Medical and physical therapy provider Union Treatment Centers (UTC) have agreed to pay $3 million healthcare fraud settlement to resolve serious whistleblower claims. The Union Treatment Centers subject to the healthcare fraud settlement are located in several Texas cities including Austin, San Antonio, Corpus Christi and Kileen.
The healthcare fraud settlement will also waive claims against Union Treatment Centers over $1.6 million, and will be permanently prohibited from participating in federal healthcare programs.
The Department of Justice (DOJ) states the healthcare fraud settlement resolves a whistleblower lawsuit, filed under the False Claims Act (FCA), alleging Union Treatment Centers developed a defrauding scheme against the Federal Workers’ Compensation Program (FECA program).
The FECA program is run by the U.S. Department of Labor, Office of Worker’s Compensation Programs (OWCP), with the program covering nearly three million federal, civilian and postal employees. If any of these employees suffer on the job injuries, the program provides benefits to the employee including medical and rehab expenses.
UTC reportedly claimed that it specialized in treating work related injuries, and advertised itself as an FECA program to patients. This means the UTC had specifically targeted unionized postal workers in Austin and San Antonio, along with civil Army employees in the Corpus Christi area.
Overview of Healthcare Fraud Settlement
The whistleblower lawsuit alleged UTC former CEO Garry Craighead and COO Christine Craighead created a fraud scheme to overcharge OWCP for its services and supplies that were meant for patients covered by the FECA.
According to the whistleblower lawsuit, UTC billed the FECA programs for services it did not provide from Jan. 1, 2009 to Dec. 31, 2012. UTC allegedly overcharged for medical examinations, exaggerated the time patients took in therapy, and billed the FECA for unnecessary services and supplies.
The Department of Justice also accused UTC of offering, paying for and receiving kickbacks between different parties for patient referrals.
The office also uses federal funds to reimburse any healthcare provider that treat applicable employees. This is where Union Treatment Centers allegedly took advantage of the federal program.
According to representatives form the U.S. Department of Labor, UTC executives submitted false claims to the FECA reportedly requesting funds to treat American workers who were eligible for FECA coverage.
Representatives and investigators state this healthcare fraud settlement provides encouragement to any other potential whistleblowers who may have witnessed healthcare fraud. The healthcare fraud settlement with the UTC is part of a movement of increased enforcement against government defrauding.
Gary Craighead is currently serving a prison sentence of 14 years. He was ordered to pay OWCP close to $18 million in restitution. Christine Craighead is currently awaiting trial with charges of conspiracy, wire fraud, kickbacks and aggravated identity theft. Her trial is set for Oct. 30, 2017.
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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