A chain of sleep clinics, also known as the Bay Sleep Clinic in South Bay, has settled Medicare fraud allegations, agreeing to pay a $2.6 million settlement to end the whistleblower lawsuit.
The settlement was announced on Dec. 28, 2016 by the U.S. government.
The settlement deal will allow $545,000 to sleep technician Elma D., according to a report on SFGate.com. The federal False Claims Act rewards whistleblowers who alert the government of fraud and can allow whistleblowers to sue those companies.
Elma worked for the clinic for eight years as a sleep technician. She says she began to take notice of the owners’ plan to defraud the government by filing false Medicare claims. She then decided to file a whistleblower lawsuit and allow the government to investigate those Medicare claims.
The whistleblower lawsuit alleges that the defendants “fraudulently billed Medicare for sleep studies conducted by unlicensed individuals in unapproved locations; improperly dispensed durable medical equipment from unapproved locations using unlicensed technicians; and paid doctors for referrals in violation of the federal Kickback Statute.”
The company’s owners did not admit or deny any claims being alleged and decided to merely opt out of further litigation.
Twenty clinics based out of Northern California are owned by the company, and they specialize in treating patients with sleep disorders. Sleep studies have currently been known of being an increasing and broadening medical specialization and field.
The whistleblower lawsuit, however, accused the company’s owners, Tara Nader and Anooshiravan Mostowfipour, of hiring technicians who did not possess the proper qualifications, nor were they properly certified in conducting the sleep tests and billing Medicare as far back as 2002.
U.S. attorney Brian Stretch said of the whistleblower lawsuit that, “Medicare patients expect to be treated by properly credentialed healthcare professionals in approved locations.”
In a press release, Dresser’s attorney states that “it’s rewarding to see the alleged fraudsters held responsible. Because of the close cooperation and work between the whistleblower and the government, we were able to recover significant funds for the government.”
She further states that “it is gratifying to represent people like Elma Dresser, who bravely stepped forward with knowledge of her employer’s wrongdoing. Many do not appreciate the risks whistleblowers face to hold alleged wrongdoers accountable.”
In general, whistleblower and qui tam lawsuits are filed individually by each plaintiff and are not class actions. Whistleblowers can only join this investigation if they are reporting fraud against the government, meaning that the government must be the victim, and that the alleged fraud should be a substantial loss of money.
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If you believe that you have witnessed fraud committed against the government, you may have a legal claim. Whistleblowers can only join this investigation if they are reporting fraud against the government, meaning that the government must be the victim, and that the alleged fraud should be a substantial loss of money.
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