On Tuesday, Acting United States Attorney Beth Drake announced that the U.S. Attorney’s Office for the District of South Carolina has settled claims of health care fraud with Drayer Physical Therapy Institute, LLC (“Drayer”). Drayer has locations in South Carolina and 14 other states from Pennsylvania to Oklahoma. The United States contended that Drayer submitted claims to Medicare, TRICARE, and Federal Employee Health Benefit Programs for services being provided to multiple patients simultaneously as though the services were being provided by a physical therapist or physical therapist assistant to one patient at a time.
The investigation began with the filing of a whistleblower lawsuit called a qui tams lawsuit under the False Claims Act. The suit was filed by former employees of Drayer. The False Claim Act allows the government to recover actual damages and penalties of three times the actual damages and up to $11,000 per false claim. This settlement was reached based on Drayer’s ability to pay.
The False Claims Act allows individuals to file lawsuits with allegations that fraud has been committed against the federal government on behalf of the government. Whistleblowers, referred to as Relators in the False Claims Act, are entitled to share in any recovery received by the government. In this case, the two relators collectively will receive 24% of the funds of the settlement or $1,680,000 plus they are entitled to attorney fees. The relators performed significant work in the investigation of this case.
Ms. Drake said, “Whistle blower cases are important to the integrity of the health care system. These civil actions – targeted to routing out fraud and abuse – protect tax payers and patients by ensuring that health care decisions are made according to medical science and not based on dollar signs.”
“Health care companies must bill taxpayer-funded health programs honestly,” said Special Agent in Charge Derrick L. Jackson of the U.S. Department of Health and Human Services, Office of Inspector General. “Those engaging in deceptive billing practices can expect our aggressive investigation to recover inappropriately obtained funds.”
The claims resolved by this settlement are allegations only and there has been no determination of liability.
If you know of or suspect health care fraud, contact us now.
