Blog & News
One of our clients recently had a big win in a whistleblower case involving cardiac monitoring fraud. Last month, the United States settled a False Claims Act (FCA) case brought by our client against three cardiac monitoring companies — Medi-Lynx Cardiac Monitoring, LLC, AMI Monitoring, Inc., and Spectocor, LLC — as well as individual defendants. The case alleged that defendants had concocted a scheme to cause unwitting physicians to order their most lucrative services regardless of medical necessity or reasonableness.
Under the terms of the settlement, defendants have agreed to pay over $13.4 million.
Defendants utilized an online enrollment portal to steer physicians to select the highest reimbursing monitoring service. Through this scheme, defendants caused Medicare to pay false claims to Medicare for unnecessary and unreasonable telemetry services. Telemetry is the most expensive option for mobile cardiac monitoring services.
Our client, Eben Steele, an employee of AMI/Spectocor, had worked in the industry for many years. He believes that health care companies should serve their patients’ needs. Mr. Steele was “offended by this underhanded scheme.” He noted “not only was it overriding the doctor’s judgment about what the patient needed, but it was lining the Defendants’ pockets at the expense of the taxpayer.” In late 2013, Mr. Steele approached us to see if, together, we could do something to stop this fraud. After investigating his allegations, compiling his evidence, and conducting research, we filed his Complaint under seal in March 2014. We then served the Complaint along with a statement detailing his evidence on the government. Thereafter, we worked with the government over the course of over three years until the settlement.
One of the most important factors in ensuring success for a whistleblower case is filing it in a district where the government prosecutors have the expertise and enthusiasm to ensure success. We filed Mr. Steele’s complaint in the district of New Jersey, permitting us to work with the excellent office there. We applaud the outstanding work of Assistant U.S. Attorney Bernard Cooney, who prosecuted this case with the assistance of Assistant U.S. Attorney Andrew Caffrey. In addition, investigators in the Office’s Health Care & Government Fraud Unit and at the Office of Inspector General of the Department of Health and Human Services provided vital support.
Whistleblowers like Mr. Steele are critically important in the fight against government fraud. Under the FCA, a person who knows of fraud can file a sealed complaint on behalf of the government. If the case is successful, the whistleblower is entitled to a share of the government’s recovery. Mr. Steele, his attorneys, and government prosecutors and investigators devoted several years to this case. Mr. Steele will receive about $2.43 million for his part in stopping an ongoing fraud against the government and helping to ensure that government victims were compensated.
We offer Mr. Steele our congratulations and deep gratitude for his courageous efforts on behalf of taxpayers.