Pennsylvania physician pays $1.2M to settle billing fraud allegations

A physician in Berwyn, Pa., has agreed to pay $1.26 million to resolve False Claims Act allegations, the Department of Justice announced Sept. 18. 

The settlement resolves allegations that Thomas Whalen, DO, submitted false claims to federal health plans for FDA-approved medications when he administered medications that were not approved by the FDA. 

Dr. Whalen administered the non-FDA-approved medications at Whalen Rheumatology, which had offices in Havertown and Exton, Pa. He allegedly received approximately $1.1 million in illicit gains by giving patients the non-FDA-approved medications and then billing insurers as if he had used approved medications, according to the Justice Department. 

The settlement also resolves Dr. Whalen's violations of the Controlled Substances Act. He admitted to prescribing controlled substances to two patients without a legitimate medical purpose, according to the Justice Department. 

Dr. Whalen permanently surrendered his controlled substance registrations with the Drug Enforcement Administration, surrendered his medical license and will be excluded from participation in federal programs. 

More articles on legal and regulatory issues:
Chicago hospital defeats allegations of 'ghost payroll' scheme
West Virginia hospital settles whistleblower suit for $50M
UnitedHealth accused of illegally deflating reimbursement

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