The government has issued warnings to individuals and businesses related to improper claim submissions and has shown its seriousness through enforcement actions using the powerful False Claims Act as tool to reach its goals.  So, when Michael A. Bennett, United States Attorney for the Western District of Kentucky stated in a recent press release: “[w]e will continue to vigorously pursue medical providers who violate federal law by engaging in illicit schemes which include the filing of false claims seeking Medicare reimbursement,” Medicare providers should heed the warning.

AUSA Bennett’s comment was quoted in a press release regarding a medical provider (Dr. Mangesh Kanvinde) who paid $720,000 to settle FCA allegations.  Dr. Kanvinde also agreed to exclusion from Federal Health Care Programs for fifteen years.  According to the press release, Dr. Kanvinde was allegedly involved in a scheme to order medically unnecessary durable medical equipment and genetic tests for patients.  The government alleged that Dr. Kanvinde violated the FCA through problematic actions and arrangements.  First, the government alleges that Dr. Kanvinde had improper financial arrangements with telehealth companies and temporary physician staffing agencies where Dr. Kanvinde allegedly received kickbacks for DME and genetic testing orders.  Second, the government alleged that Dr. Kanvinde did not have a physician-patient relationship with the patients that received the improper orders and knew the orders for DME and genetic testing were medically unnecessary. 

This case is an important reminder to medical providers that the government has the tools and resources to enforce the law and is actively pursuing those that submit fraudulent claims.  This case also serves as reminder that the government’s agencies routinely collaborate in its investigations and this practice will continue.  According to Special Agent in Charge Tamala E. Miles with the Department of Health and Human Services, Office of the Inspector General, “[o]ur agency is committed to working with our law enforcement partners to ensure that bad actors are held accountable for their actions.”

The attorneys at Chilivis Grubman represent clients of all types and sizes in connection to False Claims Act litigation, government investigations, and cybersecurity fraud investigations.  If you need assistance with such a matter, please contact us today.