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Tushar C. Patel, M.D. d/b/a HCI/Metromedic Health Center and Fall River Walk-In Emergency Medical Office, P.C. — $400,000

Fall River Walk-In Emergency Medical Office (“FRWI”) and Tushar C. Patel, M.D. d/b/a HCI/Metromedic Health Center reached a civil settlement agreement with the United States and the Commonwealth of Massachusetts, under which the defendants paid $315,000 to resolve the allegations raised in the whistleblower’s False Claims Act complaint. In addition, defendant FRWI entered into a plea agreement with the Commonwealth of Massachusetts and agreed to pay $85,000 in restitution to the Medicaid program.

In the False Claims Act qui tam case, the whistleblowers alleged that defendants were billing and causing the billing of federal and state government health insurance programs for false and fraudulent claims generated by the defendants’ clinics and medical offices. These false and fraudulent claims involved “upcoding” on government insurance claim forms, the ordering of medically unnecessary tests, and submission of claims with materially false information concerning the identity of the patients’ doctor(s), whether the medical visit in question had occurred at all, and the true nature and extent of the patient’s visit in those instances when the patient had been in one of the defendants’ clinics.

Defendant FRWI was indicted on December 7, 2004 by a Bristol County grand jury on one count each of violation of the Medicaid False Claims Act and larceny over $250. The indictments alleged that from May 2000 through May 2003, the corporation systematically defrauded the Medicaid program of $85,650 by filing 6,346 claims for physical therapy services performed by chiropractors for hundreds of patients.

The defendants reached a civil settlement agreement with the federal and state government for $315,000 and defendant FRWI entered into a plea agreement with the Commonwealth of Massachusetts and agreed to pay $85,000 in restitution to the Medicaid program.

United States and the Commonwealth of Massachusetts ex rel. Relators  v. Tushar C. Patel, M.D. d/b/a HCI/Metromedic Health Center and Fall River Walk-In Emergency Medical Office, P.C., Civil Action No. 03-11828-MLW (D. Mass.)

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