Putnam Community Medical Center of North Florida, which owned and operated Putnam Community Medical Center LLC in Palatka, Fla, has agreed to pay the United States $1 million to resolve allegations that it violated the False Claims Act by submitting claims to Medicare and TRICARE in connection with a now-closed sleep center that was alleged to have operated with inadequate physician supervision.
According to a settlement agreement, Putnam Community Medical Center provided diagnostic sleep testing services at its now-closed sleep center, which the United States and the State of Florida allege were not provided with adequate physician supervision as required under certain Medicare coverage determinations and regulations during the period from December 2013 through February 2019. Specifically, the sleep center allegedly failed to comply with two local coverage determinations: LCDs L29949 and L36839, which specify that raw data from sleep tests must be reviewed and the tests must be interpreted by either a Diplomate of the American Board of Sleep Medicine, a Diplomate in sleep medicine by a member board of the American Board of Medical Specialties, an active physician staff member of an AASM accredited sleep center or sleep laboratory, or an active physician staff member of a Joint Commission accredited sleep laboratory.
“Providers who participate in federal health care programs must follow the law governing the integrity of federally funded health care programs such as Medicare and Medicaid,” says Stephen Mahmood, acting special agent in charge of the US Department of Health and Human Services Office of Inspector General (HHS-OIG), in a release. “HHS-OIG is committed to protecting the integrity of the Medicare and Medicaid programs and the people it serves. We will continue to work with the United States Attorney’s Office and other law enforcement partners to address allegations brought under the False Claims Act.”
The settlement concludes a lawsuit originally filed in the United States District Court for the Middle District of Florida by relator Willard Revels, a former sleep center employee. Revels sued under the qui tam, or whistleblower, provisions of the False Claims Act permitting private citizens to sue on behalf of the United States for false claims and to share in the recovery.
The act also allows the United States to intervene and prosecute the action. The relator will receive $300,000 of the proceeds from the settlement with the defendants.
“Protecting Medicare and TRICARE patients is paramount,” says US attorney Roger Handberg in a release. “This civil settlement demonstrates our continuing commitment to hold accountable those who abuse the nation’s healthcare programs at the expense of the taxpayers.”
The settlement resulted from effort by the US Attorney’s Office for the Middle District of Florida, working with the HHS Office of Inspector General, and the Defense Criminal Investigative Service. Assistant United States attorney Kelley C Howard-Allen led the investigation.
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