False Claims Act: Atlanta Medical Clinic, And Dr. Timothy Dembowski Have aAreed to Pay For Violated Medicare Rules And The False Claims Act

<h2>Atlanta Pain Clinic and its owner agree to pay &dollar;250&comma;000 to resolve allegations that they violated the False Claims Act<&sol;h2>&NewLine;<p>ATLANTA – Atlanta Medical Clinic &lpar;&OpenCurlyDoubleQuote;AMC”&rpar;&comma; which is an Atlanta-based pain management clinic&comma; and Dr&period; Timothy Dembowski &lpar;AMC’s owner&rpar;&comma; have agreed to pay the United States &dollar;250&comma;000 to resolve allegations that they violated Medicare rules and the False Claims Act &lpar;&OpenCurlyDoubleQuote;FCA”&rpar; by billing the Government for&colon; &lpar;1&rpar; services performed by a physician suspended from the Medicare program&comma; and &lpar;2&rpar; the administration of foreign&comma; non-FDA approved drugs&comma; which are not eligible for reimbursement under the Medicare program&period;<&sol;p>&NewLine;<div class&equals;"mh-content-ad"><script async src&equals;"https&colon;&sol;&sol;pagead2&period;googlesyndication&period;com&sol;pagead&sol;js&sol;adsbygoogle&period;js&quest;client&equals;ca-pub-9162800720558968"&NewLine; crossorigin&equals;"anonymous"><&sol;script>&NewLine;<ins class&equals;"adsbygoogle"&NewLine; style&equals;"display&colon;block&semi; text-align&colon;center&semi;"&NewLine; data-ad-layout&equals;"in-article"&NewLine; data-ad-format&equals;"fluid"&NewLine; data-ad-client&equals;"ca-pub-9162800720558968"&NewLine; data-ad-slot&equals;"1081854981"><&sol;ins>&NewLine;<script>&NewLine; &lpar;adsbygoogle &equals; window&period;adsbygoogle &vert;&vert; &lbrack;&rsqb;&rpar;&period;push&lpar;&lbrace;&rcub;&rpar;&semi;&NewLine;<&sol;script><&sol;div>&NewLine;<p>&OpenCurlyDoubleQuote;To maximize their profits&comma; AMC and Dr&period; Dembowski violated Medicare program rules&comma; and then exacerbated their misconduct by submitting false claims to the Government&comma;” said U&period;S&period; Attorney John Horn&period; &OpenCurlyDoubleQuote;Pursuing this investigation and securing this settlement highlights our continued diligence in combating waste&comma; fraud and abuse with respect to federal health care programs&period;”<&sol;p>&NewLine;<p>&OpenCurlyDoubleQuote;This monetary resolution to allegations that violate the False Claims Act hopefully sends a message to health care providers that we are determined to root out any attempt to take advantage of our federal health care programs&comma;” said David LeValley&comma; Special Agent in Charge of the FBI’s Atlanta Field Office&period; &OpenCurlyDoubleQuote;Healthcare providers like Dr&period; Dembowski and AMC need to think twice before they so willfully&comma; and illegally try to maximize their profits&period;”<&sol;p>&NewLine;<p>&OpenCurlyDoubleQuote;When physicians and health care companies provide patients with drugs not approved by the FDA and bill for services provided by those suspended from the Medicare program&comma; they violate the basic trust that is extended to healthcare professionals&comma;” said Special Agent in Charge Derrick L&period; Jackson of the HHS-OIG’s Atlanta Region&period; &OpenCurlyDoubleQuote;Our agents continue to work with the Department of Justice to root out such fraud schemes&comma; which undermine the public’s confidence in&comma; and the <a class&equals;"wpil&lowbar;keyword&lowbar;link" href&equals;"https&colon;&sol;&sol;www&period;fraudswatch&period;com&sol;tag&sol;financial-fraud&sol;amp&sol;" title&equals;"financial" data-wpil-keyword-link&equals;"linked" data-wpil-monitor-id&equals;"786">financial<&sol;a> well-being of&comma; federal health care programs&period;”<&sol;p>&NewLine;<p>A joint investigation conducted by the U&period;S&period; Attorney’s Office for the Northern District of Georgia&comma; the U&period;S&period; Department of Health and Human Services &&num;8211&semi; Office of the Inspector General&comma; and the Federal Bureau of Investigation revealed evidence suggesting that AMC and Dr&period; Dembowski violated the FCA through two separate schemes involving the submission of fraudulent Medicare claims to the Government&period;<&sol;p>&NewLine;<p>First&comma; AMC and Dr&period; Dembowski claimed and received payment for medical services rendered by a physician that worked at AMC &lpar;&OpenCurlyDoubleQuote;Physician 1”&rpar;&period; However&comma; these claims were fraudulent as Physician 1 previously was suspended from the Medicare program in June 2013 for making false statements and omissions regarding his criminal history&period; Due to his suspension&comma; no services rendered by Physician 1 were eligible for Medicare reimbursement&period; Both AMC and Dr&period; Dembowski were aware of Physician 1’s suspension&comma; and that he was thus ineligible to provide services to Medicare patients&period;<&sol;p>&NewLine;<p>Nevertheless&comma; AMC and Dr&period; Dembowski circumvented Physician 1’s Medicare suspension and received Medicare reimbursements for Physician 1’s services&comma; by falsely and fraudulently describing – in claims submitted to the Government – services that had been performed by Physician 1 as services performed by a different AMC physician &lpar;&OpenCurlyDoubleQuote;Physician 2”&rpar; that was authorized to participate in the Medicare program&period;<&sol;p>&NewLine;<p>Second&comma; AMC and Dr&period; Dembowski violated the FCA by&colon; &lpar;1&rpar; obtaining a foreign&comma; non-FDA approved knee treatment drug – i&period;e&comma; Orthovisc– from a firm in Canada&semi; &lpar;2&rpar; utilizing such drug on Medicare patients&semi; and then &lpar;3&rpar; seeking and receiving reimbursement from Medicare&period;<&sol;p>&NewLine;<p>However&comma; Medicare does not cover the costs of foreign&comma; non-FDA approved drugs&comma; and AMC and Dr&period; Dembowski never informed Medicare that the invoices involved the administration of foreign&comma; non-FDA approved drugs&period;<&sol;p>&NewLine;<p>The claims asserted against AMC and Dr&period; Dembowski are allegations only&comma; and there has been no determination of liability&period;<&sol;p>&NewLine;<p>This matter was handled by Assistant U&period;S&period; Attorney Paris A&period; Wynn&period;<&sol;p>&NewLine;<p>For further information please contact the U&period;S&period; Attorney’s Public Affairs Office at USAGAN&period;PressEmails&commat;usdoj&period;gov &lpar;link sends e-mail&rpar; or &lpar;404&rpar; 581-6016&period; The Internet address for the home page for the U&period;S&period; Attorney’s Office for the Northern District of Georgia Atlanta Division is http&colon;&sol;&sol;www&period;justice&period;gov&sol;usao-ndga&period;<&sol;p>&NewLine;

Health Care Fraud