Anil J. Desai, M.D., East Metro Internal Medicine, L.L.C. and Rockdale-Newton Hematology-Oncology (the “Desai Parties”), based in Conyers and Covington, Georgia, have agreed to pay $213,000 to resolve allegations that they violated the False Claims Act by submitting claims to Medicare and Medicaid for drugs that were never provided to their patients, and for drugs that had not received final marketing approval by the U.S. Food and Drug Administration (“FDA”).
“When healthcare providers bill for goods and services that they did not provide, it is the equivalent of taking money from the taxpayer’s pocket,” said U.S. Attorney Byung J. “BJay” Pak. “Additionally, billing for medications that were never approved by the FDA puts patients at risk. We will continue to pursue healthcare providers who put their own bottom line ahead of patient care.”
“The Office of Inspector General will diligently investigate providers who seek to defraud the Medicare and Medicaid trust funds through nefarious billing practices,” said Derrick L. Jackson, Special Agent in Charge at the U.S. Department of Health and Human Services, Office of Inspector General in Atlanta. “This investigation illustrates how we collaborate with our law enforcement partners to protect beneficiaries while holding suspicious providers accountable.”
“FDA’s drug approval requirements are designed to ensure the safety, efficacy, and quality of drugs distributed or administered to American patients,” said H. Peter Kuehl, Acting Special Agent in Charge, FDA Office of Criminal Investigations’ Miami Field Office. “Today’s announcement should serve as a reminder of our continued focus on those that risk patients’ health for profit.”
“Our Medicaid Fraud Control Division is always at work for Georgians, ensuring that Medicaid providers who bill the Medicaid program do not abuse it for their own financial gain,” said Georgia Attorney General Chris Carr. “We greatly appreciate the partnerships we have with federal agencies who share this same mission, and we will continue supporting them to prevent fraudulent activity.”
Dr. Desai owns both East Metro Internal Medicine, L.L.C. (“East Metro”) and Rockdale-Newton Hematology-Oncology (“Rockdale-Newton”), through which he has provided treatment to cancer patients. The Desai Parties billed Medicare and Medicaid for the drugs Eloxitan and Procrit in connection with Dr. Desai’s treatment of cancer patients. Eloxitan is a chemotherapy drug used to treat certain types of cancer and Procit is a medication that is used to treat anemia caused by chemotherapy as well as other conditions.
The government alleges that between November 1, 2008 and August 13, 2012, the Desai Parties submitted claims to Medicare and Medicaid for Procrit even though there was no record that they purchased enough Procrit to cover the amount that they billed. Moreover, the Government alleges that during that same time period, the Desai Parties submitted claims to Medicare and Medicaid for Eloxitan that had been purchased from a Canadian company, Quality Specialty Products, and had not received final marketing approval by the FDA. The civil settlement resolves the government’s investigation into these allegations.
This case was investigated by the U.S. Attorney’s Office for the Northern District of Georgia, the U.S. Department of Health and Human Services – Office of Inspector General, and the Food and Drug Administration – Office of Criminal Investigations.
The civil settlement was reached by Assistant U.S. Attorney Neeli Ben-David, Deputy Chief of the Civil Division, and Sara Vann, Assistant Attorney General with the Georgia Medicaid Fraud Control Unit.
For further information please contact the U.S. Attorney’s Public Affairs Office at USAGAN.PressEmails@usdoj.gov or (404) 581-6016. The Internet address for the U.S. Attorney’s Office for the Northern District of Georgia is http://www.justice.gov/usao-ndga.