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VitalAxis Inc. False Claims Act Allegations, Atlanta GA, 2020
VitalAxis Inc., a Maryland-based billing company for diagnostic laboratories, has agreed to pay $300,479.58 to resolve False Claims Act allegations that it caused the submission of false claims to Medicare for medically unnecessary respiratory pathogen panels run on seniors who received COVID-19 tests.
Throughout 2020, VitalAxis performed billing services for a diagnostic laboratory in Atlanta, Georgia that provided COVID-19 testing to residents of senior living communities. For one chain of communities, the laboratory directed VitalAxis to bill Medicare for respiratory pathogen panels purportedly ordered by a physician who had not actually ordered the tests and who was ineligible to treat Medicare beneficiaries.
VitalAxis found the credentials of a different physician and, without authorization, billed Medicare using that physician’s name. Medicare subsequently paid the laboratory for these medically unnecessary tests.
“Federal health care programs only pay for items or services that are reasonable and medically necessary,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “Today’s settlement demonstrates our commitment to pursue those who exploited the COVID-19 pandemic by billing the government for wasteful tests that nobody wanted or needed.”
“Unscrupulous companies that exploit the Medicare billing system divert important resources away from the program and abuse patient trust,” said U.S. Attorney Ryan K. Buchanan for the Northern District of Georgia. “This civil resolution confirms that our district is committed to protecting our federal programs from fraud and holding those accountable who knowingly waste taxpayer dollars.”
VitalAxis received a credit in connection with the settlement announced today in recognition of their cooperation, including by performing and disclosing the results of an internal investigation, disclosing relevant facts and material not known to the government but relevant to its investigation, providing information relevant to potential misconduct by other individuals and entities, and admitting liability.
The resolution obtained in this matter was the result of a coordinated effort between the Civil Division’s Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Office for the Northern District of Georgia, with assistance from the Department of Health and Human Services, Office of the Inspector General.
The investigation and resolution of this matter illustrates the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement, can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).
Key Facts
- State: Maryland
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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