June 18, 2015 — When health care providers bill Medicare or Medicaid for higher levels of service than are medically necessary, it wastes the resources of taxpayer-funded government programs. To put a stop to such abuses, the False Claims Act empowers health care insiders to file a whistleblower lawsuit on the government’s behalf. Under the Act, the United States may choose to intervene in the lawsuit and take primary control for litigating it. The statute provides for the government’s recovery of three times the actual damages plus civil penalties. For their willingness to notify the government, tipsters — also referred to as “relators” — are rewarded with a portion of the government’s recovery.
Pennsylvania Cardiac Monitoring Company Allegedly Overbilled Medicare for MCOT Services
A Pennsylvania heart monitoring company will pay $6.4 million to settle False Claims Act allegations concerning overbillings to Medicare.
CardioNet, a subsidiary of BioTelemetry Inc., allegedly sought reimbursement from a number of federal healthcare programs for Mobile Cardiac Outpatient Telemetry (MCOT) services that were provided to patients who didn’t need them.
MCOT monitors are worn by heart patients who require continuous outpatient monitoring. MCOT devices detect unusual cardiac events, such as irregular rhythms, and send data in real time to CardioNet using cell phone technology. MCOT monitors are superior to traditional, more economical devices which use a landline to download patient data on a periodic basis.
Medicare will not reimburse providers for MCOT services to patients with heart palpitations that are not severe. Yet CardioNet, with knowledge of the applicable rules, reportedly submitted claims to Medicare for MCOT services that included inaccurate diagnostic codes which made it appear that patients were eligible for MCOT monitoring when they were not.
Contact Us to File a False Claims Act Lawsuit Targeting Abuse by Medical Providers
While Waters & Kraus is not handling this particular False Claims Act case, we are representing whistleblowers in similar lawsuits. If you have comparable claims against a different medical provider, contact us by email or call our qui tam attorneys at 800.226.9880 to learn more about our practice and how we can work together to notify the government about fraudulent abuses of government-funded programs. Michael Armitage and Louisa Kirakosian, two of the firm’s qui tam attorneys in the California office, protect tipsters throughout the whistleblower lawsuit process.