Florida doctor sued for healthcare fraud by whistleblowers, feds
Whistleblowers are often portrayed in the media as selfless people pointing out wrongdoing. That might be, but it is also true that whistleblowers sometimes stand to reap millions of dollars for suing people accused of defrauding the government in what are known as qui tam cases.
Qui tam cases are a type of civil lawsuit filed by whistleblowers under the False Claims Act; a law that monetarily rewards the whistleblower if their suit recovers money for the government. One Florida doctor about an hour’s drive northwest of Orlando is the focus of two such lawsuits, according to news reports.
The Marion County cardiologist is accused of Medicare fraud in two whistleblower lawsuits alleging that he gave patients kickbacks by waiving their co-payments so they would agree to often unneeded medical procedures.
The U.S. Justice Department recently announced that it is joining the civil suits against the doctor and his medical practice.
In some False Claim Act suits, plaintiffs can be awarded triple damages, which means, of course, that the share the whistleblower receives is also inflated.
Media reports did not list the amount sought in the cases by whistleblowers and the federal government, but one report indicated that the doctor billed Medicare for $18 million in 2012 – the highest amount billed to Medicare for cardiology that year.
One lawsuit claims the doctor and his practice engaged in “upcoding”: billing Medicare for more expensive procedures than were actually performed on patients. However, as attorneys experienced in health care fraud allegations know, there are sometimes disputes over these complicated billing codes that do not involve illegal or fraudulent acts. Discrepancies can be the result of differing interpretations of complex regulations and bookkeeping rules.
In these matters, it makes sense for defendants to retain an attorney experienced in both civil and criminal cases; one who can as capably defend assets and licensure as freedom and rights.