A physician group that operates multiple offices across Central Florida has agreed to pay $2 million to the United States and the state of Florida to resolve allegations that they submitted inflated claims to Medicare and Medicaid.
Florida Cardiology, P.A., Sandeep Bajaj, Karan Reddy, and eight other physicians agreed to settle the lawsuit after a multi-month investigation into claims that they improperly billed Medicare and Medicaid patients, even while the physicians were stationed outside of the United States. The physicians named in the law suit were Abbas Ali, Claudio Manubens, Milan Kothari, Saroj Tampira, Sayed Hussain, Raviprasad Subraya, Harish Patil, and Edwin Martinez.
According to the settlement agreement, Bajaj and Reddy permitted Florida Cardiology to bill patients for a variety of services that were either exaggerated or not performed by qualifying physicians. That includes claims of more intravascular stents than were actually inserted into patients, radiofrequency ablations that were not performed by a qualifying provider, and procedures that were billed by the physicians while they were outside of the United States.
Except in limited circumstances, healthcare providers are not permitted to bill for services while they are outside of the United States.
The settlement agreement indicates that Florida Cardiology submitted false claims for payment to Medicare, Medicaid, TRICARE, and the Federal Employee Health Benefits Program.
“The defendants in this case attempted to rip off taxpayers—even going as far as billing Medicaid and Medicare for services they claimed were provided to patients in Florida while these doctors were actually out of the country. As a result of their brazen scheme and the great work of whistleblowers, my Medicaid Fraud Control Unit and our federal partners, these defendants will now pay for ripping off taxpayers,” said Florida Attorney General Ashley Moody regarding the settlement.
The lawsuit was originally filed in the United States District Court for the Middle District of Florida by relators Derrick Graham and Jesse Frauenhofer, who sued under a “whistleblower” provision of the False Claims Act that permits private citizens to sue on behalf of the United States for false claims and to share in the recovery. Graham and Frauenhofer will receive $420,000 of the proceeds from the settlement.