Judge Recommends Throwing Out One Claim in $522M FCA Case

U.S Magistrate Judge Sonja F. Bivens has recommended one of the six claims against Mobile, Ala.-based Diagnostic Physicians Group be thrown out because the government had not presented sufficient evidence to support the claim, according to a Law360 report.

In 2011, a former employee of Diagnostic Physicians Group filed a lawsuit under the qui tam, or whistle-blower, provision of the False Claims Act against Infirmary Health, IMC-Diagnostic and Medical Clinic and Diagnostic Physicians Group, three Mobile,Ala.-based organizations, and in 2013, the government intervened in the case.  

The lawsuit alleged violations of Stark Law and the Anti-Kickback Statute that occurred when IMC-Diagnostic and Medical Clinic, which is one of Infirmary Health's clinics, improperly paid Diagnostic Physicians Group physicians for test referrals, according to the Department of Justice.

The lawsuit further alleged Diagnostic Physicians Group physicians falsified medical records to justify the unnecessary testing they referred to IMC-Diagnostic and Medical Clinic. According to the complaint, some of the falsifications included "stating on the nuclear request form that a patient had complained of chest pain, when the chart documents that the patient had denied such a complaint, or by stating that the patient had an abnormal EKG, when in reality, the EKG chart was perfectly normal."

From 2004 to 2010, federal health insurance programs, including Medicare and TRICARE, paid $521.6 million in false claims to the physicians, according to the complaint.

On April 15, Judge Bivens recommended the falsification of medical records claim against Diagnostic Physicians Group be thrown out because the government had not presented sufficient evidence to support the claim, according to the Law360 report.

Although the magistrate judge has made her recommendation in the case, a U.S. District Judge will make the final ruling in the lawsuit.
 

More Articles on False Claims Act:

5 Recent FCA Employee Whistle-Blower Case Settlements 
All Children's Hospital, Pediatric Physician Services, All Children's Health System to Pay $7M to Settle Stark Law Violations 
Will Physician Payment Sunshine Act Data Usher In A New Era Of FCA Litigation? 

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