On December 13, the U.S. Department of Justice (DOJ) announced it is filing a complaint under the False Claims Act against a chiropractor, 15 Modern Vascular office-based labs, and 5 Modern Vascular-affiliated companies owned by the chiropractor. In this action, the U.S. is intervening in qui tam lawsuits filed by whistleblowers.
The qui tam provisions of the False Claims Act enable private citizens 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, if one occurs.
The U.S. alleges “that from at least Jan. 1, 2018, through June 30, 2022, Yury Gampel and the Modern Vascular defendants offered physicians the opportunity to invest in Modern Vascular office-based labs to induce them to refer their Medicare and TRICARE patients to Modern Vascular for the treatment of peripheral arterial disease.” Additionally, Gampel allegedly “pressured vascular surgeons and interventional radiologists employed at the Modern Vascular office-based labs to increase the number of invasive surgical procedures performed by tracking procedures and setting aggressive weekly and monthly goals for such procedures.”
According to the press release, the U.S. “filed its complaint in three consolidated lawsuits pending in the United States District Court for the District of Arizona” under the False Claims Act’s qui tam provisions. The U.S. intervened in whistleblower cases for this action, and the complaint sheds more light on the whistleblowers.
The complaint mentions six whistleblowers, five of whom never worked for any of the defendants. Dr. Jay Radhakrishnan of Texas and Dr. William Julien of Florida, both board-certified interventional radiologists who had never worked for any of the defendants, “filed the first case of consolidated actions” in January 2020. Dr. David Terry, a board-certified vascular surgeon, Dr. Chandrahas Patel, a cardiothoracic surgeon, and Dr. Lannery Lauvao, a board-certified vascular surgeon, together “filed the second of these consolidated actions” in January 2021. All three individuals are in Arizona. The third action was brought by Katherine Diggins, a former vascular surgery physician’s assistant, in July 2021. Unlike the other whistleblowers, Diggins “was employed by Defendant Modern Vascular of Denver, LLC,” the complaint states.
This settlement — and plenty of other qui tam whistleblower cases — show how whistleblowers are critical to uncovering waste, fraud, and abuse, especially in the medical and health care industry. Fraudulent schemes can be particularly harmful to patients and erode trust in the medical system. In Fiscal Year 2021, qui tam whistleblowers helped the DOJ recover $1.6 billion in settlements. The DOJ highlighted health care fraud as “the leading source of the department’s False Claims Act settlements and judgments.”
Senator Chuck Grassley (R-IA), who has been consistently championed as the “patron saint” of whistleblowers, proposed amendments to the False Claims Act in 2021 that would strengthen protections for whistleblowers and clarify existing law. The amendment was widely supported by whistleblower organizations and advocates. However, WNN sources discovered that the pharmaceutical lobby intervened with the amendment’s passage. The National Whistleblower Center (NWC) is urging Congress to protect the False Claims Act: learn more here.