A couple has been found liable for committing Medicare fraud against the government when the pair knowingly submitted false claims for tests for reimbursement.

New Jersey residents Nita and Kirtish P., both age 53, will be forced to pay a civil settlement in the amount of $7.75 million to resolve the claims against them.

The couple was found to have submitted false claims to Medicare when they billed for neurological tests conducted without supervision.

Thousands of false Medicare claims were submitted by the couple from 2006 to 2014 through their diagnostic imaging companies Biosound Medical Services Inc. and Heart Solution PC.

The $7.75 million settlement includes $2.75 in civil monetary penalties plus another $5 million that will be paid to the U.S. for damages.

The whistleblower lawsuit accusing the couple of Medicare fraud against the government was filed in November 2015 that claimed two counts of a violation of the False Claims Act.

The U.S. requested summary judgment in the case, and it was granted, ruling in favor of the whistleblower and the United States.

The New Jersey couple both pleaded guilty to one count each of Medicare fraud against the government in the related criminal case. The couple faces up to 10 years in prison each, along with a $250,000 fine when they will be sentenced next month.

The criminal case against the couple also involved a doctor who accepted bribes from the pair for expenses related to his home ownership in exchange for referring patients to the labs. He was sentenced to a year in prison last month.

In the civil complaint from the government, the couple as accused of creating bogus diagnostic reports, forged signatures of physicians on the reports, then billed Medicare for the reports and the related tests.

Additionally, they were also accused of billing Medicare for neurological tests performed without physician supervision that was required.

Did You Witness Medicare Fraud Against the Government?

The lawsuit alleging Medicare fraud against the government was filed under the whistleblower provisions of the False Claims Act, also known as a qui tam lawsuit.

This act allows individuals with knowledge that various types of fraud, including Medicare fraud against the government, is taking place.

The government can decide to take part in the lawsuit as well, as it did in this case. Typically, when the government decides to join a case, there is a high likelihood that the evidence surrounding the alleged fraud is clear.

When a whistleblower, also known as a relator, files a lawsuit, he or she is also able to take part in the recovery, earning up to 30% of the recovered funds for assisting the government in protecting itself from fraud.

In this case, the whistleblower was a former employee of one of the diagnostic imaging companies and will receive 15-25% of the judgment recovered by the government.

It is important to note that any potential whistleblower who intends to report Medicaid or Medicare fraud against the government, government contractor fraud or other types of fraud committed against the government must do so by filing a lawsuit under the False Claims Act in order to share in the recovery.

Oftentimes, employees are encouraged to report fraudulent activities to whistleblower hotlines, however, this will not allow relators to share in the settlement. Because of this, a highly specialized lawyer with experience in lawsuits should be consulted before any reports of any kind are made.

If you believe you have witnessed Medicare fraud against the government or any other fraud directed against the government, an attorney can review your case for free and can help you determine your legal options.