Late last week, the United States Attorney’s Office for the District of Connecticut announced that a Connecticut physician and physician practice agreed to pay more than $2.6 million to resolve allegations that they violated the False Claims Act (FCA) by submitting improper claims to Medicare and Medicaid.  Specifically, the government alleged that the defendants submitted false claims for payment for medical visits “when, in fact, the patients had received fitness-related services with no legitimate medical component at a gym they operated that was staffed by a medically unlicensed coach and yoga instructor.”  The government also alleged that the defendants created false medical records that contained false diagnoses to support these claims.

In addition to these allegations, the government also alleged that the defendants submitted false claims for services that were allegedly rendered by the defendant physician in an office setting when he was not physically present in the office, including when he was out of the country or on vacation. Finally, the government alleged that the defendants violate the Anti-Kickback Statute by receiving remuneration from Boston Heart Diagnostics in return for ordering clinical laboratory services.  Those payments were in the form of specimen “processing and handling” fees, as well as speaker fees.

Notably, the DOJ announced that this matter was the result of “a critical analysis of Medicare claims data.”

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