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Laboratory and IDTF

This archive displays posts tagged as relevant to laboratories and independent diagnostic testing facilities. You may also be interested in our pages:

Page 8 of 11

February 1, 2017

Florida urologist Dr. Meir Daller agreed to pay $3.81 million to resolve allegations he violated the False Claims Act by causing claims to be submitted to federal health care programs for laboratory tests that were not medically necessary.  Dr. Meir practices as part of Gulfstream Urology, a division of 21st Century Oncology, LLC, which is a nationwide provider of integrated cancer care services.  The government previously entered into settlements relating to similar allegations with 21st Century Oncology for $19.75 million and urologists David Spellberg and Robert Scappa for $1,050,000 and $250,000, respectively.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Mariela Barnes, a former medical assistant for Dr. Spellberg at Naples Urology Associates, also a division of 21st Century Oncology.  She will receive a whistleblower award of $571,500 from the proceeds of the government's recovery in this settlement.  This is in addition to a $3,437,000 million award she already received from the prior settlements.  DOJ (MDFL)

$2.6 Million Whistleblower Settlement With Bay Sleep Clinic

The clinic will settle whistleblower allegations of using unlicensed technicians and unapproved locations and of doctor kickback referrals. Constantine Cannon LLP is pleased to announce a $2.6 million settlement on behalf of its client for whistleblower allegations against Bay Sleep Clinic. The settlement was announced by the United States government on December 28, 2016, against Bay Sleep Clinic, which currently operates 20 locations throughout northern California; its related Qualium Corporation and Amerimed Corporation businesses; and owners and operators Anooshiravan Mostowfipour and Tara Nader. The “qui tam,” or whistleblower, lawsuit alleged that the defendants fraudulently billed Medicare for sleep studies conducted by unlicensed individuals in unapproved locations; improperly dispensed durable medical equipment from unapproved locations using unlicensed technicians; and paid doctors for referrals in violation of the federal Anti-Kickback Statute. The defendants neither admitted nor denied liability. The whistleblower, Elma F. Dresser, is a former Bay Sleep Clinic employee who worked as a sleep technician and marketer for eight years. Through her various roles at the company, Ms. Dresser became familiar with the defendants’ alleged scheme to bilk money from Medicare. She filed her suit in 2012, leading the government to investigate the claims and join the case. Ms. Dresser was represented by Eric R. Havian, partner and attorney, Jessica T. Moore, partner and attorney, Anne Hayes Hartman, partner and attorney, Hallie Noecker, attorney, and Sarah Poppy Alexander, attorney of Constantine Cannon’s whistleblower practice in San Francisco, along with co-counsel from the Law Office of William C. Dresser. “It’s rewarding to see the alleged fraudsters held responsible. Because of the close cooperation and work between the whistleblower and the government, we were able to recover significant funds for the government,” said Anne Hayes Hartman, co-lead counsel on the case. “It is gratifying to represent people like Elma Dresser, who bravely stepped forward with knowledge of her employer’s wrongdoing. Many do not appreciate the risks whistleblowers face to hold alleged wrongdoers accountable.” “Sleep studies are a quickly expanding medical field,” said Jessica T. Moore, who served as co- lead counsel on the case. “Ensuring the safety of these procedures should be a top priority of the government for all patients, Medicare and otherwise.” The federal False Claims Act allows whistleblowers to sue companies that are defrauding the government and receive a reward if the government recovers any funds as a result. The government may choose to intervene in the lawsuit, as it has done in this case. The False Claims Act is one of the government’s most effective weapons in combatting fraud, waste, and abuse by those who contract with the government. Healthcare fraud alone is estimated to cost the U.S. billions of dollars. Such fraud can be difficult to discern without access to inside information; well-placed whistleblowers are necessary to provide the information the government might otherwise lack to help stop these practices.

