Karin Berntsen, the Director of Performance Improvement at Alvarado Hospital in San Diego, played a pivotal role in exposing fraudulent billing practices at Prime Healthcare. Alvarado Hospital was operated and controlled by Prime Healthcare, a rapidly expanding hospital chain.
Berntsen’s whistleblower False Claims Act (FCA) lawsuit provided critical evidence that led to a $65 million settlement with 14 Prime Healthcare hospitals. Her allegations focused on two major fraudulent schemes:
As a result of the settlement, Prime Healthcare paid $61.75 million, and its founder and CEO, Dr. Prem Reddy, was personally required to pay $3.25 million—a rare instance of direct executive accountability in healthcare fraud cases.
Berntsen understood that Prime’s rapid growth was fueled, in part, by fraudulent overbilling practices. Her efforts, alongside years of government investigation and litigation, ultimately held the company accountable.
Despite battling illness, Karin Berntsen dedicated immense time and energy to this case, ensuring that taxpayer dollars were protected. For her courage and determination, she was honored as “2018 Whistleblower of the Year” at the Taxpayers Against Fraud Education Fund conference in Washington, D.C.
This case serves as a powerful reminder of the impact whistleblowers can have in exposing fraud and protecting public funds. Wilbanks & Gouinlock is proud to have represented Karin Berntsen, whose bravery led to one of the largest False Claims Act recoveries against a hospital chain.
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This article is for informational purposes only and should not be considered legal advice.
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