Dr. Paul B. Tartell, an ENT physician practicing in Plantation, Florida and his practice Paul B. Tartell, M.D., P.L., have agreed to pay $750,000 to resolve allegations that he violated the False Claims Act by billing for surgical endoscopies with debridement and laryngeal stroboscopies that were not provided or not medically necessary.
Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, Shimon R. Richmond, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), George L. Piro, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office, and Scott Rezendes, Special Agent in Charge, U.S. Office of Personnel Management, Office of Inspector General (OPM-OIG), made the announcement today.
“We remain deeply committed to holding individual health care providers accountable for exploiting federal health care programs,” said Wifredo A. Ferrer, United States Attorney for the Southern District of Florida. “Physicians who bill for unnecessary services and services that were never provided put their own desire for personal profit ahead of their oath to provide safe and essential patient care. Doctors engaged in this conduct violate their patients’ trust and deprive federal health care programs of resources intended to provide care for the elderly, sick, and impoverished.”
The settlement announced today resolves allegations originally brought by Theodore Duay, a former patient of Dr. Tartell. Mr. Duay filed a complaint under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private parties to sue on behalf of the government and receive a share of any recovery. The False Claims Act authorizes the United States to intervene in such lawsuits and take over primary responsibility for litigation. Mr. Duay will receive $135,000.
Mr. Duay alleged that Dr. Tartell routinely performs diagnostic endoscopies on patients but bills these diagnostic procedures as more expensive and intrusive surgical debridements. Surgical debridements are a specialized procedure frequently performed following sinus surgery involving the transnasal insertion of an endoscope and parallel insertion of various instruments to remove postsurgical crusting, bone or tissue deposits. It may also be used to remove crusts and debris in patients with longstanding chronic sinusitis who have undergone surgery in the past.
In addition to the allegations regarding surgical debridements, the settlement also resolves the United States’ allegations that Dr. Tartell systematically billed federal health benefit programs, in particular, Medicare and the Federal Employment Health Benefits Program, for claims arising from laryngeal video stroboscopies that were not performed or were not medically necessary.
“When physicians and their practices bill for services not provided or not medically necessary it undermines the public’s trust in medical institutions and the financial integrity of federal health care programs,” said Shimon R. Richmond, Special Agent in Charge, U.S. Department of Health and Human Services Office of Inspector General. “Our agents and lawyers will aggressively pursue those who exploit taxpayers, patients, and government health programs.”
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Key Facts
- State: Florida
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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