This week’s Department of Justice “Catch of the Week” goes to AnMed Health. On Wednesday, the South Carolina-based hospital agreed to pay more than $7 million to resolve allegations it violated the False Claims Act by submitting false Medicare claims for a variety of services, including radiation oncology services, emergency department services, and clinic services. See DOJ Press Release.
According to the government, AnMed violated Medicare regulations by billing for radiation oncology services even though a qualified practitioner was not immediately available to provide assistance and direction throughout the radiation procedure. The government further charged that AnMed systematically billed a minor care clinic as if it were an Emergency Department, and Emergency Department services as if they were provided by a physician when they were actually provided by mid-level providers. Each of these billing practices resulted in higher Medicare reimbursements.
The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former AnMed employee Linda Jainniney. She will receive a whistleblower award of roughly $1.2 million from the proceeds of the government’s recovery. She will also receive roughly $850,000 to resolve her whistleblower retaliation claims. In announcing the settlement, the government stressed the importance of whistleblowers in being a critical supplement to government enforcement: “This is another example of how the False Claims Act whistleblower provisions help protect the public’s interest.”
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