The Norman Regional Hospital Authority in Norman, Oklahoma, a former hospital administrator, and six radiologists have agreed to pay the U.S. government more than $1.6 million to settle a whistleblower’s False Claims Act lawsuit alleging the defendants improperly billed Medicare for radiological services that did not qualify for reimbursement.
The $1,618,750 settlement resolves allegations filed in federal court in Oklahoma City by Dr. Lance Garber, a radiologist formerly employed by Norman Regional. Dr. Garber filed the lawsuit under the whistleblower provisions of the False Claims Act, which authorizes private individuals to sue on behalf of the federal government. The U.S. Department of Justice (DOJ) investigated Dr. Garber’s claims and chose to back the lawsuit.
Dr. Garber and the U.S. alleged that Norman Regional and the other defendants were billing Medicare for diagnostic services performed by radiological practitioner assistants (RPAs) without the required supervision of physicians.
“There are certain radiological diagnostic services that require ‘personal’ supervision,” the U.S. Attorney for the Western District of Oklahoma said in a statement. “This means that a physician must be in the room supervising the RPA when the RPA performs the service. If a physician is not in the room, the service cannot be billed to Medicare.”
Dr. Garber will receive $291,375, about 18 percent of the settlement, as a whistleblower award for helping the U.S. recover the Medicare funds. The defendants also agreed to pay more than $31,000 for Dr. Garber’s legal expenses.
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Are you aware of fraud being committed against the federal government, or a state government? If so, the FCA can protect and reward you for doing the right thing by reporting the fraud. If you have any questions about whether you qualify as a whistleblower, please contact an attorney at Beasley Allen for a free and confidential evaluation of your claim. There is a contact form on this website, or you may email one of the lawyers on our whistleblower litigation team: Archie Grubb, Larry Golston, Lance Gould or Andrew Brashier
Source: U.S. Attorney’s Office for the Western District of Oklahoma