WALDEN MACHT HARAN & WILLIAMS LLP - DOJ, WMHW SETTLE FALSE CLAIMS ACT LAWSUITS INVOLVING ALLEGED BLATANT MEDICARE FRAUD FOR $17.7 MILLION; HUNDREDS OF ADDITIONAL DEFENDANTS FACE SIMILAR ALLEGATIONS

"Cardiology practices in the United States have repeatedly been accused of defrauding government healthcare programs; this is yet one more example of providers reaping profits while taxpayers foot the bill." 

NEW YORK, Dec. 21, 2024 /PRNewswire/ -- Today, the U.S. Department of Justice announced 16 False Claims Act whistleblower settlements involving various groups of cardiologists – spanning a dozen states – that allegedly engaged in healthcare fraud. 

Similar allegations against hundreds of additional cardiologists will proceed to litigation in an unprecedented qui tam lawsuit filed by two whistleblowers under the False Claims Act (FCA).

The lawsuit alleges that the cardiologists blatantly overcharged the government for radiopharmaceuticals used in common cardiology diagnostic testing. The whistleblowers are represented by Dan Miller, Jonathan DeSantis and Samuel Rogers from Walden Macht Haran & Williams and Henry Furst from the Law Office of Henry Furst.

"Cardiology practices in the United States have repeatedly been accused of defrauding government healthcare programs; this is yet one more example of providers reaping profits while taxpayers foot the bill. Now, with these settlements, taxpayers will recoup some of their lost money. Meanwhile, other cardiology practices that may be engaged in similar behavior will be deterred from continuing their illegal activities," said Dan Miller, a partner at Walden Macht Haran & Williams LLP (WMHW) who represents the whistleblowers. "Whistleblowers are the key to maintaining the financial viability of government healthcare programs, so any providers or their employees who witness illegal behavior should strongly consider speaking up and taking action."

The lawsuit alleges that the cardiologists engaged in Medicare fraud. Cardiologists use radiopharmaceuticals to perform nuclear stress testing.  In the Medicare jurisdictions relevant to the case, healthcare providers are required to bill Medicare for radiopharmaceuticals based on their purchasing cost. The lawsuit contends that the cardiologists submitted reimbursement claims to Medicare for amounts that greatly exceed their purchasing costs, leading to millions of dollars in overpayments.

The settling defendants will pay a combined total of $17,761,564. The qui tam whistleblowers represented by WMHW – two cardiologists who observed the overbilling and brought it to the attention of the government – will receive more than $2.7 million from the settlements announced today. The case against the several hundred defendants also named in the lawsuit will proceed to litigation.

The case is United States ex rel. Walia v. Aaron et al. (D.D.C), No. 18-cv-00510-RJL, in the United States District Court for the District of Columbia. The claims alleged in the lawsuit are allegations only, and there has been no determination of liability.

The Walden Macht Haran & Williams whistleblower practice group is one of the most successful qui tam groups in the country. Led by former prosecutor Dan Miller and Jonathan DeSantis, attorneys in the group have worked on cases that have returned more than $3 billion to state and federal treasuries across the country, including more than a dozen cases that were initially declined by the government.

SOURCE Walden Macht Haran & Williams LLP