On June 20, the U.S. Attorney for the Southern District of Florida announced that a group of South Florida medical providers, Vascular and Interventional Specialists, LLC (VIS); Vascular and Spine Institute, Inc. (VSI); Oscar Sosa, M.D.; and Osmany DeAngelo, D.O., agreed to pay $810,000 to settle whistleblower allegations that they violated the False Claims Act (FCA) by billing Medicare for medically unnecessary procedures.
According to the government, the providers billed Medicare for medically unnecessary percutaneous transluminal angioplasties (PTA), a procedure to increase blood flow through a diseased or abnormally narrowed vessel.
“From 2015 to 2024, VIS, VSI, Sosa, and DeAngelo performed hundreds of PTAs without conducting any diagnostic inquiry or making a clinical diagnosis to support the medical necessity of the PTAs they performed,” the government alleges. “VIS, VSI, Sosa, and DeAngelo subsequently submitted claims to federal healthcare programs, including Medicare, for the PTAs that were not reasonable or medically necessary.”
The case stems from a qui tam whistleblower suit filed by Emilio Lopez, M.D. Dr. Lopez is set to receive approximately $186,000 from the settlement.
The False Claims Act’s qui tam provisions enable private citizens and private parties to file lawsuits on behalf of the government if they know of an individual or company defrauding the government. Qui tam whistleblowers are eligible to receive between 15 and 30% of the government’s recovery.
During FY 2024, settlements and judgments under the False Claims Act exceeded $2.9 billion and over $2.4 billion of the recoveries stemmed from qui tam whistleblower lawsuits. Furthermore, according to the government, a record 979 qui tam lawsuits were filed in FY 2024.
However, in September 2024, a district judge in Florida ruled that the False Claims Act’s qui tam provisions were unconstitutional. The U.S. federal government is urging the U.S. Court of Appeals for the Eleventh Circuit to reverse that decision, stating in a brief that “other than the district court here, every court to have addressed the constitutionality of the False Claims Act’s qui tam provisions has upheld them.”
National Whistleblower Center has issued an Action Alert allowing whistleblower supporters to write the members of Congress urging them to protect and strengthen and protect the False Claims Act.
The claims asserted in this case are allegations only, and there has been no determination of liability.
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