Sound Physicians, Overbilling Medicare, Washington 2012
Tacoma-based Medical Firm to Pay $14.5 Million to Settle Overbilling Allegations
Sound Physicians, a Tacoma, Wash.-based provider of hospitalists and other physicians to hospitals and other medical facilities, has agreed to pay $14.5 million to settle allegations that it overbilled Medicare and other federal health care programs, the Justice Department announced today.
According to the settlement, Sound Physicians knowingly submitted to federal health benefits programs inflated claims on behalf of its hospitalist employees for higher and more expensive levels of service than were documented by hospitalists in patient medical records.
The allegations against Sound Physicians were brought to the government's attention through a lawsuit filed by a former Sound Physicians employee, Craig Thomas, under the qui tam, or whistleblower, provisions of the False Claims Act.
Thomas will receive $2.7 million of the $14.5 million settlement for exposing Sound Physicians' inflated claims.
The settlement marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius.
The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.
The lawsuit is United States of America ex rel. Craig Thomas v. Sound Inpatient Physicians, Inc. and Robert A. Bessler, Civil Action No. C09-5301RBL (W.D. Wash.).
The claims resolved by the settlement are allegations only, and there has been no determination of liability.
Defendant: Sound Inpatient Physicians Inc.
Criminal Charges: Overbilling Medicare and other federal health care programs
City and State: Tacoma, Washington
Exact Date: 2012
Sentence or Outcome: Paid $14.5 million to settle allegations
Dollar Amount: $14.5 million
Defendant's Status: Settled
Key Facts
- State: Federal
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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