The selection below is from a story in the San Antonio Current about the patient who became the whistleblower against HealthSouth and his attorney. It is worth repeating that the billing fraud described in this case is not confined to Medicare, as too many seem to believe.
By Gilbert Garcia
James DeVage's "pride and joy" rests on a bookcase in the living room of his Elm Creek home. It's a bronze statue of David slaying Goliath and DeVage received it last year as the Taxpayers Against Fraud's "Whistleblower of the Year."
False-claims whistleblowers generally follow a predictable pattern: They work in one department of a company and see records that they assume are routine. When someone goes on vacation, the employee is pressed into double duty, sees another set of records, and detects irregularities. They attempt to help their bosses by reporting the problem, and they're swiftly rewarded with a pink slip.
DeVage did not fit that whistleblower profile. He was not a disgruntled HealthSouth employee, he was a patient who'd gone to HealthSouth for help with chronic back problems that had plagued him since the 1960s.
DeVage will celebrate his 85th birthday this month, but except for the two hearing aids he wears, he gives little indication of his age. A Pennsylvania native who served in Africa and Sicily during World War II, a few miles from the battlefront during the Korean Conflict, and as an adviser stationed near Saigon in the early days of the Vietnam War, DeVage is a born fighter with a strict code of ethics formed during the Great Depression.
Between his three decades in the military and 17 years working for the IRS, he'd served his government for nearly 50 years. He had no tolerance for fraud, and, as a former IRS investigator, he was highly skilled at detecting it.
DeVage says that he began to notice irregularities with his HealthSouth bills after his third treatment with the rehabilitation center. While his visits to HealthSouth resembled workouts at a gym, with DeVage left to his own devices, HealthSouth was billing Medicare for individual, specialized therapy.
"When I got the first bill from Medicare, and then from my insurance company, it was more than $2,000," DeVage says. "After I got that, I said, 'Jesus Christ, I could do this for $30 a month. What's the charge here? Then I found out that the charges for the gym and aquatics were excessive. None of it should have been authorized."
Between his Medicare coverage and supplemental insurance with the Government Employees Health Association, DeVage didn't spend a penny of his own money for the HealthSouth treatments. But he was infuriated to find that the health-care company willfully bilked the Medicare system out of taxpayer revenue.
"I noticed as an IRS agent, we have a culture that wants to beat the government," DeVage says. "There is no compliance. When I questioned HealthSouth on this thing, they said, 'That's the way we do business.' Nobody wants to do anything. I thought it was about time that somebody does something."