This week’s False Claims Act “Catch of the Week” goes to Baptist Health Systems Inc., a network of affiliated hospitals and medical providers in the Jacksonville, Florida area. On Tuesday, the company agreed to pay $2.5 million to settle allegations that its subsidiaries violated the False Claims Act by submitting claims to Medicare and Medicaid for medically unnecessary services and drugs. See DOJ press release.
Specifically, the government charged that from September 2009 through October 2011, two neurologists in the Baptist Health Network intentionally misdiagnosed patients with various neurological disorders, such as multiple sclerosis, and then billed the government for services and drugs the patients did not actually need. The government claimed that even when officials at Baptist Health became aware that neurology patients were being “misdiagnosed and mistreated,” they failed to immediately disclose the information to the government.
One of the complicit doctors, Sean Orr, was the former Chief of Neurology at Baptist Medical Center. In an unrelated matter, he was suspended in 2013 from practicing in Florida because he allegedly had an inappropriate sexual relationship with one of his patients. The allegations against Dr. Orr and Baptist Health were first raised in a whistleblower lawsuit — filed under the qui tam provisions of the False Claim Act — by Verchetta Wells, a former patient referral coordinator for the neurology practice at Baptist Medical Center.
Ms. Wells alleged, among other things, that Dr. Orr intentionally misdiagnosed healthy patients with serious neurological conditions in order to bill Medicare and Medicaid for expensive treatments and medications. She further alleged that instead of reporting Dr. Orr to the authorities, Baptist Health actively worked to conceal Dr. Orr’s conduct to avoid liability and retain the illicit proceeds from his fraudulent billings. Ms. Wells will receive a whistleblower reward of $424,000 for her work in bringing this case forward.
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