December 28, 2016

Bay Sleep Clinic, its related businesses -- Qualium Corporation and Amerimed Corporation -- and their owners and operators, Anooshiravan Mostowfipour and Tara Nader, agreed to pay $2.6 million to settle allegations they fraudulently charged Medicare for diagnostic sleep tests and medical devices in violation of Medicare payment rules. The allegations originated in a whistleblower lawsuit filed by Elma F. Dresser under the qui tam provisions of the False Claims Act. She will receive a whistleblower award of approximately $545,000 from the proceeds of the government's recovery. DOJ (NDCA)

Bay Sleep Clinic – Medicare Fraud/Unapproved Facilities, Unlicensed Technicians, and Physician Kickbacks ($2.6M).

Constantine Cannon represented whistleblower Elma Dresser, a sleep technician and former Bay Sleep employee. Ms. Dresser alleged that Bay Sleep Clinic and associated businesses, a network of sleep clinics in the San Francisco Bay Area, fraudulently billed Medicare for sleep studies conducted by unlicensed technicians in unapproved locations; improperly dispensed durable medical equipment from unapproved locations using unlicensed technicians; and paid doctors for referrals in violation of the federal Anti-Kickback Statute. The government joined a portion of the case, and in 2016, defendants agreed to pay $2.6 million to settle the matter. For her significant contributions, the relator’s share award was almost 21% of the government’s recovery. See DOJ for more.

December 13, 2016

Elite Lab Services, LLC, along with its husband-and-wife owners Gerard and Suzanne Dengler, agreed to pay $3.75 million to settle charges of their violating the False Claims Act through their billing Medicare for tens of thousands of miles that were never driven by Elite Lab’s personnel.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Elite Lab employee Karen Malcolm.  She will receive a whistleblower award of $787,500 from the proceeds of the government's recovery.  DOJ (EDTX)

July 22, 2016

Preferred Imaging, LLC, a provider of diagnostic imaging services, agreed to pay $3,510,000 to resolve allegations it violated the False Claims Act by improperly billing Medicare and Texas Medicaid for services performed without proper medical supervision.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Preferred Imaging employee Tracy Sifuentes.  She will receive a whistleblower award of $596,700 from the proceeds of the government's recovery.  DOJ (NDTX)

July 12, 2016

New Jersey couple Nita and Kirtish Patel and their diagnostic imaging companies Biosound Medical Services Inc. and Heart Solution PC were ordered to pay more than $7.75 million for violating the False Claims Act by submitting false claims to Medicare for thousands of falsified diagnostic test reports and the underlying tests.  The government had alleged that defendants created fraudulent diagnostic test reports, forged physician signatures on these reports, and then billed Medicare for the fraudulent reports and the underlying tests that were used solely to create these reports.  The government further alleged that defendants billed Medicare for neurological tests that they conducted without the required physician supervision.  The allegations originated in a whistleblower lawsuit filed by a former Biosound employee under the qui tam provisions of the False Claims Act.  The whistleblower will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (DNJ)

April 13, 2016

Florida Pain Medicine Associates, Inc. and its owners, Drs. Bart Gatz, Alexis Renta, and Albert Rodriguez, agreed to pay $1.1 million to resolve allegations they violated the False Claims Act by billing Medicare for medically unnecessary nerve conduction studies.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Rosa Gomez, who had worked in Florida Pain Medicine’s billing department.  She will receive a whistleblower award of $242,000 from the proceeds of the government's recovery.  DOJ (SDFL)

April 11, 2016

Tennessee-based drug urine screening company PremierTox 2.0, Inc. (previously called Nexus) agreed to pay $2.5 million to resolve allegations it violated the False Claims Act by submitting false claims when billing Medicare, TennCare and Kentucky Medicaid for drug urine screening services.  According to the government, PremierTox had a swapping arrangement under which Nexus gave below cost discounts on its urine drug screen tests to patients in Tennessee without insurance, in exchange for physicians’ referring their patients with Medicare or TennCare coverage to Nexus. The government also contended that in Tennessee Nexus submitted excessive claims to Medicare and TennCare for laboratory testing that was beyond what was medically reasonable and necessary.  The allegations originated in two whistleblower lawsuits filed under the qui tam provisions of the False Claims Act by a former office manager of a pain clinic and the former CEO of PremierTox.  The office manager will receive a whistleblower award of $361,250, and the former CEO will receive a whistleblower award of $56,250.  DOJ (MDTN)
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