For Eight Years, Maryland Clinic Sent Improper Bills to Medicare And Other Programs for Patient Consultations, Say U.S. Prosecutors
WASHINGTON, D.C. (June 27, 2019) — An anti-coagulation clinic owned by Anne Arundel Medical Center (AAMC) billed Medicare and other government insurance programs for a large number of medically unnecessary services, according to federal prosecutors, and AAMC will pay $3.154 million to taxpayers to settle a lawsuit filed by the former supervisor who reported the wrongdoing.
Whistleblower Barbara McHenry will receive a share of the government’s proceeds, plus attorney fees and an additional payment from AAMC to settle her separate employment claim. A clinical pharmacist who had worked at AAMC’s anti-coagulation clinic since its 2007 opening in Annapolis, Md., Dr. McHenry was fired in 2014 and now works as a science teacher at a Maryland high school. In 2015, represented by The Employment Law Group® law firm, she filed a whistleblower complaint against her former employer under the federal False Claims Act (FCA).
The case was pursued by the U.S. Attorney’s Office for the District of MarylandThe FCA, originally signed into law by President Abraham Lincoln in 1863, makes it illegal to deceive the federal government for financial gain. The law includes a “qui tam” provision that allows whistleblowers to file a legal complaint on behalf of the government and — if they prevail — to receive a portion of any settlement or judgment.
Dr. McHenry’s lawsuit remained under seal for several years while being investigated by the U.S. Attorney’s Office for the District of Maryland; it unsealed today after prosecutors filed the settlement agreement yesterday in federal court.
According to an amended complaint filed by Dr. McHenry, AAMC invoiced Medicare and other government programs for consultations that never should have been billed — at least half of all patient visits, she estimated — while avoiding Medicare scrutiny by underbilling on certain other visits. Dr. McHenry further alleged in her complaint that AAMC executives refused to halt the practice after she raised concerns, purportedly because a change in billing practices might trigger a Medicare audit that would uncover the fraud.
The false billing scheme lasted at least eight years, continuing through the end of 2017, according to federal prosecutors who investigated the matter. AAMC doesn’t admit to wrongdoing, but it has agreed to pay restitution and to abide by the terms of a Corporate Integrity Agreement (CIA) that will be enforced by the Office of the Inspector General for the U.S. Department of Health and Human Services.
This isn’t the first time AAMC has settled a Medicare fraud case: In 1999, the non-profit hospital group paid $2.1 million to settle allegations that it billed inappropriately for infusion therapy services. It entered into a CIA in that case, too.
“Dr. McHenry has proved herself as a teacher in more ways than one,” said R. Scott Oswald, managing principal of The Employment Law Group. “By bringing her concerns to the government, she helped to show how medical businesses really should be run.”
Mr. Oswald represented Dr. McHenry along with Janel Quinn, the law firm’s qui tam associate. They worked on the case closely with Assistant U.S. Attorney Roann Nichols of the District of Maryland.
About The Employment Law Group
The Employment Law Group® law firm represents whistleblowers and other employees who stand up to wrongdoing in the workplace. Based in Washington, D.C., the firm takes cases nationwide.