Physician Failure to Supervise Allegations
The (DOJ) Department of Justice, the Department of Health and Human Services, and the United States Attorneys have been cracking down on allegations of health care fraud.
Our health care attorneys have experience handling all types of health care fraud cases and able to guide and advise you through whatever health care legal matter you may be dealing with.
If you, as a physician, have been charged with, or are under investigation for, failure to supervise during medical procedures contact one of our attorneys today to ensure that your predicament ends with the best solution possible.
Physician failure to supervise fall under what violation?
Facing allegations of health care fraud, as a medical professional, can be daunting. There is the possibility of jail time, hefty fines, and a ruined reputation all on the table as potential punishments. Let our experienced health attorneys advise and guide you through the process.
There are many laws and schemes that constitute what is commonly known as health care fraud. This article specifically looks at fraud cases involving accusations of a physician’s failure to supervise medical treatments.
An alleged fraud scheme involving physician failure to supervise will typically fall under a violation of the false claims act.
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Free Confidential Case ReviewDefenses
Claims of health care fraud in relation to physician failure to supervise are allegations that require a unique and individualized defensive strategy.
If you have been charged with, or are under investigation for, failure to supervise it is best to contact an attorney as soon as possible.
Contacting one of our attorneys today, for a free consult, can give you a better idea of what could work best in your individual case and give you a piece of mine as an investigation, or trial proceedings, move forward.
False Claims Act, 31 U.S.C, Chap. 37, Subchap. III.
Falsely reporting a diagnosis is a violation of United States Law under the False Claims Act, 31 U.S.C, Chap. 37, Subchap. III.
Liability under the False Claims Act, specifically 31 U.S.C. §3729 arises when a defendant, to the detriment to the United States Government,
- knowingly presents, or causes to be presented, a false or fraudulent claim for payment;
- knowingly makes, or causes to be made or used, a false record or statement material to a false or fraudulent claim;
- conspires with others to commit a violation of the False Claims Act ;
- knowingly makes, uses, or causes to be made or used, a false record or statement to conceal, avoid, or decrease an obligation to pay money or transmit property to the Federal Government.
A defendant who is found guilty of a violation of the false claims act may be liable to the U.S. Government for a civil penalty of between a minimum of $5,000 and a maximum of $10,000, plus 3 times the amount of damages which the Government sustains because of the act of that person. All of the amounts may be adjusted for inflation.
These damages may be reduced to no less than 2 times the amount of damages for several reasons, including,
- The defendant fully cooperated with the government throughout the investigation; or
- The defendant furnished the government with information about the violation prior to there being any prosecution or legal action.
In addition to the action brought against you by the government, if you have been accused of falsely reporting a diagnosis, you may also be subject to civil actions by a private person.
Under 31 U.S.C. §3730, a private citizen may bring an action on behalf of both themselves and the U.S. Government. The government may move to have the case dismissed, may intervene in the case, or may move for extensions of time as is appropriate under U.S. federal civil procedure.
If the government does proceed with the action, they take over the primary responsibility for prosecuting the case. The private citizen may continue to be a part of the case. This type of case is known as a Qui Tam action or a Whistleblower action.
What is Qui Tam Action?
A Qui Tam Action means that the private citizen that is a party, and that assists the prosecution, will be able to receive all, or part, of any penalty imposed by the court in the case.
There is a statute of limitations that runs from the time of the violation of the False Claims Act to no more than 10 years later. A claim must be brought within this time period if one is not then is barred.
Cases of Physician Failure to Supervise in the News
United States Government Settles False Claims Act Allegations Against Florida Vein Clinic and Its Owner
In January 2014, Dr. Ravi Sharma agreed to pay $400,000 to resolve allegations that he, and his clinics, violated the False Claims Act by billing Medicare for vein injections and physician office visits that were performed by unqualified personnel.
The United States alleged that between 2009 and 2010 Sharma owned and operated a clinic call Premier Vein Centers. It was further alleged that during this time period he sent texts to his office manager instructing to perform varicose vein injections on patients when he was not in the office.
The government further alleged that between 2009 and 2010 Sharma also owned and operated a weight loss clinic. Here, allegedly, unqualified personnel met with patients of the clinic, but Sharma billed them as physicians visits using his own Medicare provider number.
For more information and for the full Department of Justice (DOJ) press release, click this link or copy and paste the URL below.
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Free Confidential Case ReviewBoard Certified Obstetrician and Gynecologist Agrees to Civil Fraud Settlement in Conjunction with Deferred Prosecution in Medicare and Medicaid Fraud Investigation
In July 2015, Haroutyoun Margossian, a Board Certified Obstetrician and Gynecologist (OB/GYN), agreed to pay $8,047,291.06 to settle claims that he violated the federal false claims act. Margossian was the owner of and sole practitioner for NY Urogynecology & Reconstructive Pelvic Surgery, P.C. in Brooklyn, NY.
Margossian had allowed unlicensed and unsupervised staff to treat patients for urinary incontinence. The government’s investigation revealed that for about 6 years, from 2007 to 2013, treating women for incontinence was the main practices focus. While patients received urodynamics testing and underwent pelvic floor rehabilitation, Margossian was often absent.
Medicare and Medicaid mandate that the procedures that were being conducted must be performed by a licensed physician or licensed physical therapist, or properly trained medical staff under a physician’s direct supervision. Margossian billed Medicare and Medicaid for these procedures violating their requirements and the False Claims Act.
For more information and for the full Department of Justice (DOJ) press release, click this link or copy and paste the URL below.
John Muir Health Agrees to Pay $550,000 to Resolve False Claims Allegations
In June 2015, John Muir Health, a system of doctors and health professionals throughout Northern California, agreed to pay $550,000 to resolve allegations that it had submitted false claims for Medicare Reimbursement.
The investigation into the health care system revealed that between 2009 and 2013, physicians who were contracted with John Muir Health to deliver radiation therapy to patients had failed to supervise that treatment adequately.
The proper supervision of radiation therapy is a condition of payment for Medicare.
For more information and for the full DOJ press release, click this link or copy and paste the URL below.
If you are a physician and have been accused of, or are under investigation for, failure to supervise in conjunction with health care fraud contact an experienced health care attorney as soon as possible.
An attorney will be able to guide and advise you through every step of an investigation and trial. In addition, a knowledgeable attorney will also ensure that your right and interests, as well as the rights and interests of your patients, are protected at every stage of the proceedings.
You work hard to help your patients when they are in medical need, let an attorney help you when you are in legal need.
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