The federal government announced Tuesday that it had reached a settlement with a Florida-based physician over allegations that he and his clinics violated the False Claims Act by knowingly billing Medicare for procedures and offices visits conducted by unqualified personnel. And San Francisco qui tam lawsuit attorney Gregory J. Brod would point out that the case is a good example of many claims the federal government pursues against alleged schemes to defraud Medicare that are settled before going to trial.
According to the Justice Department, the government alleged that, between 2009 and 2010, Dr. Ravi Sharma, who owned and operated a clinic in the Tampa area called Premier Vein Centers, had sent text messages to his office manager instructing her to perform varicose vein injections on patients when he was not present in the office. The government also alleged that Sharma performed unnecessary vein injections and ultrasound imaging procedures associated with those injections.
Between 2009 and 2010, Sharma also owned a weight loss clinic in the Tampa area called Life’s New Image. The government alleged that at that facility unqualified personnel met with patients, but Sharma billed the visits as physician office visits by using his own Medicare provider number. Sharma closed Premier Vein Centers and Life’s New Image in 2010.
There are many methods that healthcare scammers employ to defraud government programs such as Medicare. The allegations against Sharma generally fall into the category of fake or phantom billing, which involves the submitting of bills for unnecessary procedures or medical tests or the billing for procedures or tests that were never performed. In Sharma’s case, the added twist was that he allegedly authorized unqualified employees to perform the procedures.
As part of his deal with the government to resolve the allegations, Sharma has agreed to pay $400,000 and to enter a three-year integrity agreement with the Office of Inspector General of the Department of Health and Human Services. The latter requires Sharma to attend training classes held by the Centers for Medicare and Medicare Services, and the deal sets in motion an independent external review of Sharma’s federal health care program coding and billing procedures.
The allegations against Sharma arose out of a lawsuit filed by Patti Lovell, who was Sharma’s former office manager, under the qui tam, or whistleblower, provisions of the False Claims Act. Those provisions permit private parties to file a lawsuit on behalf of the government and to receive a share of any recovery. As a result of her role as the whistleblower in the case against Sharma, Lovell will receive $72,000.
Against the backdrop of the more recent cases the federal government has pursued for alleged violations against the False Claims Act, putting a monetary price tag on the Sharma case would categorize is as a relatively small one – since January 2009, the DOJ has recouped more than $17 billion through False Claims Act cases, with $12.2 billion of that arising from fraud against federal health care programs. However, the case is an excellent example of how charges in such lawsuits are often resolved and the whistleblower associated with the case is justly rewarded.
If you have knowledge of fraud that has been committed against the government, it is important to seek the counsel of an experienced qui tam lawsuit attorney such as those at the Brod Law Firm to be your legal advocate. And the professionals at the Brod Law Firm encourage the brave individuals who step forward with such information to contact them for a free consultation.
-James Ambroff-Tahan contributed to this article.
See Related Blog Posts:
The Many Guises of Medicare Fraud: Part I
The Experience of Whistleblowers