INDIVIDUAL PROVIDERS
DA TE
ENTITY
FCA ALLEGATIONS
AMOUNT
A physician agreed to pay $215,228 to resolve allegations that he received compensation as a medical director from a hospital that exceeded the FMV of his services and was an effort to incentivize him to make referrals to the hospital, in violation of the Stark Law and the AKS. The hospital and six of its owners previously agreed to pay $8.1 million to settle similar allegations. The physician entered into a three-year IA with HHS-OIG as part of the resolution. 123 A physician and his practice agreed to pay $800,000 to resolve allegations that he billed Medicare for vascular surgery procedures that he routinely performed regardless of whether they were medically necessary and, at multiple points, misrepresented patient conditions in medical records to justify the procedures. The physician also consented to exclusion from federal healthcare programs for four years, and the prosecution of related criminal charges was deferred for one year. 124 A physician and his practice agreed to pay $106,255 to resolve allegations that they billed for procedures performed by nurse practitioners as if the procedures had been performed by the physician. 125 A primary care physician agreed to pay $350,000 to resolve allegations that he violated the CSA and FCA by: (1) pre-signing prescriptions for controlled substances and being out of the state when the prescriptions were issued; (2) issuing prescriptions for controlled substances to patients who were either not examined or were examined by non-physicians; and (3) billing Medicare for services that were provided by other individuals while he was travelling. 126 A physician agreed to pay $475,000 to resolve allegations that he certified patients for home health services based solely on the forms provided by the home health company without examining the patients. He also allegedly received payments from the agency for referrals, in violation of the AKS. 127 A cardiologist and his practice agreed to pay $2 million to resolve FCA allegations that they billed Medicare, Medicaid and TRICARE for diagnostic tests that were medically unnecessary or not conducted. The cardiologist and the practice entered into a three-year IA with HHS- OIG as part of the resolution. 128
Dr. Ashok Kumar
3/3/2021
$215,228
Dr. Feng Qin; Qin Medical P.C.
3/8/2021
$800,000
Vedat Obuz; Lotus Clinics P.C./Lotus Family Medicine
3/8/2021
$106,255
Dr. Hugo A. Rojas
$350,000
3/9/2021
Dr. Truc Le
$475,000
3/18/2021
Dr. Dinesh M. Shah; Michigan Physicians Group, P.C.
3/18/2021
$2 million
123 https://www.justice.gov/usao-cdca/pr/south-bay-doctor-settles-federal-lawsuit-alleging-he-accepted-illegal-kickbacks-patient. 124 https://www.justice.gov/usao-sdny/pr/manhattan-us-attorney-announces-resolution-civil-and-criminal-healthcare-fraud-charges. 125 https://www.justice.gov/usao-nj/pr/new-jersey-physician-and-medical-practice-agree-pay-106255-resolve-false-claims-act. 126 https://www.justice.gov/usao-wdtx/pr/san-antonio-physician-agrees-pay-350000-resolve-allegations-he-pre-signed-prescriptions. 127 https://www.justice.gov/usao-sdtx/pr/physician-pays-nearly-half-million-dollars-resolve-home-health-care-fraud-allegations. 128 https://www.justice.gov/usao-edmi/pr/cardiologist-dinesh-shah-pays-2-million-resolve-false-claims-act-allegations-relating.
NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 70
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