance company of defrauding a government insurance program.

Crystal Derrick, who was a national account manager in Roche Diagnostics Corp.’s diabetes division, was awarded the money nearly two years after filing the whistleblower case against her former employer, according to documents filed in U.S. District Court in Chicago.

Roche Diagnostics and Humana Inc., a Louisville, Kentucky-based health insurer, paid $12.5 million to settle a lawsuit after Derrick accused them of defrauding a government insurance program.

Derrick received 29% of that settlement agreement, totaling $3.625 million. The remainder of the payment went to the government, the Indianapolis Business Journal reported.

In her lawsuit, Derrick said Roche Diagnostics had paid Humana for access to certain formularies — a list of prescription drugs or medical products covered by an insurance plan — after Roche decided not to recover rebate overpayments it had learned that Humana owed it.

Humana’s formularies included a wide range of Roche diabetes products, including its Accu-Chek product line, insulin pump and test strips.

Derrick, who left Roche in December 2013, claimed the two companies violated the Anti-Kickback Statute and False Claims Act, and defrauded taxpayers by causing false claims to be submitted to the Medicare Advantage program.

The Anti-Kickback Statute makes it a felony to knowingly pay or accept money to induce anyone to furnish any item or service for payment under a federal health care program.