Two former employees of New York and New Jersey pain management practices owned by Amit Poonia, MD were awarded nearly one million dollars after alerting the government to improper billing practices amounting to serious violations of the False Claims Act (FCA) and other federal laws. Last month, the Department of Justice announced a $7.4 million settlement in a 2018 case brought by Anu Doddapaneni and Christian Reyes on behalf of the United States.
The lawsuit, filed under seal in Federal District Court in Brooklyn, recoups millions of taxpayer dollars fraudulently billed by the doctor and several medical centers based in New York and New Jersey (“the Defendants”).
An Acupuncture Scheme
The whistleblowers, called “Relators” under the law, were former employees who became concerned for patients, many of whom were chronic pain sufferers, who were frequently referred for treatments known as “P-Stim” and “Neurostim.” The procedures utilize electro-acupuncture devices to transmit electronic pulses through needles placed just under the skin on a patient’s ear.
Neither procedure is considered surgical under the Medicare guidelines; however, the Defendants routinely submitted claims for reimbursement by using improper billing codes used for surgical procedures. The Defendants also illegally billed and were reimbursed for anesthesia used in conjunction with the acupuncture procedures. Dr. Amit Poonia, his surgery centers, and medical offices used this scheme to defraud the government out of millions.
Through private attorneys, relators Anu Doddapaneni and Christian Reyes filed their case under the qui tam provisions of the FCA, which allow private citizens to bring suit against individuals or entities who defraud the federal government: in this case, by violating healthcare provisions. Illegal conduct may include improper billing, kick-back schemes providing financial incentives in return for patient referrals, billing for medically unnecessary products or services, and the list goes on. False claims were also submitted under the Federal Employees Health Benefits Program (“FEHBP”).
Doddapaneni and Reyes were not alone; the states of New Jersey and New York, along with federal prosecutors, joined in the lawsuit. The government alleged the Defendants knew or should have known their actions were improper under federal law.
A Million Reasons to Blow the Whistle
Rather than face trial, the parties agreed to a settlement requiring Defendants to pay $7.4 million in restitution and fines. Defendants did not admit to wrongdoing under its terms. For their efforts, the Relators will receive $722,707.57 as their share, plus an additional $200,000 from the Defendants to cover expenses, attorney fees, and other costs. In all, the Relators are set for a payday in excess of $920,000.
Healthy rewards for whistleblowers serve to encourage those with information about fraudulent healthcare practices to come forward under the FCA. Often Relators’ share ranges from 15-30% of the total award, plus repayment of attorney fees and costs incurred.
In this case, by mischaracterizing acupuncture procedures as surgical implantation of a neurostimulator, the Defendants defrauded the federal government to the tune of millions. Without the efforts of Relators Doddapaneni and Reyes, the scheme may have continued for years. In addition to large paydays, successful Relators enjoy FCA protection against job retaliation by accused employers.
New Jersey and New York Pain Management Scheme
According to the Plaintiffs, in the nearly five years the scheme was carried out, Dr. Poonia owned medical offices and surgery centers in several New Jersey locations: East Brunswick, Edison, Springfield, Old Bridge, and Clifton, as well as practices in Brooklyn, New York. According to WebMD, Amit Poonia, MD is a Board-certified Interventional Pain Management Specialist and Anesthesiologist. In addition to the $7.4 million settlement due, the Defendants also entered into an “Integrity Agreement” with the U.S. Department of Health and Human Services, Office of the Inspector General, New York Region.
The agreement requires the Defendants to implement specific measures to prevent future health care fraud and address compliance risks, including training staff on health care fraud laws.
No one will work harder and mroe tirelessly on your behalf. Our qui tam whistleblower lawyers have helped the government and taxpayers get back billions of dollars while our whistleblower clients have received tens of millions in whistleblower rewards.
Large or small, we will work with you to stop the fraud and obtain the maximum whistleblower reward possible.
To learn more, contact us online, or by phone 202.800.9791. All inquiries are protected by the attorney – client privilege and kept confidential. Let us help you become a hero and stop corruption in its tracks.
The False Claims Act can be accessed here.