Grimy Times has learned that Bay Area Sleep Associates LLC, dba SomnoMedics LLC, and its owner Edward Killmer Jr. are at the center of a major healthcare scam. The United States has filed a complaint under the False Claims Act (FCA) against the defendants, alleging that they knowingly submitted false claims for payments from multiple federal health care programs.
The complaint, filed today in U.S. District Court for the Middle District of Florida, alleges that the defendants hired unlicensed sleep technicians to perform sleep tests at one or more of their facilities. Medicare regulations require that diagnostic testing services performed at independent diagnostic testing facilities such as SomnoMedics must be performed by a technician licensed or certified by a state or national credentialing body in order to be reimbursed by Medicare.
According to the complaint, SomnoMedics utilized unlicensed sleep technicians to perform sleep tests on Medicare and TRICARE beneficiaries, but knowingly requested payment for these services despite being fully aware that SomnoMedics failed to comply with federal program reimbursement regulations.
“Providers who participate in federal health care programs must play by the rules, not cut corners,” said Tony West, Assistant Attorney General for the Justice Department’s Civil Division. “Billing the government for diagnostic tests performed by unlicensed technicians, as we allege here, is unfair to patients and a misuse of taxpayer dollars.”
The lawsuit was originally filed under the qui tam or whistleblower provisions of the FCA by William Revels, a former sleep study technician. Under those FCA provisions, a private party, known as a relator, can file an action on behalf of the United States and receive a portion of the recovery.
The government’s complaint is part of the United States’ emphasis on combating health care fraud and another step for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced by Attorney General Eric Holder and Kathleen Sebelius, Secretary of the Department of Health and Human Services in May 2009. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.
The Justice Department has used the False Claims Act to recover more than $5.8 billion since January 2009 in cases involving fraud against federal health care programs.
Mandatory Facts:
Defendant/respondent: Bay Area Sleep Associates LLC, dba SomnoMedics LLC and Edward Killmer Jr.
Criminal charges: Violated the False Claims Act (FCA) by knowingly submitting false claims for payments from multiple federal health care programs.
City and state: Tampa, Florida
Exact date of crime: 2004 (alleged start date)
Sentence or outcome: Case ongoing, no sentence or fine imposed
Dollar amounts: $5.8 billion in recoveries since January 2009
Related Federal Cases
- Bodega Importadora de Pallets, False Insurance Claims, Washington 2023 · Florida
- Fuada Delic, Aiding and Assisting in Filing False Tax Return, Florida 2009 · Florida
- Orlando Pascual Jr., Medicare Fraud, Florida 2023 · Florida
- Juan A. Tony Marrero, Medicare Fraud Scheme, Florida 2023 · Florida
- Juan A. Tony Marrero, Medicare Fraud Scheme, Florida 2004 · Florida
Key Facts
- State: Florida
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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