Orthopaedic and Neuro Imaging LLC (ONI) and its owner were accused of submitting some $6,125,947.13 in false claims to Medicare. A default judgment has been issued against them. Generally, a default judgment is entered when defendants fail to defend themselves in court.
The case was initiated by a whistleblower. The former ONI employee brought forward the claim and the government intervened in the lawsuit. In False Claims Act cases, whistleblowers are entitled to a percentage of the total recovery as a reward. In this case, the former employee will receive 18 percent of the judgment, or approximately $1,102,670.
ONI runs a number of independent diagnostic testing facilities in Delaware and Maryland. According to the acting U.S. Attorney for the District of Delaware, the false claims were submitted for services for which Medicare requires a physician's supervision.
In this case, ONI and its owner were alleged to have knowingly submitted claims for administering contrast dye during MRI (magnetic resonance imaging) scans without appropriate doctor supervision.
When Medicare's rules require a supervising physician, it is illegal to bill for claims without the physician. In certain situations, doing so may amount to fraud.
"This case exemplifies the utility of the False Claims Act to deter fraudulent conduct, protect patient safety, and save taxpayer dollars," said the acting U.S. Attorney for Delaware.
"We will continue to work tirelessly to prevent these programs from becoming targets and fight fraud wherever we find it," added the special agent in charge of the FBI's Baltimore Division. "Medical Providers who take shortcuts to enrich themselves in delivering patient care will be held accountable."
If you work in the healthcare field or any organization with government contracts, you may be in a position to notice fraud, waste or abuse against the government. If you do, you may be eligible to file a False Claims Act lawsuit. If it is successful, you could receive a substantial portion of the total recovery as a reward.