KY Med Office to Settle Medicare False Claims for $3.7M; Whistleblower to Get $283K
Elizabethtown Hematology Oncology, PLC (EHO) and its owners have agreed to pay $3.7 million to resolve allegations that they knowingly submitted or caused the submission of false claims to federal health care programs Medicare, Medicaid, TRICARE, and the Federal Employee Health Benefit Program (FEHBP), the U.S. Attorney’s office for the Western District of Kentucky announced earlier this month.
According to the settlement agreement, Dr. Rafiq Ur Rahman and Dr. Yusuf K. Deshmukh, owners of Elizabethtown Hematology Oncology, PLC (EHO), billed Medicare, TRICARE, FEHBP and Medicaid for unnecessary office visit evaluations at the same time patients were receiving chemotherapy or other types of infusion treatments. The United States and Commonwealth of Kentucky contend that EHO did this by improperly billing evaluation and management codes using Modifier-25 (allows for billing evaluation and management necessary prior to the performance of a procedure).
The United States and Commonwealth of Kentucky further contend that Dr. Rahman, Dr. Deshmukh, and EHO unnecessarily and improperly extended the duration of chemotherapy infusion treatment times for their patients in order to improperly bill Medicare, TRICARE, FEHBP and Medicaid for those additional hours of chemotherapy infusion treatments.
The lawsuit was originally filed by Dr. Ijaz Mahmood, a former employee of EHO, under the whistleblower provision of the False Claims Act. The Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery. Dr. Mahmood will receive $283,412.90 as his portion of the settlement.
The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments. We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud. Read more about our expertise in False Claims Act cases and how you can take action.