Healthcare Management Corporation to Pay $4M to Resolve False Claims Act Charges
By the Constantine Cannon Whistleblower Team
Maryland-based CVR Management, LLC, the Center for Vein Restoration, Center for Vascular Medicine (CVM), LLC, and Sanjiv Lakhanpal, MD, FACS (the entities’ CEO and president and CVM’s chairman of the board), agreed to pay $4 million to resolve allegations they violated the False Claims Act by billing Medicare, Medicaid, and TRICARE for medically unnecessary treatments.[1]
From January 1, 2010, to December 31, 2016, CVR allegedly submitted claims to government healthcare programs for medically unnecessary chronic venous insufficiency treatments. This health condition involves malfunctioning vein valves, causing blood to pool in the veins instead of moving upward toward the heart. This results in weakened and distended vein walls, leading to varicose veins, cramping, swelling, skin discoloration on the affected leg, and sometimes ulcers or skin necrosis.[2]
The government alleges that Medicare, Medicaid, and TRICARE do not cover varicose vein treatments solely for cosmetic purposes. To qualify for coverage, providers must meet specific clinical criteria and attempt conservative treatments first. CVR allegedly billed government healthcare programs for medically unnecessary treatments including sclerotherapy, radiofrequency ablation, and endovenous laser ablation procedures.[3]
U.S. Attorney for the District of Maryland Kelly O. Hayes commented: “Billing for medically unnecessary procedures saps public confidence in the healthcare system and is a drain on the public fisc. We will hold accountable healthcare providers that knowingly engage in such conduct.”[4]
Whistleblower-Initiated Case
This lawsuit was brought by whistleblowers (or relators) Karen Fulton and Jane Doe, former CVR employees. The cases are captioned U.S. ex rel. Fulton v. CVR Management, LLC, et al., No. 15-cv-3591 (D. Md.) and U.S. ex rel. Jane Doe v. Center for Vein Restoration, LLC, et al., No. 20-cv-1943 (D. Md.).
How Can Whistleblowers Help Fight Healthcare Fraud?
Whistleblowers can play an important role in stopping healthcare fraud. Under the qui tam (or whistleblower provisions) of the False Claims Act, private parties may bring lawsuits on behalf of the government and receive up to 30% of successful recoveries. In this case, the relators will receive $752,000.
The federal government will receive $3,395,634.93 of the settlement. The total Medicaid recovery is $604,365.07, with eight Medicaid participating states, and the District of Columbia receiving $325,208.84 of the civil settlement and the United States receiving $279,156.23.[5]
Our Firm Represents False Claims Act Whistleblowers
Constantine Cannon whistleblower attorney Dan Noel stated: “This settlement highlights the government’s continued focus on fighting healthcare fraud and its commitment to using the False Claims Act to target providers who submit claims for medically unnecessary treatments.”
Our firm has significant experience representing whistleblowers under the False Claims Act and other whistleblower rewards programs, with many record-breaking successes.
If you believe you have a case, please contact us and we will connect you with an experienced member of our whistleblower team for a free and confidential consultation.
Speak Confidentially With Our Whistleblower Attorneys
Sources:
[1] See https://www.justice.gov/usao-md/pr/health-care-management-corporation-agrees-pay-4-million-resolve-false-claims-act
[2] Id.
[3] Id.
[4] Id.
[5] Id.
Tagged in: False Claims Act, Healthcare Fraud, qui tam,