The Department of Justice has announced that American Sleep Medicine LLC, headquartered in Jacksonville, Florida, has agreed to pay $15,301,341 to settle allegations that the company violated the False Claims Act by improperly billing for sleep diagnostic services that were not eligible for payment under Medicare, TRICARE and the Railroad Retirement Medicare Program.
According to the lawsuit, American Sleep had technicians who did not meet federal program requirements conduct polysomnographic diagnostic sleep testing. This test is used to diagnose sleep disorders but must be conducted by technicians who are licensed or certified by a state or national credentialing body in order to be eligible for reimbursement by Medicare and TRICARE. The DOJ alleged that American Sleep knew that it was violating the law and submitted false claims between January 1, 2004 and December 31, 2011.
This lawsuit is part of the federal government’s effort to combat health care fraud under Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative and to ensure that patients receive what is represented to them by healthcare professionals. It also highlights the government’s effort to stop abuse of taxpayer-funded programs like Medicare. David J. Hale, U.S. Attorney for the Western District of Kentucky, stated:
Medical providers who overbill Medicare defraud the taxpayers and drive up the cost of health care for us all. Recovering taxpayer dollars lost to fraud helps keep strong those critical public health care programs so many people depend on.
In addition to the $15.3 million settlement, American Sleep entered into a five-year Corporate Integrity Agreement with the Office of Inspector General of the Department of Health and Human Services to enhance accountability by the company.
The Employment Law Group® law firm’s whistleblower attorneys have helped many clients file suit against employers that fraudulently bill the U.S. government, and have established favorable precedents under the retaliation provision of the False Claims Act.