The Department of Justice (DOJ) has announced that Jacksonville, Florida-based American Sleep Medicine LLC has settled allegations that it fraudulently billed Medicare, TRICARE (the health care program for uniformed servicemembers and families) and the Railroad Retirement Medicare Program for services provided to Medicare patients and military families. American Sleep Medicine LLC operates 19 facilities throughout the United States, including centers in California, Delaware, Illinois, Kentucky, Maryland, Missouri, New Jersey, Texas and Virginia.
In addition to the multimillion dollar settlement, the company also entered into a five-year Corporate Integrity Agreement with the Office of the Inspector General of the Department of Health and Human Services (HHS). The Corporate Integrity Agreement contains monitoring provisions regarding accountability in the provision of services, as well as enhanced examination of billing activities by internal and external reviewers. However, there was no determination of liability as a result of the settlement agreement.
The lawsuit was filed under the False Claims Act by a whistleblower, Daniel Purnell, who will receive $2.6 million as part of the settlement. This settlement constitutes part of the DOJ's focus on the False Claims Act in its enforcement efforts, with recoveries totaling well over $13 billion over the past three years.
In light of this enforcement trend, employers should take steps to ensure internal compliance with federal and state health care laws and regulations. In addition, employers must emphasize integrity in the workplace in order to reduce whistleblower lawsuits and federal investigations.