The whistleblower, Amy Vermillion, “brought a case [the government] never would have known about, [and theDefendants] would have continued the fraud if it wasn’t for her bringing this forward,” said her lawyer, Mike Bothwell.
Full 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 lawsuitexposing 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 wereaccused of breaching the FCA by submitting improper claims to the Medicare and TRICARE programs for evaluationand management services and medically unnecessary urine drug screening tests.
“The federal government expects that physicians and their practices will properly bill Medicare and TRICARE forservices they provide,” U.S. Attorney Ryan K. Buchanan said in the release. “The Department of Justice will workdiligently 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, theamount of employment and attorney fees were not. Also, under the agreement, no determination of liability has beenmade, and Ellner can continue to practice medicine and keep his businesses open as long as the fine is paid and hecommits 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 divorcedand changed her name back to Amy Vermillion, filed a qui tam lawsuit in the U.S. District Court for the Northern Districtof 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 andprinting 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, falseclaims 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 StatesAttorney’s Office’s Civil Division to redress fraud, waste and abuse within federal programs, including Medicare andTRICARE.
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 andjudgments under the FCA totaled more than $2.2 billion in fiscal 2022, which ended Sept. 30.
Full Article here. | The Bothwell Law group does not claim ownership of this article.
About the Bothwell Law Group:
Since 1996, the Bothwell Law Group has earned a national reputation for successful representation of whistleblowers in federal and state courts across the United States, and is one of only a handful of firms exclusively representing whistleblowers. Bothwell Law Group’s cases have resulted in the recovery of more than $400 million for the United States treasury and in the payment of millions of dollars in whistleblower rewards. Inquiries may be directed to Mike Bothwell at (770) 643‐1606, email Mike@WhistleblowerLaw.com.