Winter Park Urology Settles Whistleblower/Qui Tam Lawsuit
Wednesday, October 2, 2013
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health LawA federal whistleblower or qui tam lawsuit against a local physician group has been settled, according to the Orlando Business Journal (OBJ) on September 30, 2013. The providers were accused of fraudulently billing Medicare and TRICARE from 2007 until 2010. The allegations allegedly stem from radiation therapy used to treat cancer patients. According to the OBJ, the defendants include Winter Park Urology Associates, Radiation Oncology Consultants, Steven Lester, M.D., John Looper, M.D., and Maneesh Gossain, M.D. Click here to read the OBJ article.The lawsuit identifies the former director of Winter Park Urology as the whistleblower.Defendants Dismissed with Prejudice from Lawsuit.According to the complaint filed in 2010, the defendants regularly billed for procedures to treat patients with radiation without the supervision of a physician. This is required by Medicare and TRICARE. It also alleges the clinics submitted false claims to the government programs and received $20 million in reimbursements.
To read the complaint, click here.Winter Park Urology has agreed to settle the case, although the Department of Justice (DOJ) has to sign off on the settlement. Currently, the financial details of the settlement are unknown.Most Qui Tam Claims Filed by Employees.From our review of qui tam cases that have been unsealed by the government, it appears most of these are filed by physicians, nurses or hospital staff employees who have some knowledge of false billing or inappropriate coding taking place. Normally the government will want to see some actual documentation of the claims submitted by the hospital or other institution. Usually physicians, nurses or staff employees have access to such documentation. Whistleblowers are urged to come forward as soon as possible. In many circumstances, documentation that shows the fraud “disappears” or cannot be located once it is known that a company is under investigation.
Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.Attorneys with The Health Law Firm also represent health care professionals and health facilities in qui tam or whistleblower cases both in defending such claims and in bringing such claims. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.Comments?Individuals working in the health care industry often become aware of questionable activities. Often they are even asked to participate in it. In many cases the activity may amount to fraud on the government. Has this ever happened to you? Please leave any thoughtful comments below.Sources:Aboraya, Abraham. “$20 Million Wistleblower Lawsuit Alleging Health Care Fraud Settled.” Orlando Business Journal. (September 30, 2013). From: http://www.bizjournals.com/orlando/blog/2013/09/20-million-whistleblower-lawsuit.html?page=allUnited States ex rel. Carlo Santa Ana v. Winter Park Urology Associates, P.A.; Radiation Oncology Consultants, P.A.; Steven G. Lester, M.D., John D. Looper, M.D.; and Maneesh Gossain, M.D. Case Number 6:10-cv-00806-JA-TBS. Complaint. May 19, 2010. From: http://www.thehealthlawfirm.com/uploads/Winter%20Park%20Urology%20Complaint.pdf
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
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