Whistleblower Suit Leads to Settlement on Medicare Fraud Charges

A whistleblower lawsuit filed under the False Claims Act has resulted in a $750,000 settlement by a Maryland doctor regarding allegations that he participated in Medicare fraud.

Steven Pringle, a former employee of three medical establishments owned by Mubashar Choudry, M.D., filed a qui tam lawsuit in 2016 accusing Choudry of submitting false claims to Medicare and TRICARE, a veterans’ health program.

The suit named Choudry, the Washington Cardiovascular Institute, Advanced Vascular Resources, and Washington Vascular Institute. The whistleblower alleged that between Jan. 1, 2013, and Dec. 31, 2016, Choudry performed heart-disease tests on patients “under agreements with the referring physicians but without collecting from the physicians the fair market value for the tests.”

The U.S. Department of Justice joined the suit the following year. It charged Choudry with violating the Anti-Kickback Statute, which prohibits “knowing and willful” remuneration in exchange for referrals paid for by a federal healthcare program. Submitting claims resulting from kickbacks amounts to defrauding the government, e.g., violating the False Claims Act.

The False Claims Act contains qui tam whistleblower provisions that allow individuals to sue on behalf of the government. Whistleblowers are eligible to collect 15 to 30 percent of any penalties collected by the government as a result of a prosecution that succeeds based on information provided by the whistleblower. These penalties are often significant since fraudsters are liable for civil sanctions as well as treble damages. Pringle will receive a $121,500 whistleblower reward for his efforts, according to a DOJ press release.

This instance is not the first time Choudry has come under scrutiny for billing practices: He and two associates paid a $1.9 million settlement in 2014 for double-billing Medicare for medical tests. As in the current settlement, Choudry and his associates did not admit to wrongdoing.

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