Whistleblower Nurse Wins $6.1 Million Settlement Against Banner Health for Medicare Home Health Fraud in Wyoming

Debbie Evans worked at Washakie Memorial Hospital in Worland, Wyoming, a county-owned facility managed by the nonprofit Lutheran Health Systems. When the hospital fired her, Evans believed the termination was retaliation for her refusal to go along with billing practices she considered fraudulent. She took her concerns to Casper attorney R. Michael Shickich.

Shickich filed a qui tam complaint in U.S. District Court in Wyoming in 2001 under the federal False Claims Act, which allows private citizens to sue on behalf of the government and share in any recovery. The complaint alleged that Lutheran Health Systems, operating Wyoming facilities including Washakie Memorial Hospital, submitted Medicare claims for home health visits that were medically unreasonable, unnecessary, or billed at rates and frequencies that could not be justified. The alleged false billing covered the period 1995 through 1999.

The federal government reviewed the case and intervened, joining Evans as a co-plaintiff. By the time the case reached resolution, Lutheran Health Systems had rebranded as Banner Health. Banner Health agreed to pay $6.1 million to settle the allegations without admitting liability. Evans received $1 million of that total as her whistleblower share under the False Claims Act.

At the time of the settlement, federal officials described it as one of the largest, if not the largest, recoveries by the United States in Wyoming.

The case illustrated how the qui tam mechanism can surface hospital billing abuses that government auditors might never reach on their own. A single employee's decision to report what she witnessed, backed by counsel willing to file in federal court, produced a multimillion-dollar accountability moment for a major regional health system.