Whistleblower Suit Leads to Doctor Paying $625K for Alleged False Claims Act Breaches
The whistleblower, Amy Vermillion, was represented by Mike Bothwell. She "brought a case [the government] never would have known about, [and the Defendants] would have continued the fraud if it wasn't for her bringing this forward," said her lawyer.
The McCabe Law Firm closely follows outcomes like this one, where a whistleblower's willingness to come forward led to real accountability under the False Claims Act. Cases such as this highlight the critical role FCA counsel plays in helping employees safely report fraud against federal healthcare programs like Medicare and TRICARE and the significant recoveries that can follow. Our team monitors these results to stay informed on how FCA litigation continues to protect taxpayer dollars and hold bad actors accountable.
Original Article https://www.law.com/dailyreportonline/2023/06/05/whistleblower-suit-leads-to-doctor-paying-625k-for-alleged-false-claims-act-breaches/
A Georgia doctor has agreed to pay the federal government more than $600,000 after a whistleblower filed a lawsuit exposing alleged False Claims Act (FCA) violations. According to a Tuesday news release, Dr. James Ellner and his Woodstock practice, Georgia Pain Management PC, and ambulatory surgical center, Samson Pain Center PC, agreed to pay $625,000. Ellner and his businesses were accused of breaching the FCA by submitting improper claims to the Medicare and TRICARE programs for evaluation and management services and medically unnecessary urine drug screening tests.
“The federal government expects that physicians and their practices will properly bill Medicare and TRICARE for services they provide,” U.S. Attorney Ryan K. Buchanan said in the release. “The Department of Justice will work diligently to hold healthcare providers accountable when they break the rules and overbill federal healthcare programs.”
Though the amount Ellner and his businesses owe the government was released in the settlement agreement, the amount of employment and attorney fees was not. Also, under the agreement, no determination of liability has been made, and Ellner can continue to practice medicine and keep his businesses open as long as the fine is paid and he commits no more Medicare fraud.
Lawyer: Plaintiff Fired for Raising Concerns
The settlement came after Georgia Pain Management billing department employee Amy Tyson, who later got divorced and changed her name back to Amy Vermillion, filed a qui tam lawsuit in the U.S. District Court for the Northern District of Georgia against Ellner and his two businesses in 2018.
Earlier that year, she was fired after raising concerns over billing issues she’d discovered, said her attorney, MikeBothwell, founding partner of the Bothwell Law Group in Roswell. Prior to her termination, she had her computer and printing activity audited and “was harassed [and] discriminated against,” according to her amended complaint.
The FCA is a federal law that levies civil liability on any individuals or entities who submit or cause to be submitted false claims for payment on the federal government or its contractors. It imposes treble damages and a civil penalty between$12,537 and $25,076 per false claim, the release said. The FCA is the main authority used by the United States Attorney’s Office’s Civil Division to redress fraud, waste and abuse within federal programs, including Medicare and TRICARE.
Bothwell, whose practice centers on FCA whistleblower suits, said the law is important because, through its cases, more than $72 billion has been returned to federal taxpayers. According to a February news release, settlements and judgments under the FCA totaled more than $2.2 billion in fiscal 2022, which ended Sept. 30.
Full Article here. | The McCabe Law Firm does not claim ownership of this article.
