False Claims Act Settlement: Florida Health Company Will Pay $24.5 Million

On April 12th, 2022, the Department of Justice (DOJ) announced that Physician Partners of America LLC (PPOA)—a pain management relief center based in Tampa, Florida—has agreed to pay nearly $25 million as part of a False Claims Act investigation. The company allegedly engaged in a number of different violations, including overbilling of a federal health program and making false representation to obtain COVID-19 relief funds. Here, our Florida COVID-19 fraud whistleblower attorneys provide an overview of the False Claims Act settlement announced by the DOJ.

Allegations: COVID-19 Related Health Billing Fraud 

In effect, the DOJ pursued two overlapping False Claims Act cases involving Physician Partners of America LLC (PPOA). One claim alleged federal health billing fraud. The other claim alleged that PPOA obtained federal COVID-19 relief money that it was not really due. Here are the specifics of the separate False Claims Act allegations against PPOA:

• Federal Health Care Billing Fraud: The DOJ contends that PPOA improperly submitted federal health care billing claims for medically unnecessary urine-based drug tests. Some employees were encouraged to order certain tests multiple times without justification.
• COVID-19 Relief Money Violations: The DOJ also contends that PPOA obtained an improper COVID-19 relief through the Paycheck Protection Program (PPA). The company received nearly $6 million in funds from the SBA that it was not due under the law. 

To resolve all False Claims Act allegations that were raised against the company, PPOA will pay $24.5 million. In addition, the company entered into a multi-year Corporate Integrity Agreement (CIA) with the federal government that gives authorities enhanced oversight for the practices of the business.   

Five Doctors Filed a Whistleblower Claim Against the PPOA 

As with many federal health care billing fraud cases and COVID-19 loan fraud cases, the improper practices came to light after whistleblowers took action. The DOJ emphasizes that this case was initiated by five doctors—some of whom were employees of PPOA, others who worked for affiliated entities. They will collectively receive a portion of the funds recovered by the DOJ as whistleblower compensation. Typically, whistleblowers in successful qui tam lawsuits are entitled to receive between 15 and 25 percent of the funds ultimately recovered by the government.

Notably, some of the doctors also alleged retaliation by PPOA. Under False Claims Act, employers are strictly prohibited from taking any retaliatory adverse action against an employee who brings a qui tam whistleblower complaint. The federal False Claims Act and the Florida False Claims Act both provide strong legal protections to whistleblowers. 

Schedule a Confidential Consultation With a Florida False Claims Act Attorney

At Guttman, Freidin & Celler, our South Florida False Claims Act lawyers fight tirelessly to protect the rights and interests of whistleblowers. If you are preparing to disclose health billing fraud and/or COVID-19 fraud, we can help. Call us now or connect with us directly online to set up your no cost, no obligation case review. Our firm represents whistleblowers nationwide.

Resource:

justice.gov/opa/pr/physician-partners-america-pay-245-million-settle-allegations-unnecessary-testing-improper