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United States Settles False Claims Act Allegations Against Billing Manager

September 4, 2013 - WorkCompWire

San Francisco, CA – A billing manager, her billing company, and her son have agreed to pay $1.7 million to settle allegations that they violated the civil False Claims Act in connection with claims submitted to the Department of Labor, Office of Workers’ Compensation Programs (DOL-OWCP), United States Attorney Melinda Haag announced.

The settlement resolves a whistleblower lawsuit filed in the United States District Court for the Northern District of California. In July 2012, the United States settled with six other defendants for $3.15 million — Advanced Physical Medicine & Rehab Group Inc. (located in Oakland, Calif. and Rhonert Park, Calif.), Advanced Occupational Rehabilitation, Inc. (located in Oklahoma), Advanced Medicine and Rehabilitation of Texas, Inc. (located in Texas), Advanced Medicine and Rehabilitation of Texas, P.A. (located in Texas), and the two physicians located in Oakland who own these clinics. The remaining three defendants – Farideh Heidarpour, her billing company A.B.C. Billing Inc., and her son Ali Heidarpour (who was also her employee) – will pay an additional $1.7 million.

The United States alleges that, from 2005 through 2008, Heidarpour, her company, and her son submitted or caused to be submitted to DOL-OWCP false claims by the clinics for supplies and services not provided, not supported by medical documentation and/or not medically necessary, resulting in millions of dollars of damages to the United States. The majority of the patients at issue were United States Postal Service (USPS) employees claiming work-related injuries.

“This settlement demonstrates this office’s continued commitment to protecting the federal health care programs from fraud and false claims,” U.S. Attorney Haag, said.

A physician who formerly worked at the clinic in Texas filed the case pursuant to the qui tam provisions of the False Claims Act. Under those provisions, private citizens, called “relators,” may file lawsuits on behalf of the United States and receive a portion of the proceeds of a settlement or judgment. The relator will receive $323,000 as her share of the government’s recovery from the three defendants. This is in addition to the relator’s share of $598,000 from the earlier settling defendants.

Assistant U.S. Attorneys Sara Winslow and Melanie Proctor handled the matter on behalf of the U.S. Attorney’s Office for the Northern District of California, with assistance from Financial Fraud Investigator Michael Zehr and Legal Assistants Yvette Baird and Kathy Terry. The matter was investigated by DOL-OWCP and the USPS Office of Inspector General.

Source: USDOJ

Filed Under: Claims, Legal, & Compliance News, Industry News, Top Stories, Workers' Compensation

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