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Feds pursue millions from FCA cases in first quarter of 2021

United States Attorney’s Offices throughout the country continue their aggressive pursuit of physicians and other medical professionals who fail to follow the regulations set out in the False Claims Act (FCA). The feds have found success, reportingly pursuing the return of millions from healthcare professionals who allegedly violated this federal law in cases that were moving forward during the first quarter of 2021.

Some notable examples include:

  • Texas dermatologist. The Northern District of Texas accused a local dermatologist of requesting payment for over $4 million in false or fraudulent claims. The feds claim the doctor allowed a lab to use his clinic’s lab license to submit the claims, and that he was aware of the violation when it was happening.
  • New York surgeon. The United States Department of Justice moved forward with a case against a New York vascular surgeon. The feds state the surgeon falsely billed Medicare for end-stage renal disease procedures that ere not medically reasonable or necessary. The surgeon agreed to a settlement payment of over $780,000.
  • Texas CEO. The agency also accused a CEO of a Texas-based hospice agency of providing pain prescriptions without physician input, leading to the filing of over $60 million in fraudulent claims to Medicare. When faced with the evidence, the healthcare exec chose to accept a plea deal.

These are just a few of the examples of cases that are currently working their way through the system. They serve as a reminder of the importance to make sure healthcare organizations are operating in full compliance of the FCA and other applicable regulations. As shown in the examples above, a violation can result in serious allegations.