Physician Pays Nearly $800,000 To Resolve False Claims Act Violations

According to the Department of Justice (DOJ), Vinay K. Malviya M.D. of Michigan will pay $775,000 to resolve False Claims Act allegations. The gynecologic oncologist allegedly billed federal health programs for operations and procedures that were “medically unnecessary.” The health bill fraud case was brought to light after three whistleblowers filed a qui tam claim. In this article,  our Florida health care billing fraud lawyers discuss the False Claims Act settlement in more detail.

Allegations: Federal Government Billed for Unnecessary Procedures 

The DOJ contends that Vinay K. Malviya M.D. performed medically unnecessary procedures between February of 2011 and June of 2017, Doctor Malviya allegedly billed federal health programs for expensive, complex radical hysterectomies when simple hysterectomies were actually required.

Additionally, the DOJ determined that Doctor Malviya billed federal health programs from certain services that were not actually rendered. He will not pay $775,000 to resolve the False Claim Act lawsuit. Further, he is being excluded from Medicare and Medicaid for three years.

Notably, this is the second part of this health care billing fraud False Claims Act case. In the summer of 2021, a medical provider in Michigan agreed to pay out $2.8 million to resolve allegations that it received improper federal health payments as part of the scheme. 

A Three Party Qui Tam Lawsuit Brought the Health Billing Fraud to Light 

Sadly, health billing fraud remains a very serious problem. The federal government estimates that Medicare, Medicaid, and other health programs are defrauded out of millions of dollars each year. It is a significant burden for taxpayers and beneficiaries. In many cases, health care billing fraud is only brought to the attention of authorities because of whistleblowers. This case is no exception: The False Claims Act lawsuit against Vinay K. Malviya M.D. and Ascension Michigan started as a qui tam lawsuit.

The False Claims Act allows individual whistleblowers to step into the role of the government and file a lawsuit to stop fraud. These types of legal actions are called qui tam lawsuits. When successful, the whistleblower(s) who filed a qui tam claim can receive a portion of the funds recovered by the federal government. In this case, three individuals filed a qui tam lawsuit against the doctor. The DOJ confirmed that they will receive a combined $147,250 in whistleblower compensation. The whistleblowers have already received a joint $532,000 payment as part of the prior False Claim Act lawsuit against Ascension Michigan. 

Schedule a Free Consultation With a Whistleblower Lawyer in South Florida

At Guttman, Freidin & Celler, we advocate tirelessly for the rights of whistleblowers. If you or someone you know is preparing to disclose health care billing fraud and/or file a qui tam claim, we are here to help you navigate the legal process. To arrange a no cost, no obligation review of your case, please contact us today. We provide nationwide legal representation in whistleblower cases.

Source:

justice.gov/opa/pr/michigan-doctor-pay-775000-resolve-false-claims-act-allegations