The Department of Justice announced it has fined Diagnostic Imaging Group $15.5 million after finding the company had billed Medicare for radiology services that were not preformed. The government also claims the company paid illegal kickbacks to doctors. The penalties are the result of whistleblower cases filed in New Jersey and Brooklyn. Under the terms of the federal False Claims Act, the whistleblowers will receive a combined total of $2.8 million.
Diagnostic Imaging Group (DIG) operates a chain of diagnostic imaging facilities in New York under the name Doshi Diagnostic Imaging Services. Previously the company operated facilities in New Jersey and Florida under the Doshi name and also Signet Diagnostic Imaging Services.
According to the complaints originally filed by the whistleblowers, DIG submitted false claims to Medicare as well as the New Jersey and New York Medicaid programs. The complaint says that the programs were billed for CT scan services never performed. In addition, the company also “bundled” services so as to force physicians to order medically unnecessary services.
In some cases, the company paid kickbacks to doctors who referred patients.
All three cases were filed under the False Claims Act, a law that dates back to the Civil War. That law allows ordinary people to file a lawsuit in the name of the government and collect a piece of the recovery.
In announcing the successful prosecution of DIG, the U.S. Attorney for the Eastern District of New York, XXXXXXX Lynch, said “Patients deserve testing decisions based solely on medical need, not doctors’ pocketbooks. We will continue to work with our federal and state law enforcement partners to investigate vigorously allegations of fraud on federal programs like Medicare and to pursue those who seek to fraudulently deplete the Medicare Trust Fund.”
Lynch’s New Jersey counterpart, Paul Fishman, had similar comments, “Health care providers who make decisions based on profit instead of medical need compromise patient safety and confidence. Unnecessary tests and the payment of kickbacks also siphon precious resources from our health care system.”
To qualify as a whistleblower under the False Claims Act, a person generally needs three things:
1) Knowledge of fraud involving a government funded program. Medicare fraud claims are the most common false claims act cases but they are by no means the only ones. Bank and mortgage fraud (FDIC, TARP and Fannie Mae / Freddie Mac loan guaranties), defense contractor fraud and government projects built with foreign goods are also common sources of whistleblower lawsuits.
2) The knowledge of the fraud must be “original source”. To qualify, you must have first hand and direct knowledge of the fraud.
3) A great whistleblower lawyer. Receiving a False Claims Act whistleblower award requires filing a lawsuit under seal in federal court. There are several lawyers that know how to file such a suit but choosing the right lawyer may mean the difference between a multi-million check and the government not understanding or pursuing your case.
Since 2009, the federal government has collected over $19 billion through whistleblower cases. $13.4 billion of that total has involved Medicare fraud.
If you believe that you qualify for a whistleblower award, give us a call. Let an experienced whistleblower lawyer evaluate your case. No obligation, no fee and in strict confidence, of course.
We have represented many whistleblowers and presently have one of the largest whistleblower cases pending in the United States, HUD’s $2.4 billion case against Allied Home Mortgage.
Mahany & Ertl – America’s Whistleblower Lawyers. Services provided in most jurisdictions.
(whistleblower photo courtesy of Dave Winer – scripting news)